How to Manage Fatigue in the Workplace

Transcription

1 Managing MS Fatigue in the Workplace Outline Fatigue management strategies Getting to work At work Creative rest breaks Equipment & gadgets Entitlements Where to go for follow up? 1

2 MS Fatigue - Recap Fatigue is one of the most common symptoms of MS, occurring in about 80% of people with MS. Fatigue can significantly interfere with a person's ability to work and function. It may be the most prominent symptom in a person who otherwise has minimal disease. MS Primary Fatigue Lassitude fatigue Neuromuscular fatigue Cognitive fatigue MS Secondary Fatigue E.g. Sleep disturbance, spasms, restless legs, continence, mood, temperature sensitivity, pain, medication side effects, cognitive fatigue In the Drivers Seat Are you self managing your MS from the drivers seat? 2

3 Making Some Changes General Fatigue Strategies Fatigue assessment Planning and prioritisation Rest breaks Exercise Diet Sleep Energy conservation & Work simplification Communicate Refer to General Management Strategies program 3

4 Getting to Work Getting ready for work - Plan tasks to maximise energy conservation Transport Parking Other - Public transport vs Driving - Community transport options - Taxis - Disability Parking Permit - City of Melbourne City Access Permit (or equivalent) - Allocated car park at work - Can you negotiate work hours to avoid peak times? - Can you work from home? At Work TASK How can you change the way you complete a work task to make it less fatiguing? ENVIRONMENT How can you change or adapt your work environment to make it less fatiguing? PERSON How can you change your personal practices for whole of life to maximise energy levels for your work day? 4

5 Creative Rest Breaks TAKING REGULAR BREAKS TO MANAGE MS FATIGUE CAN INCREASE YOUR WORK EFFICIENCY & PRODUCTIVITY What type of quality rest break works for you?? Quiet room Car Somewhere to lie down Headphones on at your desk Apps for relaxation, meditation or mindfulness Walk mindfully to the toilet Half fill your waterbottle so regular refill trips give cognitive breaks Set up pop up reminders in your calendar or phone to take breaks Lunch break walks Equipment and Gadgets Aim to increase task efficiency & energy conservation Can you modify the environment or your work practices? Can you use equipment to assist? Examples: Energy saving and lightweight equipment Dragon Naturally Speaking Software Smartpen Keyboard & mouse options Larger screen Light weight or supportive shoes/boots Heating or cooling clothing Automate doors to manage physical demands with access 5

6 Entitlements Work specific Reasonable adjustments by your employer Workplace policy s on flexible working arrangements Leave entitlements Job Access Employment Assistance Fund (EAF) Job Access Work Based Personal Assistance (WBPA) Employee Assistance Program (EAP) Superannuation Insurance Income Protection & TPD Personal Parking Permits, Mobility Allowance, Disability Support Pension, Medical Cooling Concession / Essential Medical Equipment Payment, Continence Aids Payment Scheme (CAPS) Summary THINK ABOUT WHAT CHANGES YOU CAN MAKE TO REDUCE IMPACT OF FATIGUE ON YOUR WORK Assess and monitor your specific fatigue levels and work demands Plan Prioritise Experiment with rest Think outside the box 6

7 Follow Up MS Employment Support Service (Melbourne, Geelong, Sydney) MS Education Sessions MS Fatigue General Overview MS Fatigue Management Strategies Managing Fatigue at Home Managing Fatigue When Out and About Working with MS Individual follow up for fatigue management with MS OT or local health services OT MS Connect

8 Managing Fatigue in the Workplace MS Australia Employment Support Service Fatigue is one of the most common symptoms of Multiple Sclerosis (MS), and can often be the most difficult symptom to live with. It is also one of the most common reasons why people with MS stop working (MSIF Survey on Employment and MS, 2010). Explaining fatigue to colleagues can also be difficult, as it is not a symptom that can be easily seen, and can be difficult for others to understand. This information sheet provides an overview of fatigue in MS, and some strategies that can assist people to manage fatigue in the workplace. How is fatigue in MS different to other types of fatigue? Ordinary fatigue is the tired feeling everyone experiences after an excessively busy day or a lack of sleep. It is the type of fatigue that is usually managed by rest and a good night s sleep. Ordinary fatigue is quite different to the fatigue experienced in MS. Fatigue associated with MS is a direct result of damage to the central nervous system. It usually occurs more rapidly, lasts longer and takes more time to recover from than ordinary fatigue. As with other symptoms of MS, the effects of fatigue vary from person to person, and levels of fatigue are often very unpredictable. Types of MS fatigue include: Neuromuscular fatigue is a failure of damaged nerves to conduct messages to muscles during repetitive or prolonged activity, and usually resolves with short rest. It occurs in specific muscle groups, like the hands after typing, or legs when walking or standing. Lassitude fatigue is described as an overwhelming sense of tiredness that can occur at any time of the day without warning. Lassitude fatigue can occur for no apparent reason or after relatively mild exertion, such as a short period of walking, writing or reading, and does not necessarily resolve after rest. Other factors that can contribute to fatigue are warm ambient temperatures (people with MS can often be sensitive to heat), stress, and sleep disturbance. These factors, in conjunction with MS-fatigue, can also cause a temporary worsening of other MS symptoms, such as muscle weakness, visual disturbances, and difficulties with concentrating. Strategies to manage fatigue at work: Balance activity with rest. If working in an active role, balance heavy tasks with regular rest breaks throughout the day and week. If working in a sedentary role, such as an office environment, take short breaks every mins to stretch your muscles and give your eyes a rest from the computer screen. Think about locations in your workplace where you can take a good physical and cognitive rest break. Rearrange your work environment. Move most frequently used items to within easy reaching distance. Use lightweight tools and equipment where possible. Plan your day. Keep organised, use electronic reminders, and prioritise your to do tasks. Consider performing tasks with a higher physical or cognitive demand at the time of day when you are least fatigued. Perform all printing/copying tasks at once to reduce the number of trips to the photocopier. Look at your travel. Think about the most time and energy efficient way of commuting to and from work to conserve your energy for the workday. Manage heat sensitivity. Even small increases in temperature can increase a person s fatigue. Plan to work outdoors in the cooler part of the day, consider wearing cooling attire, keep hydrated, use desk fans, and park undercover. You may also want to explore the possibility of moving your workstation to a cooler part of the building. Manage mobility issues. Explore the possibility of having a designated car park close to the work building, having a printer on the desk, or moving to a workstation closer to staff amenities. Use trolleys where possible to avoid the need to carry items, take the lift instead of stairs to conserve energy, and correspond with colleagues by phone or to reduce the frequency of trips required. Assess your hours. Your employer may be flexible with start and finish times so you may avoid working during most fatiguing times of the day. Starting earlier or later may also help you to avoid peak hour traffic times. If you work part-time, take your day off in the middle of the week to break up your week. You may also be able to negotiate working from home arrangements for part of the working week.

9 For example Creating an hourly reminder in Windows Task Scheduler 1. Click Start (the windows button in bottom left corner of screen), then in the search box type Task Scheduler. 2. In the list of programs that appears, click Task Scheduler and this program will open up. 3. Click on the Actions tab, then on Create Basic Task and the Create Basic Task Wizard will open up. 4. Type a Name and Description for the task then click Next (e.g. Name: Stand up, Description: A reminder for me to stand up and stretch every hour I am working at my computer) 5. Select Daily as when you want the task to Start and click Next 6. Today s date, current time, and recur every 1 day will appear. Change the time to when you normally start work e.g. 8am, then click Next 7. Select Display a Message as the action you want the task to perform and click Next 8. Write in Title and Message of the message you want to be displayed on your computer screen (e.g. Title: Stand up, Message: Stand up, stretch, move, walk around) and click Next 9. The summary page will appear with all details you have entered in. Tick the Open Properties dialogue box then click Finish 10. In the new box that pops up select the Triggers tab and click on New 11. Change Begin The Task to At log on so that the message will only appear when the individual is logged onto the computer. 12. Tick the Repeat task every box which has every 1 hours, and for a duration of 1 day written next to it. Then click OK 13. Click OK again to complete the task. 14. Double click on Task Scheduler Library on the left side of the screen and all active reminders/messages will appear. 15. Right click on the reminder/message you just set up and select Run. This will test the message and make it appear so you can check that it is working as you want.

10 To edit, disable or delete the task/reminder/message 1. Open the Task Scheduler. 2. In the Active Tasks area, double click the task you have created. A list of active tasks appears. 3. Right-click the task, then click the action that you want to perform: Run Allows you to run the task to ensure that it is working the way you want it (instead of waiting for the clock to run out). End This stops a task that is in progress. Won t need it for timed tasks like this one. Disable Prevents the task from running until you enable it. (If you rightclick a disabled task, this option changes to Enable. Export Allows you to save the task to a file, and then you can import it into another computer. Properties Opens a Properties dialog in which you can edit the task. Delete Permanently removes the task from the Scheduler.

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14 Living Better with MS Date: Daily Energy Tracker Print several copies of this tracker and fill out one at the end of each day. This can help you identify what may be causing or worsening fatigue. You may notice what adjustments you can make to your schedule and habits after a few weeks of completing the tracker. It may also be helpful to show your logs to your doctor, who may be able to identify patterns and recommend changes. LIKE A LOG Last Night I Slept ON AND OFF SLEEP WHAT S THAT? My Energy Level Today Place a mark on the scale My Stress Level Today READY FOR ANYTHING PRETTY GOOD WIPED OUT Place a mark on the scale I Had the Most Energy COOL COOL AS A AGITATED BOILING CUCUMBER OVER Place a mark on the scale My Activity Level Today IN DAWN THE MID IN THE DAY EVENING THE MORNING AFTERNOON EVENING Place a mark on the scale, or check a box LOW ALL DAY HIGH ALL DAY PERSONAL BEST! A FEW ERRANDS, BUT THAT S ABOUT IT JUST ME & THE COUCH MS Symptoms I Experienced Today: Place a mark on the scale I Was Most Active My Pain Level Today Circle one My Symptoms Were the Worst IN DAWN THE MID IN THE DAY EVENING THE MORNING AFTERNOON EVENING Place a mark on the scale What I Ate Today IN DAWN THE MID IN THE DAY EVENING THE MORNING AFTERNOON EVENING A HEALTHY DIET WHATEVER I COULD GRAB Place a mark on the scale Place a mark on the scale Non-MS Symptoms I Experienced Today: Changes I Will Try to Make Tomorrow: healthcommunities.com/remedymd-ms

15 Maximising Your Time Urgent Not Urgent 1 High Importance High Urgency 2 High Importance Low Urgency Important Crises Pressing Problems Deadline-driven projects, meetings, preparations Preparation Prevention Planning Building relationships 3 DO IT NOW High Urgency Low Importance 4 DECIDE WHEN Low Urgency Low Importance Not Important Interruptions, some telephone calls Some mails, reports, meetings Many popular activities Trivia, busy work Some telephone calls Time wasters Escape activities Irrelevant Mail Excessive chatting DELEGATE IT DUMP IT

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20 SLEEPING WELL Good sleep is very important. Sleeping well consists of practices that reinforce the body's natural tendency to sleep at night. 1. Maintain a regular bedtime and awakening time. Get out of bed at the regular time even if sleep was poor, as "sleeping in" can disturb sleep the following night. 2. Limit alcoholic beverages in the evening as this can disturb sleep. A heavy meal is also unadvisable prior to bedtime. 3. Avoid caffeinated beverages after noontime, as caffeine disturbs sleep. Limit total caffeine consumption to no more than two beverages per day. 4. Do not smoke just before bedtime or during the night as this disturbs sleep. 5. Exercise regularly during the day, but avoid exercise in the evening within 3 hours of bedtime. 6. Do not use the bed or bedroom for anything other than sleep and sexual activity. If the bedroom is used for non-sleep activities (such as watching TV), it may become a stimulus for alertness, rather than for sleep. 7. Establish a routine in preparation for sleep. Engaging in frustrating activities or excessive worry close to bedtime may result in arousal and prevent sleep. 8. Maintain a comfortable temperature in the bedroom. 9. Keep the bedroom dark and quiet. Try to screen out any disturbing noise or light. 10. Utilise meditation or relaxation techniques to assist in getting to sleep 11. Consult your GP or Neurologist if sleep is disturbed by snoring, restless legs or night spasms. The prevalence of Sleep Disorders is higher in the population of people with MS. 12. See your doctor if frequent night-time toileting interrupts your sleep. Try to avoid fluids an hour before bed time, and empty your bladder before bed..