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# JAN’S ACCOMMODATION FACT SHEET SERIES

**Job Accommodations for People**

**with Cognitive Impairment**

Cognitive impairment, as used in this publication, refers to disturbances in brain functions, such as memory loss, problems with orientation, distractibility, perception problems, and difficulty thinking logically.  Cognitive impairment is a syndrome, not a diagnosis.  Many conditions can cause cognitive impairment, including multiple sclerosis, depression, alcoholism, Alzheimer disease, Parkinson disease, traumatic brain injury, chronic fatigue syndrome, and stroke. The following is a quick overview of some of the job accommodations that might be useful for people with cognitive impairment. For a more in depth discussion, access JAN's publications at http://askjan.org/media/atoz.htm.  To discuss an accommodation situation with a consultant, contact JAN directly.

**Maintaining Concentration:**

· Reduce distractions in the work area

· Provide space enclosures or a private office

· Allow for use of white noise or environmental sound machines

· Allow the employee to play soothing music using a cassette player and headset

· Increase natural lighting or provide full spectrum lighting

· Reduce clutter in the employee’s work environment

· Plan for uninterrupted work time

· Divide large assignments into smaller tasks and steps

· Restructure job to include only essential functions 

**Staying Organized and Meeting Deadlines:**

· Make daily TO-DO lists and check items off as they are completed

· Use several calendars to mark meetings and deadlines

· Remind employee of important deadlines via memos or e-mail or weekly supervision

· Use a watch or pager with timer capability and electronic organizers 

· Divide large assignments into smaller tasks and steps

· Assign a mentor to assist employee determining goals and provide daily guidance

· Schedule weekly meetings with supervisor, manager or mentor to determine if goals are being met

# Handling Memory Deficits:

· Allow the employee to tape record meetings

· Provide type written minutes of each meeting

· Use notebooks, calendars, or sticky notes to record information for easy retrieval

· Provide written as well as verbal instructions

· Allow additional training time

· Provide written checklists

· Provide environmental cues to assist in memory for locations of items, such as labels, color coding, or bulletin boards

· Post instructions over all frequently used equipment

**Handling Problem Solving Deficits:**

· Provide picture diagrams of problem solving techniques, i.e., flow charts

· Restructure the job to include only essential functions

· Assign a supervisor, manager or mentor to be available when the employee has questions 

**Working Effectively with Supervisors:**

· Provide positive praise and reinforcement

· Provide written job instructions 

· Write clear expectations of responsibilities and the consequences of not meeting them

· Allow for open communication to managers and supervisors

· Establish written long term and short term goals 

· Develop strategies to deal with problems before they arise

· Provide written work agreements

· Develop a procedure to evaluate the effectiveness of the accommodation

**Handling Stress and Emotions:**

· Provide praise and positive reinforcement

· Refer to counseling and employee assistance programs

· Allow telephone calls during work hours to doctors and others for needed support 

· Provide sensitivity training to coworkers

· Allow the employee to take a break to use stress management techniques to deal with frustration

**Handling Change:**

· Recognize that a change in the office environment or of supervisors may be difficult 

· Maintain open channels of communication between the employee and the new and old supervisor to ensure an effective transition 

· Provide weekly or monthly meetings with the employee to discuss workplace issues and productions levels 

**Maintaining Stamina During the Workday:**

· Allow flexible scheduling / Allow part-time work schedules

· Allow longer or more frequent work breaks

· Provide additional time to learn new responsibilities 

· Provide self-paced workload

· Provide backup coverage for when the employee needs to take breaks

· Allow for time off for counseling 

· Allow for use of supportive employment and job coaches 

· Allow employee to work from home during part of the day 

· Provide for job sharing opportunities 

Updated 3/23/10.

This document was developed by the Job Accommodation Network, funded by a contract agreement from the U.S. Department of Labor, Office of Disability Employment Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the position or policy of the U.S. Department of Labor. Nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Department of Labor.

Fact Sheet Series

Job Accommodations for People with Cognitive Impairment