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MANAGING Managing Through Cancer WORKBOOK

Created by Cosmetic Executive Women Foundation

INTRODUCTION

The Cancer and Careers program started with a very simple mission: to help women with cancer continue on the job. However, the more people we talked to, the more we realized that it wasn't just women with cancer who were looking for support. Managers were, too.

We created the Managing Through Cancer program––made possible by a generous donation from the Avon Foundation––to help managers offer support to their employees with cancer. This workbook is part of that program. It will provide you with clear direction: how to respond when an employee is diagnosed, create flexible work arrangements, keep lines of communication open, and maintain team morale.

A number of corporations are leading in this effort by example. Cancer and Careers created the Best Boss Award to spotlight those at the forefront of making work and cancer treatment possible. Honorees thus far include Andrea Jung of Avon and Susan Arnold of Procter & Gamble.

We hope that the Managing Through Cancer program will help others to follow their lead.

If you would like more information about coping with cancer in the workplace, please visit cancerandcareers.org, our online resource and community.

Sincerely,

Carlotta Jacobson President CEW Foundation

INTRODUCTION

A NOTE FROM AVON PRODUCTS, INC.

How can you best support an employee with cancer while still maintaining a fully productive workplace? This booklet will tell you, so you can provide tangible help when it's needed most.

Information, practical guidance, and hands-on tools for employers and managers at your fingertips, here and on the Cancer and Careers website, www.cancerandcareers.org.

TABLE OF CONTENTS

Introduction

1

The Manager's Role

4

What to Expect

6

Communication

10

Relevant Federal Laws

17

Respecting Privacy

20

Workplace Policy

22

Flexible Work Options

24

Leaves of Absence

28

Little Things Managers Can Do To Help

32

Working from Home

36

Charts & Checklists

40

Avon and the Avon Foundation are proud to support this important Managing Through Cancer Workbook, and we sincerely hope it will provide valuable information and guidance for working women facing cancer.

Whether one is at the first stage of diagnosis, or well into treatment, the challenge of managing the demands of a job while facing cancer can feel overwhelming. Resources for help are scarce, and we are pleased that both the cancerandcareers.org website and the workbook can fill this need.

Avon Products, Inc. is committed to being the company for women, and an important part of this commitment is the Avon Foundation. In 2005 the Avon Foundation celebrates its 50th anniversary serving the mission to improve the lives of women and their families, with a focus on the issues of domestic violence and breast cancer. From 1992 through 2004, the Avon Breast Cancer Crusade has raised more than $350 million in 50 countries for access to care and finding a cure for breast cancer. Projects such as the Managing Through Cancer Workbook bring our mission to life while bringing hope and help to women and their families.

For more information on the mission, programs and impact of the Avon Foundation, we invite you to visit www.avonfoundation.org.

If you or someone you love is facing cancer, we send our most sincere wishes for a successful journey through treatment and a return to health.

Sincerely, Kathleen Walas President, Avon Foundation Corporate Social Responsibility Officer, Avon Products, Inc.

THE MANAGER’S ROLE

The Manager stands at the intersection of company commitments and employee needs when a team member struggles with cancer. While employers and supervisors may have little preparation for facing the complex demands of managing through cancer, they can have considerable impact on the employee's experience. Among the many issues they face are: • • • • • •

Maintaining compensation in an equitable manner Adjusting work schedules over the course of treatment Setting and managing the expectations of co-workers Enabling effective flexible schedules Working out appropriate forms of communication Maintaining the morale of the person and the team

If the only thing expected of a manager was strict interpretation of policies, the extra workload would be taxing enough. But these policy and procedural matters are not always clearly defined or adequately communicated across the company. The role of the manager in supervising an individual and a work group through cancer is one of endless balancing: • • • • •

YOUR ROLE 3

Work and time off as treatment progresses Company procedures and employee need Too little or too much communication The employee's time off and the team's workload Maintaining one's commitment to all aspects of the manager's ongoing role

Done well, the work of effectively managing an employee through cancer can prove invaluable to the employee, inspiring to the team and beneficial for the company. And for the effective manager, managing through cancer can prove personally rewarding as well.

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WHAT TO EXPECT WHEN AN EMPLOYEE HAS CANCER One out of four U.S. workers over the course of their career will be diagnosed with cancer. For each individual, the process of diagnosis, treatment, and recovery will be unique: undergoing tests, waiting for results, scheduling appointments with specialists. Treatments and side effects vary, the length of time required for treatment and recuperation differ widely. If you––and your employee––understand the time frames for common diagnostic tests, treatments, and expected recovery times, you'll greatly enhance your ability to successfully manage this difficult period.

UNDERSTANDING CANCER The word cancer doesn't describe a single illness. Cancer is a spectrum of illnesses characterized by abnormal cell growth. Some cancers can be very fast moving and require immediate and intensive intervention. Others are more indolent, progressing more slowly.

Cancers are named according to the cell type and part of the body in which the tumor originates. Detailed information about the types, causes, and treatment of cancer is available at the American Cancer Society's website: www.cancer.org, and at the website of the National Cancer Institute: www.nci.nih.gov.

DIAGNOSTIC TIME FRAMES

THE FACTS 5

Worry may be a constant companion for your employee. It's normal.

Scheduling diagnostic procedures and waiting for results can cause a lot of anxiety. Tests range from a simple blood test to invasive procedures that may require time off from work. Some tests are designed to “stage” the cancer (i.e., determine the extent of its growth and whether it has spread). Staging results help the oncologist determine the most appropriate treatment approach.

TREATMENTS AND RECOVERY The goal of cancer treatment is to control and if possible eradicate the disease. To do this, doctors employ a variety of treatments, including surgery, chemotherapy, radiation treatment, and the use of newer vaccines as well as biologic and targeted therapies.

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SIDE EFFECTS Sometimes it gets worse before it gets better. Cancer treatments can produce more disability than the initial disease. Side effects such as nausea, fever, and fatigue are common.

Many strategies can help combat side effects. Medications and lifestyle changes are effective at alleviating symptoms but may not completely eradicate them.

Oncology nurses, who specialize in treating cancer patients and interact closely with them, can provide a wealth of information about what to expect from treatment and how to manage side effects.

WHAT TO EXPECT WHEN AN EMPLOYEE HAS CANCER SURGERY Surgery is often the first step. Its goal: to remove the tumor and any surrounding tissue that may be affected. For some cancers, chemotherapy or radiation treatments may be used to shrink the tumor prior to surgery.

Recovery from surgery typically ranges from one to four weeks.

CHEMOTHERAPY Chemotherapy treatments can be time-consuming, both during administration and in coping with side effects, early and delayed. For breast cancer, a typical course may last from four to eight months.

Depending on the recommended treatment, a patient may receive intravenous treatments once a week or every other week at a doctor's office or cancer center. Sometimes oral therapy is used which may require fewer office visits.

Fatigue and nausea are the most common side effects. Some treatments cause hair loss as well.

Recovering from subsequent rounds of chemotherapy may take a little longer each time. As the treatment goes on, the body may become less able to “bounce back� from the toxic regimen. Some people tolerate chemotherapy well and continue to work right through the treatment period. Others need time off or make adjustments in their work schedules to allow for adequate rest and recuperation.

RADIATION

THE FACTS

Radiation can be used alone or in combination with other therapies such as surgery and/or chemotherapy. Radiation treatments are typically given once a day for several weeks. Common side effects include mild to severe fatigue, poor appetite, and skin irritation at the radiation site. Radiation to the head and neck area or chest can cause difficulties with eating and swallowing.

Flexibility in work schedules and hours may enable employees with mild side effects to continue to work during a course of radiation.

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FIVE THINGS YOUR EMPLOYEE WANTS TO HEAR You and your employee are in a unique situation. Try to keep lines of communication open and reassert your position as a proactive and involved manager by using these neutral phrases.

1.

2.

3.

4.

5.

I'm so sorry you're going through this.

If you need to talk, I'm here for you.

We'll figure out what we need to do about your duties––together.

Tell me what we can do to make your workload more manageable.

Let's talk regularly to see how you're doing.

Reassure the employee that you will interact with HR and explore all appropriate benefits and options (health care insurance, long and short term disability, etc.,) to be in compliance with company policies and state and federal regulations.

COMMUNICATION

HOW TO RESPOND TO THE NEWS If your employee approaches you regarding her illness, it's natural to feel uncertain about how to best respond. Here are some general guidelines that should help make your conversations with your employee easier and more productive.

As an employer, you have the right to know about disabilities that will affect your employee's performance. But be aware that privacy rights vary greatly from state to state. Your HR or legal departments should be able to guide you on the limitations––if any––of state and federal privacy mandates. Even if you have a personal relationship with the employee, think twice about asking about specifics.

• Choose the right place. Don't try to catch a moment on the fly, in the office hallway or lunchroom. Find a private place where you can sit comfortably and talk without distraction or interruptions.

• Acknowledge her concerns. You don't have to agree or disagree with what she's telling you. Just encourage her to continue by nodding and letting her know you're listening.

• Respond thoroughly and clearly. When your employee asks questions, answer specifically and thoroughly, and then let her continue on with the conversation at her pace.

COMMUNICATE

• Reassure and reinforce. Don't interpret; just reiterate what is being said.

• Summarize. At the end of the conversation, review the key points or concerns your employee made to make sure both of you have a clear understanding of the situation.

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There are no “crib sheets” for discussing cancer with your employee. However, there are some general guidelines you can follow to make sure your words provide comfort, and are considerate and careful.

WORDS OF COMFORT:

WHAT TO SAY AND WHAT NOT TO SAY WHAT NOT TO SAY

WHAT TO SAY

Don't give advice. Just listen.

•HOW TO TALK ABOUT HER CANCER DIAGNOSIS: Steer clear of asking specific questions about your employee’s illness, treatment, and recovery, but do ask for clarification on information she’s given you. Make it clear you’re as concerned about her well-being.

Sample language: “I’m not sure I understand what that means. Can you explain it to me?”

“What will the treatment involve for you?”

•WHAT TO SAY WHEN YOU DON'T KNOW WHAT TO SAY: As a manager, you may not be used to feeling at a loss for words. Expressing your uncertainty doesn’t weaken your position as a manager; rather, it increases your “human-ness.”

Sample language: “I’m new to this experience, but I’ll work with you to figure out some solutions.”

“I’m feeling unsure how to approach this topic. Maybe you can help me out?”

•HOW TO EXPRESS YOUR CONCERN: EMPATHIZE, BUT AVOID PITY. Sample language: “It must be very scary for you.”

“This must be difficult to deal with.”

•HOW TO APPROACH WORK ISSUES: It's your job to find out how your employee’s illness will affect her job performance. Start by reiterating that you’re a team and encourage suggestions.

Sample language: “We want to keep your stress to a minimum.”

“Let’s take a look at what’s on your plate and how you think we should handle it.”

“What do you feel capable of handling right now?”

•KEEP COMMUNICATION OPEN. Strong communication is an ongoing process––as is treatment for cancer–– which means your employee’s feelings, energy, and attitude may change over time. If you see changes, address them directly.

Don't try to cheer her up. Although you may mean well, telling your employee to cheer up may make her feel that her feelings are being discounted. Avoid clichés, such as “Things could be worse” and “Time heals all.” It's natural to want to bring comfort by saying things like “Everything will get better” or “Things will work out” ––but you don't know if that's true.

Don't discount her feelings. If she says she's scared, worried, or anxious, don't tell her not to be.

Don't share stories. Everyone knows someone who's had cancer, but sharing such information shifts focus away from her and threatens to devalue what she has to say. In addition, stories may not provide accurate or helpful information.

Don't worry about silent moments. If she is quiet then sit quietly with her. When in doubt, say nothing, and let your employee take the lead.

Sample language: “How do you feel about the plans we made? Are our arrangements still working for you?”

“I know this is a very difficult time. You don't seem like yourself. Let's talk about how I can help you.”

COMFORT 12

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FURTHER ACTION RECORD KEEPING Managers should gather the following information: • Contact information for your employee's doctor and primary caretaker • A written note from her doctor confirming that she will be undergoing treatment • A schedule of treatments, if possible • Emergency contact information • Accurate records of when your employee takes time off or leaves early (to prove your compliance with the ADA and FMLA, should the issue ever arise) • Check with your HR department about other information your company may require

KEEPING COMMUNICATIONS OPEN Your employee will need to be kept “in the loop.” If her treatment and recovery schedule make it possible, she should attend regularly scheduled meetings and training, either live or via conference call. It might help if she can find a “point person” who can fill her in on what is happening in the office when she's not there. You may want to pay particular attention to giving positive feedback regularly to make your employee feel more a part of the organization.

COMMUNICATION TECHNIQUES INCLUDE:

KEEPING TRACK 13

• • • • • • • • • •

Meeting face to face E-mail Telephone Fax Pager Written notes Shared calendar Posted schedule Conference calls Voicemail

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RELEVANT FEDERAL LAWS A GENERAL OVERVIEW OF RELEVANT FEDERAL LEGISLATION

1. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA) Although HIPAA provides detailed guidelines regarding privacy and maintenance of healthrelated information, the Act applies only to “covered entities,� namely: healthcare providers, healthcare clearing houses, health insurance plans, and any entity that acts as one or more of these. Therefore, a typical Fortune 500 company, such as General Motors or IBM, will not be covered by HIPAA. Nevertheless, companies can follow the example set by HIPAA to ensure that all medical records are locked and access is limited to Human Resources, the employee, and his or her supervisor.

For additional information: http://www.hhs.gov/ocr/hipaa/

2. AMERICANS WITH DISABILITIES ACT (ADA) The ADA requires employers to make reason-

able accommodations for applicants or employees with disabilities. A reasonable accommodation means any modification or adjustment to a job or the work environment

that will enable a qualified applicant or employee with a disability to participate in the application process or to perform essential job functions. A disabled employee is one who is substantially limited in performing a major life activity when using a mitigating measure. (See page 16 for more on Reasonable Accommodations).

Current cancer patients are disabled people under the ADA; people who have recovered from cancer are similarly protected by the ADA if they are perceived as disabled due to their history of cancer. Under the ADA, an employer can establish attendance and leave policies that are uniformly applied to all employees regardless of disability, but may not refuse leave requested by a disabled employee if other employees get such leave. Reasonable accommodations for employees with cancer include time off for treatment, breaks from work, job sharing, telecommuting, and similar measures.

For additional information: http://www.usdoj.gov/crt/ada/adahom1.htm

3. FAMILY MEDICAL LEAVE ACT (FMLA)

LEGISLATION 15

FMLA-eligible employees are entitled to a total of 12 weeks unpaid leave during any 12month period for any of the following reasons: birth of a child, placement of an adoptive or foster child, care for an immediate family member with a serious health condition, or inability to work due to a serious health condition.

An FMLA-eligible employee is one who has been employed for at least 12 months, has worked at least 1,250 hours during the 12 months immediately preceding the leave, and is employed at a work site where 50 or more employees are employed by the employer within 75 miles of that work site. All employers with 50 or more employees are covered by the Act. An employee who returns from FMLA leave is entitled to be restored to the same or an equivalent job (defined as one with equivalent pay, benefits, responsibilities, etc.). The employee is not entitled to accrue benefits during periods of unpaid FMLA leave, but the employer must return her to employment with the same benefits at the same levels as existed when leave began. For additional information: http://www.dol.gov/esa/whd/fmla/

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RELEVANT FEDERAL LAWS A GENERAL OVERVIEW OF RELEVANT FEDERAL LEGISLATION

REASONABLE ACCOMMODATION The key to both the ADA and the FMLA is the rather ambiguous term “reasonable accommodation.” The following is the legal definition of the phrase from the U.S. Department of Justice: A reasonable accommodation is any modification or adjustment to a job or the work environment that will enable a qualified applicant or employee with a disability to participate in the application process or to perform essential job functions. Reasonable accommodation also includes adjustments to assure that a qualified individual with a disability has rights and privileges in employment equal to those of employees without disabilities.

As the employer, it's up to you to determine what the “essential job functions” are for each position in your company. Here's where it pays off to have solid and thorough job descriptions that set forth exactly what is required of each employee.

Using these “essential functions” as your guide, you must consider what accommodations will be required in order for your employee to perform her job properly. For help, consult the Equal Employment Opportunity Commission's Guide to Reasonable Accommodations and Undue Hardship Under the Americans with Disabilities Act. This 50-page document examines in detail just what constitutes reasonable accommodation and gives examples of different types of accommodation, such as job restructuring, leave, modified or part-time scheduling, modified workplace policies, and reassignments.

LEGISLATION

It may also help to rule out accommodations that are not considered reasonable under the ADA. Accommodations are not reasonable if they: • Pose a threat to the safety and/or health of the employee's co-workers, managers, etc.

• Require your company to substantially change the way it conducts basic, everyday business functions • Put you or your company under an excessive financial or administrative burden––referred to in Department of Labor lingo as “undue hardship”.

For specific advice, call the ADA Regional Disability and Business Technical Assistance Center Hotline at 1-800-949-4232.

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RESPECTING PRIVACY PRIVACY FUNDAMENTALS: THE BASICS A MANAGER NEEDS TO KNOW When you find out a worker has cancer, one of your first concerns must be the worker's privacy. Federal law requires it, and your employee deserves it.

Protection for cancer patients who choose to disclose their condition is provided by federal laws such as the Americans with Disabilities Act (ADA). As an employer, you must be aware of the ADA provisions, which stipulate, among other things, that you may ask only job-related medical questions ensuring that a cancer patient's privacy is maintained.

In addition, a person's medical privacy rights have been strengthened since the Health Insurance Portability and Accountability Act of 1996 (HIPAA) became fully effective in 2003. These new rules govern the distribution of personal health information and impose penalties on doctors, hospitals, health plans, and pharmacies for breaching that privacy.

DISCOVERING AND RESPECTING YOUR WORKER'S PRIVACY WISHES • Once armed with legal information, you can gently find out how much privacy your worker wants.

• Preferences among workers with cancer vary dramatically. The desire for privacy can be pervasive or nonexistent. Some may not tell anyone of their diagnosis; others may wear it as a badge of honor.

PRIVACY 19

• Most workers will probably fall somewhere between these two extremes.

Don't try to guess which way your employee will react. The worker who is outgoing and typically tells you all the personal details of her life may turn out to be the cancer patient who clams up and doesn't want anyone to know specifics.

• Guarding privacy when you first hear the news of your worker's cancer is a wise first step. It speaks volumes about your respect for the worker and can pave the way for a successful outcome.

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WORKPLACE POLICY SUPPORTIVE TIME-OFF POLICIES: PAID TIME OFF (PTO) AND LEAVE SHARING Employees with cancer might need time off for treatment, surgery, and recuperation. Your organization might already have supportive time-off policies on its books, or might be willing to consider developing them. Two that are very useful for those with cancer are Paid Time Off (PTO) Programs, and Leave Banks and Pools. Here are brief descriptions of these programs.

PAID TIME OFF (PTO) PROGRAMS A PTO plan usually combines all of an employee's paid time off (sick leave, vacation, and personal leave) into one block of time, or bank, to be used as the employee needs it for whatever purpose the employee wants. For example, if an employee originally received 5 sick, 10 vacation, and 5 personal days per year, under a PTO plan she might receive a bank of 20 days per year to use as she determines.

One value for the employee is that she doesn't have to give a “reason” for taking off the days; she just manages her time-off account. She can use the time for treatment and recovery or for an opportunity to rest. PTO programs allow employees to decide how much time to take for their various needs.

For employers, PTO programs result in fewer unscheduled absences and enhance employee morale. They also reduce friction between managers and employees and can lower overall costs.

LEAVE BANKS AND POOLS

POLICY 21

Leave banks and pools can help employees with cancer who exhaust their paid leave, yet need additional time off to deal with their illness and cannot afford to take it as unpaid leave. In both banks and pools, employees donate some of their accumulated paid leave to be used by employees who need it. Some programs allow the donation of vacation days but not sick leave, while others allow just the opposite. Other programs allow the donation of any kind of paid leave.

The main difference between banks and pools is that the former is an ongoing program where employees “deposit” days off every year to the “bank,” while pools are set up specifically for donations to a particular person, with donations made as needed. Having leave banks and/or pools can enable the whole organization to help retain a valuable employee and participate in a colleague's recovery. It can help the employer establish a caring, supportive environment that enhances employee morale.

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FLEXIBLE WORK OPTIONS FREQUENTLY ASKED QUESTIONS ABOUT EMPLOYEES WITH CANCER WORKING FLEXTIME Q. Does an employee working ad hoc flextime have to work the same schedule each day and each week?

A. Ideally, the employee will be afforded the maximum amount of flexibility necessary to accommodate her diagnosis, treatment, and recovery schedule. At the same time, you'll want to make sure that her work gets done. If you are able to arrange coverage on an ad hoc basis, scheduled around her needs, the employee won't have to work the same schedule each day and each week. If the co-worker providing the coverage needs a more consistent schedule, complete flexibility may not be possible.

Q. Can an employee working ad hoc flextime work more than 8 hours in a day or 40 hours in a week?

A. You'll want to pay attention to relevant state and federal labor laws. If an employee is exempt from these laws (an “exempt” employee), she can vary the length of her workday and workweek without any difficulty if it meets the needs of the business. If she is a “non-exempt” employee, she may be able to work over 8 hours in a day but not 40 hours in a week without there being overtime implications. Consult with Human Resources about this.

Q. Won't an employee on ad hoc flextime inevitably be working unsupervised and therefore unproductively?

A. Clear performance measures are the cornerstone of any successful flexible work arrangement. Most managers cannot watch their employees work all the time. Flexible hours foster an environment of “managing for results” and of self-sufficient and selfmanaging employees.

FLEXIBLE HOURS At some stages in an employee's treatment and recovery, she might want to work full time but need additional flexibility. Flextime allows an employee with cancer to continue working full time while varying the start and end times of her workday and/or taking time out during the workday to make appointments and making the time up by working either earlier or later in the day. The amount of flexibility might be modest––an occasional change of schedule on the day of an appointment––or it might be a temporary change to her regular schedule for a number of weeks. An employee whose job isn't suited to flextime might temporarily want to switch to some kind of work that would allow her to flex her hours.

FLEXIBILITY 23

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FLEXIBLE WORK OPTIONS PART-TIME WORK ARRANGEMENTS At different times in the employee's treatment and recovery process, she may want to work fewer or more hours. You and the employee will want to talk about her needs and discuss workload and schedules. The Work Schedule Planning Tool at the back of this book will help you keep track of the days and times she plans to be in your organization's office and any regularly scheduled treatment or medical appointments. It will be up to you to assess the staffing needs and workflow of your work group. Questions the two of you might discuss: • What work will she be doing on a part-time schedule?

• How will the rest of the job be accomplished?

• Will it be: - Delegated to other employees?

- Outsourced in some way?

- Postponed or not done at all?

SAMPLE FLEXIBLE WORK ARRANGEMENTS • An employee going through chemotherapy and feeling fatigued might combine ad hoc part time and telecommuting, working one day a week at home and two in the office on non-chemo weeks and two days a week at home and none in the office on chemo weeks.

• An employee with cancer might want to take a leave right after surgery and work part-time, perhaps three days a week, during chemotherapy and radiation.

FLEXIBILITY 25

• An employee who is the caregiver of someone with cancer might choose to take days off around that person's treatment schedule.

• An employee whose job isn't suited to to a part-time schedule might temporarily want to switch to some kind of work that would allow her to reduce her hours without there being too much of a negative effect on the work that needs to be done.

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LEAVES OF ABSENCE

At some point, your employee may need to take some extended time off. Here are some points for you and your employee to consider:

LOOK AT THE WORKLOAD • Consider the workload. Go over with your employee which projects she is responsible for, their current status and deadlines, and which she can feasibly complete before she leaves.

• Reassign and delegate. You might consider assigning one project or client per co-worker, or you may feel more comfortable having just one person cover for your employee.

• Explain your system for keeping track of information, including telephone numbers and e-mail, to your point person.

• Figure out what you'll do about the mail. Perhaps your point person can forward what she thinks you might want to see, file the non-urgent mail for later, and give the urgent stuff to a co-worker.

NAME A POINT PERSON No matter how you divide the workload, there are bound to be questions. A “point person” can help manage interactions between the office and your employee once she's on medical leave. Instead of getting a zillion phone calls, your employee can decide when and how often she gets called with updates and questions.

• Pick the point person wisely. It doesn't have to be someone who does the same exact job; just make sure it's someone that you and your employee trust.

• Let co-workers and clients know who the point person is and how best to contact him or her.

• Have your employee review the details of each project or each client with you and/or the point person before they leave, so everyone knows what to expect.

TIME OFF 27

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HELPING YOUR EMPLOYEE RETURN TO WORK AFTER A LEAVE OF ABSENCE Even if an employee's absence for medical treatment has been brief, returning to work can be an adjustment for her and her co-workers. Some workers will be gung-ho to get back to their routine, while others will likely be apprehensive, nervous about facing co-workers, and unsure if they're up to the tasks.

To make it less of an ordeal, communicate with the worker before the scheduled return date. Discuss the needed accommodations both with the worker and Human Resources and, if necessary, other workers who might be affected.

Among the questions to address: • What do we need to do ahead of time to make it a smooth return?

• If the worker needs to rest during the day, can we accommodate that? The time to order a cot or lounger is before the return–to–work date, of course.

• If the worker needs other accommodations, what do we need to do to make them happen?

Most organizations have had experience with people phasing back into work after having children or taking disability leave. Check with Human Resources to see what arrangements have been made in the past. It's even possible that your organization has a formal “return to work” program.

WHEN AN EMPLOYEE NEEDS TO PHASE BACK INTO WORK SLOWLY

RETURNING 29

Ideally, you can let your employee set the pace at which she returns to work. Your employee may give you a set schedule for her return, but due to the nature of cancer, it may change. She may have a setback; she may be more fatigued than expected. It is important to be flexible during this time and have a lot of backup support in place.

Here are some possible plans for phasing back into work slowly: • Right after a medical leave an employee might want to phase back in gradually, perhaps starting by working three shorter days a week: one day at home and two in the office.

• When the employee feels ready to increase the amount of time she is working, she might choose to increase the number of days a week or the number of hours she works each day.

• Having the ability to mix ad hoc part time, flextime, and work-at-home can help an employee return to full productivity more easily.

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LITTLE THINGS MANAGERS CAN DO TO HELP Simple kindnesses that don’t require much effort or funds––if any––are often the best remembered. A few things that may help show your support: • Tell your worker she can use your private office for phone calls to her doctor.

• Find a private room with a cot, sofa, or recliner––or create one.

• Keep the worker feeling “in the loop.” Keep your worker updated on what’s happening at the office during any absences.

• Respect your worker's wishes about their cancer. Some employees will come back eager to share their war story and triumph over the disease.

Others may be close-lipped and just want to get on with a normal work life.

• Communicate the worker's wishes to the rest of the staff. If you have a worker who doesn't want to be asked about her medical status, be sure that co-workers and other employees know this.

• Provide an outlet when she needs to talk. If she’s not comfortable talking to you, her manager, be prepared to hook her up with someone in HR. • Help your employee stay visible. Help her attend as many meetings, trainings, and other functions as possible. When this isn’t possible, encourage her to stay visible through frequent phone and e-mail contact.

HELPING 31

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IMPACT ON OTHER EMPLOYEES When an employee has cancer, there may be effects on other employees as well. Typically, if an employee reduces her schedule from full-time to parttime, some tasks and responsibilities will be assigned to others in the department or work team. Deadlines may be be revised; work schedules altered. If the employee with cancer wishes to keep her diagnosis confidential, the situation may be further complicated.

Managers can encourage team support in several ways: • If resources are available, hiring an additional part-time worker or a temporary employee could ease the situation.

• If resources are not available, you might have to look at another way to encourage cooperation, like team-building training. This will be especially important if the employee has not told her co-workers her situation and you are granting a reasonable accommodation as required by the ADA. • Present your employee’s abbreviated schedule as an opportunity for coworkers to step in and learn new skills. A part-time approach can create opportunities for cross-training and employee development, which may be valued by co-workers.

• Social workers from cancer support organizations like CancerCare can also be brought in to facilitate changes and address co-workers’ concerns.

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WORKING FROM HOME If an employee is going to be working from home all or part of the time during her cancer treatment and recovery, here are some issues for the two of you to discuss before she starts her work-at-home arrangement.

• Work-at-home schedule: What hours and days will the employee be working at home?

• Office space: Will the employee keep her office space onsight or will she relocate her office to her home, at least temporarily, and use shared space at your organization's offices?

• Equipment: What telecommuting equipment will this employee need and who will provide it, the employee or the organization? Keep a list of any organizationprovided equipment and software to be used during the work-at-home arrangement and their ID numbers.

• Telephone/Connectivity: Will the organization reimburse the employee for all business-related use of her home telephone line? If so, how will reimbursement requests be submitted? Will she need a mobile phone or other portable communication device?

• Office Supplies: How are you going to handle office supplies? Most organizations provide their employees with general office supplies when they work at home and reimburse employees if they need to purchase additional supplies, assuming their manager approves the expense.

WORKPLACE 35

• Workers' Compensation/Liability: Workers Compensation Insurance will cover an employee working at home but not a family member or visitor. If your employee does get injured working at home, decide whom she should call and how quickly.

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WORK SCHEDULE PLANNING TOOL Here is a tool that you and your employee with cancer can use to keep track of the days and times she plans to be in your organization's office, in her home office, at scheduled treatments and at medical appointments. It can also be used to record decisions you make about how and when you'll be in touch with one another when she's working at home and how and when others who need to communicate with her can do so.

EMPLOYEE WORKLOAD FEEDBACK TEMPLATE While an employee is going through treatment and recovery, it may be difficult to assess whether or not she can handle her responsibilites. Here is a template that can act as a “progress report� to help you gauge her workload. A first step is for you and your employee to agree on the key tasks that need to be accomplished and put them in writing along with their due dates. Then the two of you can schedule periodic feedback sessions to talk about progress toward goals.

She can fill out this workload feedback template before you meet.

SCHEDULED ITEM

DAYS/DATES/TIMES

Regular office days

________________________ ________________________

KEY TASK

Home office days

________________________ ________________________

__________________________________________________________

Scheduled treatment days

________________________ ________________________

Date __________________________________________

DATE DUE

PROGRESS/COMMENTS

__________________________________________________________ __________________________________________________________ __________________________________________________________ Scheduled medical appointments

_________________________ ________________________

__________________________________________________________ __________________________________________________________ __________________________________________________________

Regularly scheduled times and methodsfor check-in with one another

________________________ ________________________

__________________________________________________________ __________________________________________________________ __________________________________________________________

Best way and times for others to contact employee

________________________ ________________________

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EMERGENCY MEDICAL CONTACT INFORMATION

EMERGENCY CONTACT INFORMATION Date Submitted ______________

Name of employee:____________________________________________ Name of manager: ____________________________________________ Person you want contacted first in an emergency: Name: ______________________________________________________ Relationship to you:____________________________________________ Home Phone: _________________________________________________ Business Phone: ______________________________________________ Cell Phone: ___________________________________________________

Person you want contacted second in an emergency: Name: ______________________________________________________ Relationship to you: __________________________________________ Home Phone: ________________________________________________ Business Phone: ______________________________________________ Cell Phone: ___________________________________________________ Notes: ______________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ 39

PHYSICIANS Primary Physician Name: ____________________________________________________________________ Address: __________________________________________________________________ Phone: _____________________________ Additional Phone: _____________________ When to contact:___________________________________________________________ __________________________________________________________________________ Specialist Physician Name: ____________________________________________________________________ Specialty: _________________________________________________________________ Address: __________________________________________________________________ Phone:_____________________________ Additional Phone: ______________________ When to contact: __________________________________________________________ Specialist Physician Name: ____________________________________________________________________ Specialty: _________________________________________________________________ Address: __________________________________________________________________ Phone: _____________________________ Additional Phone: _____________________ When to contact: __________________________________________________________ OTHER INFORMATION: Please provide any other information that you want communicated to medical personnel in meeting your needs in an emergency. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 40

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