Making the personal decision to continue working
For someone who has received an early-stage dementia diagnosis, the decision to continue working is deeply personal and depends on a variety of factors, including the type of work they do, their financial situation, and their support network. A person's identity and sense of self-worth are often tied to their career, so continuing to work can offer significant benefits to their physical and emotional well-being.
Experts recommend engaging in open conversations with trusted individuals, such as family, doctors, and legal professionals, to evaluate one's symptoms and job demands. This helps determine if adjustments can be made to support their continued employment or if an alternative plan, like retirement or disability, is a more appropriate and safe path forward.
Benefits of continued employment
- Enhanced cognitive function: A 2025 study suggests that volunteering and working longer can provide protective benefits for cognitive function, likely tied to the social engagement and physical activity involved.
- Increased self-esteem: Maintaining a productive and valued role in the workplace can foster independence and boost self-esteem, counteracting the stigma often associated with dementia.
- Improved quality of life: A fulfilling job nurtures social connections and provides a sense of purpose, contributing to a higher overall quality of life.
- Social interaction: Continuing to interact with colleagues helps maintain social skills and prevents the isolation that can accompany a dementia diagnosis.
Potential risks and challenges
- Safety concerns: Certain jobs, particularly those involving heavy machinery, complex decision-making, or high-stakes situations, may pose safety risks to the employee and others as the disease progresses.
- Workplace friction: Lack of awareness or accommodations from an employer can lead to decreased performance, resentment from co-workers, or workplace embarrassment.
- Increased stress: Attempting to hide cognitive difficulties can cause significant stress and anxiety, which can worsen symptoms and negatively affect health.
- Erosion of skills: Progressive cognitive decline can make it increasingly difficult to meet job demands, leading to frustration for both the employee and the employer.
Legal rights and workplace accommodations
For employees in the U.S., the Americans with Disabilities Act (ADA) offers legal protections against discrimination and mandates that employers with 15 or more employees provide "reasonable accommodations" for employees with disabilities, including dementia. The employee is typically responsible for disclosing their condition to request accommodations, though they do not have to use specific legal terminology.
Reasonable accommodations
- Modified schedule: Flexible hours or a reduced workload can help manage fatigue and stress.
- Simplified tasks: Adjusting job duties to focus on familiar or simpler tasks can help maintain productivity.
- Assistive technology and reminders: Providing calendars, checklists, voice recorders, or other memory aids can help compensate for memory deficits.
- Structured environment: Creating a quieter workspace with fewer distractions can improve concentration.
- Team support: A "buddy system" with a co-worker or a transition to a team-based approach can provide on-the-job support.
Employers must engage in an "interactive process" to determine effective accommodations, but they are not required to provide an accommodation that would cause "undue hardship" or eliminate essential job functions.
Comparison of working with vs. leaving employment with dementia
| Feature | Continuing to Work with Accommodations | Leaving Employment / Retirement |
|---|---|---|
| Sense of Purpose | Often maintained, continuing to contribute and feel valued. | May feel a sense of loss of identity and purpose initially. |
| Social Engagement | Continues regular interaction with colleagues and a professional network. | Can lead to social isolation without a deliberate effort to find new social outlets. |
| Financial Security | Continued income and health benefits reduce financial stress. | Potential financial strain if not planned, but disability benefits may apply. |
| Health and Well-being | Can provide cognitive stimulation and physical activity benefits. | Reduced work-related stress may improve overall health. |
| Mental Strain | Risk of increased anxiety and embarrassment if performance declines. | A dignified exit can protect self-esteem and reduce mental burden. |
| Safety | Requires careful assessment, especially for high-risk jobs, to ensure safety. | Eliminates work-related safety risks associated with cognitive decline. |
| Employer Responsibilities | Requires the employer to provide reasonable accommodations and navigate legal requirements. | Releases employer from accommodation obligations and performance management. |
Transitioning out of the workforce
Inevitably, dementia is a progressive condition, and there will likely come a time when continuing to work is no longer feasible or safe. A well-planned and dignified exit is crucial for protecting the individual's mental and emotional health. Strategies for a graceful transition include:
- Phased retirement: A gradual reduction in work hours can ease the transition and allow for a slower handoff of responsibilities.
- Knowledge transfer: Employees can take pride in mentoring a successor and documenting their processes, ensuring their expertise is not lost.
- Exploring disability benefits: Understanding Social Security and other disability options can provide financial security.
- Pursuing new passions: Focusing on hobbies, volunteering, or other engaging activities can help maintain a sense of purpose and social connection post-retirement.
Conclusion
While the progressive nature of dementia presents undeniable challenges to employment, the question of whether people with dementia should work does not have a single answer. In the early stages, with appropriate workplace accommodations, many individuals can and do continue to work safely and productively, enjoying the psychological, social, and financial benefits that employment provides. However, the decision must be continuously evaluated based on the individual's evolving capabilities, job demands, and safety considerations. Open communication with medical professionals, family, and employers, guided by an understanding of legal rights under the ADA, is essential for a thoughtful and empowered approach to working with dementia. Ultimately, a supportive environment that values individual dignity and provides timely assistance is key to ensuring a high quality of life, both during and after one's working years.
Optional outbound link
For more information on legal protections and guidance for employees with disabilities, visit the Job Accommodation Network website.
