Page 488 - ILAE_Lectures_2015

Table 2 (Continued)

Assistance at work
When an employee has seizures for the first time, the employer should respond fairly by
giving the employee adequate opportunity to receive proper medical treatment before
making any decisions about job suitability:

 If seizures are likely to occur at work, the employer should help the employee with
epilepsy to disclose the epilepsy to work colleagues

 Some first-aid training or other information should be provided to those who might be
involved should a seizure occur

 If any special job restrictions are needed there should be clearly stated policies about
how they are to be implemented, reviewed, or lifted, in terms of set time periods

 If, despite proper medical attention, redeployment to another job is necessary,
appropriate counselling and vocational guidance and if necessary rehabilitation services
should be made available at an early stage

Educating employers
Negative attitudes regarding the employment of people with epilepsy is often the result of
ignorance. Much can be accomplished by educating employers. To this end the Employment
Commission of the International Bureau for Epilepsy has drawn up a set of principles aimed
at employers to improve awareness and hopefully employment practice. Attention is drawn
to four key areas: health care, job suitability, recruitment, and selection and assistance at
work. An adaptation of the Commission’s Principles are presented in Table 2.

Summary
Employment serves a number of important functions, including providing a sense of self-
worth, an identity and personal status. Being unemployed contributes to emotional and
behavioural problems and is considered as a major source of stress and a contributory factor
to increased psychopathology in people with epilepsy11. A number of studies have
highlighted that rates of employment are lower in people with epilepsy than those without,
however, more recent findings have suggested that rates will vary by clinical and
demographic characteristics. For example, people with well controlled epilepsy and those in
remission have employment rates similar to those of the general population without epilepsy6.
Smeets and colleagues12 have recently provided a conceptual overview of the employment
barriers experienced by people with epilepsy. The authors conclude that there is a need for
specific vocational rehabilitation that focuses on increasing self-efficacy and coping skills.
However they also recognise the need for longitudinal research to demonstrate that
employment opportunities can indeed be improved through specified vocational
rehabilitation interventions.

Jacoby, Gorry and Baker13 have recently argued that the need for continuing education of
employers of people with epilepsy is self-evident. However, according to the authors
‘education alone is not enough: the problem of bridging the gap between knowledge and
attitudes and behaviour also needs to be addressed though exposure of persons without
disabilities to those with them.’