As the country began shutting down to focus on beating back the coronavirus at the height of the pandemic in March 2020, people with chronic health conditions fell to the back of the health-care line.
“While all Canadians probably faced — to some extent — a negative impact due to some of the public health restrictions in place, the impact was likely exacerbated for those with a chronic health condition,” says Julie Gaudry, head of group insurance at RBC Insurance Inc. “As we think about returning employees to the workplace [after disability leave], it may not be in the same situation as they were when they left.”
Pandemic-fueled delays to care
In the wake of government closures, accessing health-care services, such as screenings, became challenging.
“With chronic disease, there’s a lot of management and treatment, but there’s also a lot of screening involved,” says Diana Sherifali, an associate professor at McMaster University’s School of Nursing. “If you have diabetes, there’s routine screening of feet, eyes, kidneys, liver and blood pressure. Those touchpoints of opportunities to screen and keep people healthy dissipated. I suspect we’re going to see the tail end coming out of this with a lot of people coming forward with complications . . . that just weren’t screened and treated right away.”
People with chronic conditions are also typically accessing some form of specialized care at milestone checkpoints throughout the year. During the pandemic, access and availability to this care was limited, says Sherifali. “The nature of chronic disease is, it takes a village — whether it’s getting self-management support from a nurse, getting dietary advice from a dietitian, getting advice from a kinesiologist or talking to a psychotherapist.”
Some clinics closed completely, she notes, with patients going several months without routine check-ins. But once health-care professionals started to get a handle on the crisis, they were able to return their focus to other chronic conditions. As well, access to care pivoted to the virtual space, which isn’t standardized, says Sherifali, noting this puts the onus of care management squarely in the hands of patients.
Added to these stressors, most at-risk people for coronavirus complications are those with chronic diseases. “Coming out of this, I would guess that some people will have some degree of distress and anxiety because they know their underlying chronic conditions are putting them at greater risk.”
Facilitating a safe, healthy return to work
Many employers and group benefits providers are now asking what they can do to make it easier for employees with chronic conditions to access care and handle the current climate while preparing for the return to work, says Gaudry.
Employers recognize the pandemic will present new challenges to the return-to-work process, she adds. “Employees [returning] may have exacerbated health conditions that may need either accommodations or help getting access to care.”
Even prior to March 2020, mental-health support was top of mind for employers, says Gaudry, but amid the pandemic and the shift to remote working, in addition to the fear of getting ill and financial uncertainty, it’s doubly important.
For many years, data has shown mental health and diabetes travel together — in fact, mental health often appears alongside any chronic condition, says Sherifali. “If people have the burden of daily decision-making, daily behaviour modification, it takes a toll and, if their coping mechanisms are suddenly strained due to COVID, that obviously takes a greater toll on them.”
It’s critical for employers to have appropriate coverage for mental-health care through a group benefits plan or other additional services, says Gaudry, adding it’s also important employees are aware of the types of support available to them in their benefits plans and have easy access to the services.
Communication is key
For employers facilitating the return to work for employees on leave due to a chronic health condition, communication and collaboration are imperative for a successful re-entry to the workplace.
“Supporting employees with chronic conditions in returning to work hasn’t changed,” says Lyne Moussa, workplace and well-being manager at Coast Capital Savings. “It’s with absolute care and collaboration. It’s with inclusion of their and their manager’s perspectives, the medical information provided in confidence through the carrier if they’re on a disability leave, for example, or as much of the info the employee would like to share with us so that we can better support them and know what we need to do to understand the barriers and limitations.”
However, Moussa notes this is likely more complex as many employers are now supporting employees’ return in the remote working space. “Communication is essential and we always preface our communication with the fact we’re taking guidance from health authorities. This whole situation is unprecedented and we’re all learning together.
“There’s always more than just the diagnosis. It’s a matter of understanding the true needs and our capacity to support those needs. If it’s not within our capacity, then where do we go and how do we support that transition?”
Many employees don’t know what benefits are available until they need them, adds Moussa. “We’re continually communicating the various offerings in the hopes that, at some point, it will click with people for when they need to use them.”
It’s also vital to provide support to company leaders to help them understand their role in accommodations and how that support impacts and influences employees’ return to work, she says.
At Coast Capital Savings, leaders are always ready to start the process to ensure that the less time employees are off, the greater chance they return to work successfully, says Moussa, and that begins with making sure they know they’re still connected to the workplace while on leave.
“It’s never too soon to start planning a return to work for employees with chronic conditions. The sooner we get started, the sooner the communication is there, the more we know what the onset is and the more we can better plan and provide support.”
Lauren Bailey is an associate editor at Benefits Canada.