Cognitive issues at work

Changes in the world around us affect workplace health. One example of this is a shift towards an ageing population. People are living…and working longer. Many governments, including the UK government are increasing the retirement age to address economic pressures. Chronic conditions, including mental and physical illness are on the rise. All of this means organisations need to prepare for and respond to cognitive health issues arising in their workforce. 

What sort of health conditions impact cognition?

Cognition is a term describing mental processes - such as thinking, learning, memory and perception- that take place in the brain. Cognition can be affected by a number of health issues, and not all of these relate to aging. This means cognitive issues can arise in anyone at any time of their life. Examples include dementia -  a term describing loss of cognitive function to the extent that day to day activities are affected. Dementia is an umbrella term, as there are various types of dementia, such as vascular dementia and Alzheimer’s disease. Other health issues that can impact cognition include depression and hypothyroidism, but there are many more. 

Why is cognition relevant at work?

When people are at work, they use their cognitive skills all the time. Whether planning, managing, communicating or decision making, the exact nature of the tasks will vary from role to role. Often, the cognitive skills people use at work are more advanced than in their day to day lives. This means issues with cognitive function can be apparent in the workplace before people at home notice anything has changed. 

What might you notice about an individual experiencing cognitive issues affecting their work? 

Part of the challenge is that cognitive changes can be subtle and gradual. Things you may notice include:

• Decreased performance or productivity

• Difficulty with memory, attention, or problem-solving

• Increased errors

• Reduced ability to meet deadlines

• Changes in behavior or communication style.

These example indicators are quite non-specific. They illustrate that it can be difficult to identify cognitive changes as the cause of changes in someone’s behaviour and performance at work, versus another cause. 

What can you do if you are worried about an employee?

Raising concerns about an employee’s workplace performance is challenging, particularly in the context of potential ill health. It helps to be able to signpost the individual to confidential occupational health support. This allows them to discuss what they are going through with a clinician, away from the workplace. While occupational health clinicians cannot formally diagnose or treat causes of cognitive impairment, they can use information about the individual’s symptoms to discuss what may be going on and inform them of where they can get help. It is then up to the employee how much they communicate back to their workplace.

Occupational health clinicians may suggest workplace adjustments that could be helpful to share with an individual's employer. In rare cases, where someone with possible cognitive impairment is doing a safety critical role and performance has been affected, occupational health may assess that they are not fit for that role or certain aspects of it. 

What can employers do in the absence of occupational health? 

Communication is important, though it is definitely more challenging to do this without occupational health support. Engaging the employee around any concerns and encouraging them to seek medical support is the first step. In circumstances where there are concerns that changes in their performance are affecting competencies in safety critical tasks, it is important to review their suitability for those tasks. Where long term ill health or disability is suspected as a cause of change in performance, employers have a legal duty to offer reasonable adjustments under the Equality Act 2010. All of this is much harder to navigate without occupational health input as most employers do not have clinical expertise, in addition to the challenge of offering support while respecting an individual’s confidentiality. 

What sort of adaptations are suitable where employees have cognitive impairment?

Reasonable adjustments help optimise the work environment for an individual living with long term ill health or disability. This helps organisations to improve productivity while retaining talent and maintaining a diverse workforce. The nature of adjustments really depends on the role and what the individual is experiencing. For example, where interruptions and noise further impede focus on task, it can help to provide a quieter workspace and to review the job plan to allow uninterrupted periods of work on particular tasks. Some individuals find software useful to support tasks, for example, diary management. Extra supervision can also be useful and also helps as a forum to keep dialogue open around changing needs. 

Final thoughts 

Cognitive challenges in the workforce are a growing concern as health trends shift and the workforce ages. By fostering a supportive environment, organisations can respond to these issues proactively. Occupational health services play a pivotal role in managing cognitive issues in the workplace, from assessments to advice while helping to ensure compliance with legal and ethical standards.