A life-limiting illness is one which cannot be cured, though it can be treated, and which will shorten a person’s life. A terminal illness is one that is incurable however the effects of the illness can be managed so that a person can live with it for days, weeks, months or even years.
There are a wide range of life-limiting and terminal illnesses including heart failure, lung disease, Duchenne Muscular Dystrophy and cancer that are no longer responding to treatment.
Before you can even start planning for how your colleague and their work may be affected by a terminal illness, you need to have a conversation with them about it.
This is likely to be a challenge for both of you. Few people are comfortable about raising the topic of death and dying. Your colleague is likely to feel sad and may be frightened about their future.
It is not an easy situation but it is better to talk about it than to say nothing. Your colleague may welcome the chance to talk, so even if you were expecting a practical discussion about managing work and leave, it is best to be prepared.
Hospice UK’s Dying Matters website has a series of guides to help with these conversations. Find links to these in the useful resources section.
Each condition is different and each individual will deal with their situation in their own way. It is up to them how much they want to share with you as their line manager, though a good working relationship will make this easier.
The more they feel able to share with you, the better you will be able to support them and the better you will be able to manage issues such as workload and maintaining your team’s contribution to your organisation.
Your colleague will become the expert in their own condition and how it affects them. If you want to find out more, to help you ask the right questions and look out for any particular needs, websites such as NHS.UK provide trustworthy information.
Hospice UK has a wide range of information focusing especially on hospices and palliative care. There are also well established and respected charities for many conditions.
One conversation is unlikely to be enough. Conditions can develop unpredictably and someone with a new life-limiting or terminal illness may not know quite what to expect. They may be over-optimistic about how their work will be affected, so be prepared to revise plans over time in light of what actually happens.
People are likely to want to carry on working for as long as possible, with benefits to themselves and to the organisation, but the time will come when they need to stop. Human resources (HR) will be able to advise on the financial aspects of giving up work.
When you are discussing flexible working options and scheduling work with your colleague, you may be able to plan ahead around courses of treatment so that sick leave can be built in. However, it is sensible to expect the unexpected.
As they progress, life-limiting conditions can become disabling. The Equality Act 2010 sets out employers’ duties towards disabled staff. Some conditions are automatically treated as a disability, including:
- Cancer – including skin growths that need removing before they become cancerous
- Multiple Sclerosis
- An HIV infection – even if the person doesn’t have any symptoms.
If an employee is disabled by their condition, they are entitled to reasonable adjustments to help them in the workplace. These can be changes to policies, working practices or physical layouts, or providing extra equipment or support.
An employer only has to make reasonable adjustments if they know or could reasonably be expected to know someone is disabled and that they are disadvantaged because of it.
The first step is to discuss with your colleague what they need. It is a good idea that you document the conversation in writing. You could ask your colleague to write to you so that you have something concrete to work through with your HR team.
“I don’t put the end of life stuff to the back of my mind – in fact it’s at the front of my mind. It makes me make the most of life.”
There is no limit on the kind of changes employers can make, but they could include:
- Changing hours of work – permanently or for a short while if someone is going back to work after being off sick
- Changing someone’s work duties – like reducing their workload if they have work-related stress
- Allowing someone with back pain more breaks to allow them to stand and move away from their desk.
If your organisation has an occupational health service, they will be able to help with reasonable adjustments in the workplace.
It can be stressful dealing with a life-limiting or terminal illness. Carrying on working can help someone’s mental health but it can also bring its own stresses.
As a line manager, you will want to be as supportive as possible, helping your colleague to manage their work as well as their condition. If you notice signs of stress, you can discuss with your colleague how well they are coping and see if you can find ways to make things easier.
For example, if travelling to work has become difficult it might be possible for them to do some work from home.
If your employer is signed up to an Employee Assistance Programme (EAP), staff will have free access to a 24-hour confidential helpline, offering information and advice.
Depending on which provider your organisation works with, they may be able to ask for face-to-face counselling sessions. They can also provide help to you as line manager if you need it; helping others through their stress can be difficult for you too.
Long-term sick leave
If someone is off sick for more than four weeks, this counts as long-term sick. They may still be able to return to work, maybe by working flexibly or part-time or doing different or less stressful work.
As their line manager, you will want to keep in touch with your colleague while they are away to see when and if they will be able to return.
A life-limiting or terminal illness may eventually mean that someone has to give up work. Your HR team will be able to advise on any schemes your organisation offers, such as income protection, ill health retirement or whether an employee can take their pension early.
To be able to best support your colleagues, check with your HR team what policies are in place and what benefits are available from your employer for someone with a life-limiting or terminal illness.