Rheumatoid Arthritis
Work and rheumatoid arthritis
Although some people prefer to stay at home, most people work, not only for money, but because working gives a sense of achievement, a structure to the day, social contact and social status. But people with arthritis may have particular problems which affect their working lives.
Some people told us that arthritis had ruined their careers. Many thought that employers didn't always understand that the symptoms of arthritis fluctuate; that one day they might be feeling well but the next day too ill to cope with work.
Some people's working conditions were very difficult. One man who needed to work on building sites said using ladders made his RA worse and he tried to avoid them. One woman had to walk up three flights of stairs to work because there wasn't a lift.
Some people had decided not to work, or had changed career because of their arthritis. Others had given up work, retired early or had changed jobs. For example, a housewife had been disappointed that she had not been able to work as an artist. A young woman had planned to be a teacher, but then decided to take a less stressful job. Another woman decided to give up her part-time job at a school, because getting ready to go out became too much effort.
She would have liked to have been an artist but didn't have the physical strength to make it her...
She would have liked to have been an artist but didn't have the physical strength to make it her...
Pearl's employers provided her with what she needed to work around her RA but she decided to take...
Pearl's employers provided her with what she needed to work around her RA but she decided to take...
Some people described their frustration when they found they couldn't do their jobs properly. One woman had had to retire from her job as a laboratory assistant because she couldn't use the machines.
She felt depressed and had to retire early because she couldn't cope with the work.
She felt depressed and had to retire early because she couldn't cope with the work.
I did, I used to hide a lot of it but I couldn't, I couldn't use the machines and I just was getting frustrated with myself as well. It just, you know, I, in the end my doctor kept saying to me 'You'll have to finish work, you've just got to'. 'Cos I used to get depressed and upset about it because I, I couldn't. I, I really could not do my job.
And what was your job?
Oh, but, in, in the beginning I worked in the development kitchen in the lab, in Nestles, in the laboratory. It was quality control, you know. And then that closed down and then I was downstairs in the office only with my manager, just bits and pieces, nothing, they have got names for it but nothing exciting.
So did you retire early, I mean, did you '
Yeah, yeah, I took early retirement, yeah. Yeah. Well it was a case of having to. You know, I had to then, yeah. I realised then I had to 'cos I couldn't do my job, not to 100%. No, I used to bring work home and that and because I couldn't do it in the time it should have been done and it was paperwork that just had to be done. You know and it was just, I just couldn't cope with it.
So is it, towards the end it was office work?
Yeah.
' that you were doing?
Yeah, hmm. I just couldn't cope with it.
Work can be physically very demanding, and one man had to give up his job as a chef. As a result he felt shocked and depressed and had a nervous breakdown. A recently diagnosed woman who trained and worked as a horticulturalist was advised by her doctor to change her line of work because tasks such as digging and lifting heavy pots were aggravating her condition.
Janet was diagnosed in late 2006 and her illness has affected the type of work she can do....
Janet was diagnosed in late 2006 and her illness has affected the type of work she can do....
Originally I trained to be a horticulturist at college, I went to college for two years and I got. Top results. And I thought I was going to go into that line of work, but, of course, the rheumatoid arthritis affects that line of work. So I've not been able to use that so, I've hit quite a depression after training for two years, to do something, and working really hard for something, not to be able to carry on with it, I hit quite a depression. And occasionally, I still hit depressions, because I know I'm not capable of doing what I used to do. When I wake up in the mornings I'm still aching.
My back aches, my joints ache. It takes me a good hour in the mornings to get going, so I have to, I always make sure I get up an hour earlier to everybody else to actually get going in the morning still, which means the, the drugs aren't controlling anything at the moment. And that can run you down quite a bit.
I've been working part time for the last two years on and off jobs. One job in horticulture in the summer but it got too heavy, and I was advised by the hospital to stop doing it. And the other one is for a shop.
And again, I went back full time this year and I just couldn't cope with it at all. I ended up having to give it up so I'm having to come to terms with the fact that I can't do what I've always been able to do.
And I'm having to come to the terms with the fact that I may have to retrain in something new and something different. So not brilliantly [laughs], I'm still not brilliantly coping at the moment. Two years on, I've sort of come to terms with the fact I've got rheumatoid arthritis but not really come to the terms with the fact of what I can and can't do.
I still need to find my little niche and what, what I can do with my life. I don't want to give up work, I don't want to sit at home, I've done that and, it, you end up, your depression gets worse. You ache more, you're not doing anything, you're not seeing anybody and you get more and more on a downward spiral.
Yeah. So is there any jobs within that field that you might think that.
Well not really. Everything is manual. I mean, the job I've been doing part time, it starts off with just seed sowing and planting or whatever, and that's quite rhythmical and it's quite, actually, good exercise for your hands.
But it's when it gets on to the heavier work of planting on, planting into bigger pots or planting into the ground, that it starts to become more tiresome for your back, for your knees, for your legs, for your, your arms, for your wrists.
So, you know, I can do a little bit in horticulture but there's nobody that wants you for just a little bit, you know [laughs]. It's a range of work that you have to do, and, you know, although I enjoy it and it's nice to do it in my own garden, I've had to come to terms with the fact that I can't spend as long in there myself.
Other people too hated the idea of not working and felt guilty that they were claiming state benefits (see 'Financial implications and financial support'). Some people considered work a priority; they sacrificed their leisure time to keep working by using it to recover from work, e.g. in the evenings and at weekends.
Many other people had reduced their working hours because of illness. Some had found jobs with flexible hours or chosen self-employment. One woman gave up her full time job as a human resources director and worked freelance, so that she could control when she worked and how much she worked from day to day.
A 58 year old man found it hard to cope with his job as a carpet fitter as it was heavy work, but was determined to carry on. He was self-employed so he managed by working one day and resting the next, thus giving his inflamed joints time to recover. A cleaner also said she struggled and was a lot slower but felt it kept her sane.
Some people had had better experiences. Companies and organisations can often adapt the working environment or hours worked to make it easier for people to continue. Occupational health departments had often helped people. One woman talked about the 'Access to Work' initiative, which provides advice and practical support to disabled people and their employers to help overcome work related obstacles resulting from a disability. She said she had obtained voice activated software for her computer, an ergonomic keyboard, and a special telephone headset. This scheme also provides financial support for additional work related transport costs.
A bank manager said that after his ankle operation his company had given him a motorised scooter to help him get around while at work. He thought companies could re-claim money for such items against tax.
His company got him a motorised scooter to help him get around the workplace more easily.
His company got him a motorised scooter to help him get around the workplace more easily.
The first seven weeks one of the girls on my shift had got an, an old wheelchair at home, that I think it belongs to [name] Hospital and had never been returned and it was her grannies, so she brought that in for me, so I was going around in that for about seven weeks and they did nothing, and then all of a sudden out of the blue, they came up to me and said you know we should get you one of these motorised scooters like Ozzie Osbourne was going around on when he broke his foot, and I said 'oh great' you know, and it arrived the following week.
I don't think there was anything altruistic in it at all, because I looked up again on the internet and found that employers, you can actually claim that as a taxable thing against, against your company so it didn't actually cost them anything and I think they just got a bit, they didn't like the image of this guy in this battered old wheelchair roaming around their brand new data centre, which is state of the art you know, so I don't think there was anything caring or sharing about the fact that got it, it was just that I was a bit of an inconvenience and I looked better on this other thing, so that's how I got it I think. But I didn't ask for it no.
Some people we interviewed indicated that their families have helped a great deal both by providing the practical and emotional support they need to manage their everyday working routine. Just before her diagnosis (2007) a young teacher applied for another job in a school in her home town and says that it was the best choice she could have made because she now lives at home and has the support of her family.
After her diagnosis her employers and family have each helped her in different ways to manage her...
After her diagnosis her employers and family have each helped her in different ways to manage her...
Well I started a new job, I had the interview for my job and I got the job so I was going to, I was in London and I decided to move home to [city]' which turned out to be a complete blessing because I don't think I could have lived away and I've had this. So I am, moved home. I got the job, started feeling ill and I started the job but I didn't say anything to them I, well I said obviously I was in a lot of pain but I wasn't really sure what had happened. But they've been really good. In my old job they, they were brilliant and said any time you need off or anything else, but I didn't, I hate taking days off work so I got myself in there whether I was half paralysed or not. But they, they were really good. And my new job's been really good. They've said if you need time this, that or the other. But it's, some days again, just if my back, because I have to stand up all day and walk around, if my back's gone I find it really hard. Or particularly now, I'm just so tired it gets to, it's so hard to get up in the morning. And then I get home and I just can't do anything. And that's why I'm so grateful that I'm living back at home because I just don't think I could, you know, cook and clean and wash and do everything you need to do in a house that I've done for the past few years. The way I feel at the minute, you know, although I'm so much better I don't, I'm still not 100%, I still couldn't do that.
So in terms of work it's been difficult, really difficult, particularly starting a new job, because obviously you need, I've had a lot of work to do and you kind of want to prove yourself and be the person you were when you were interviewed for the job. And you do, you just get up, you get on with it but it just doesn't, it doesn't help with the tiredness and everything else 'and with the pain and things like that, that you do have some days. But they're really good. And the kids are really good. If I've ever got my curaheat hand things on, they don't say anything. You know, I try and cover them but they don't, you know, they're really good. And they don't know why.
You haven't told them?
I've told my 6th Form because they were kind of asking questions and they would, you know, didn't bother. But, no, the rest of them, just said, I though, I had sore hands. Because, yeah, they don't, there's no reason for them to know, so, no, I wouldn't.
Emma works in the same hospital but in a less demanding ward. Previously, she worked in the A&E...
Emma works in the same hospital but in a less demanding ward. Previously, she worked in the A&E...
Most companies understood that people had to take time off for regular GP, physiotherapy and hospital appointments and for in-patient treatment. However some people felt taking time off as annual leave rather than sick leave helped them keep their jobs. A retired physiotherapist said that although she had had two or three months off work after each operation, the NHS had been supportive and had kept her job open for her each time. Sandra was in hospital for treatments and she was off work for several weeks. Her employers have been supportive but while they accepted for her to work part-time they did not accommodate her wishes of working afternoons instead of mornings.
Sandra's employers have been supportive and agreed for her to return to work part-time but she...
Sandra's employers have been supportive and agreed for her to return to work part-time but she...
Have you had any problems at work because of your rheumatoid?
Yes I have. They’ve been very good in one way in that they always let me have time, to take time off to go for appointments. I did, every so often, have to take time off sick just to completely recuperate at home and, you know, have a week off. I had, when it reached a real peak, I ended up in hospital for a week and during that time, that was the end of last year, I was off work for about six to eight weeks I think. My plan was just to take two weeks off and just try and completely relax and recover but in fact I got worse and worse and ended up in hospital. So since going back after my spell in hospital, I’ve been on part-time hours but it was very much hours that suited them, rather than suited me. They wanted me in for the mornings which actually for myself is the worse time. Mornings are getting better but to begin with my stiffness would last easily till 11 o’clock in the morning and I was expected to be at work at eight o’clock.
Linda has responded so well to anti-TNF therapy and talks about the difficulties she experienced...
Linda has responded so well to anti-TNF therapy and talks about the difficulties she experienced...
People are often unsure whether or not to tell future employers about their arthritis at interviews for a new job for fear of prejudice. Some people were sure that they had suffered discrimination when applying for jobs. One man had worked for the same company for many years so they understood his limitations but he didn't tell his next employers at the interview and they seemed unpleasantly surprised when they found out. One young woman says that if you are disabled and meet the minimum criteria for the post potential employers have to give you an interview. She advices other young people with RA to include in the application form that you are disabled especially if you really want the job.
She believed she faced discrimination when applying for jobs.
She believed she faced discrimination when applying for jobs.
Yeah. When applying for jobs. You know, people have a preconceived perception that someone that sort of would put rheumatoid arthritis on an application must be severely disabled or severely handicapped. I mean, I've put on applications 'Have had rheumatoid arthritis X number of years. Time off in last year from work zero days.' And have not had a response.
We actually, we, I was a bit cheeky, I actually did this quite a long time ago, was testing the water out and we randomly sent out CVs changing the addresses and that and putting my, my skills through on an application and putting a friend's skills through that didn't have as many qualifications, or didn't match to the criteria as closely as I did but had no physical problems, had two weeks off their previous job with a chest infection. I'd put down rheumatoid arthritis, had no previous time off. They get offered an interview, I didn't. And it was just, you know, it was something that I wanted to prove for myself that despite what people are saying there is still a lot of discrimination.
At his job interview he didn't tell them about his arthritis, but usually he found it easier to...
At his job interview he didn't tell them about his arthritis, but usually he found it easier to...
I suppose I was spoilt by the fact that everything else happened with one company, they actually see, see it develop in me and really sort of took it for granted and knew what was going on, where perhaps somebody else didn't, which is why I tended to become more open and will, would discuss it with people rather than perhaps let them wonder why I'm struggling to do something that they can't understand that I can't sort of you know, carry out quite easily. I've sort of found it easier to, sort of cope with things that way by sort of being honest and you know saying, rather than try to put it behind me and just sort of try to soldier on.
One woman, however, thought she had got her job because of her illness. She pointed out that some companies employ people with arthritis because they have to employ a certain quota of disabled people. She also said that certain organisations had helped her to find work.
She thinks that her disability made it easier to get some jobs.
She thinks that her disability made it easier to get some jobs.
And you know, since you have been made redundant have you been for a few interviews or ..?
No this was my, this was my first interview. What's happened was, because I can only work limited hours, I found it very difficult to find work that would allow me to do them limited hours, because a lot of them want twenty hours or full time, so there's been very few jobs I, I could apply for.
What I did was again, through speaking to other disabled people a friend of mine told me about an organisation that specialises in finding work for people with disabilities and will send you, instead of you scouring through all the papers, they will regularly send you jobs listed and they sent me, they sent me various jobs, loads of them, that I just poured through, I didn't have the energy to go through the papers.
I did do that as well and I did do my own research, go to the job centre, go to staffing agencies and this particular company sent me a job and although I did see it later advertised somewhere else, and through them I saw this job, applied for it and apparently if you have a disability you get a fifty pound grant towards if you get a new job, which you don't get if you are able bodied, do you know what I mean, so I thought, ooh, so I actually found, I got accepted for the job yesterday. I'm a little bit nervous obviously about going to a new job, after twelve years, but I'll see how I get on. I suppose nearer the time I'm going to start get anxious. So I have found another job.
Some people felt that discrimination occurred in the work place affecting their annual gradings and chances of promotion. Sometimes they experienced bullying by co-workers which included comments about their ability to do the job and time off for treatments. Educating colleagues and employers about RA sometimes helped. Several people who had given up work had found fulfilment by studying part time at colleges, night classes and through the Open University.
He is sure there is discrimination in his place of work.
He is sure there is discrimination in his place of work.
So that was the level of interest that I got from work, and it's quite a large corporation indeed. The last couple of years they've gone, become a bit more sympathetic because I think they've come to terms with the Disability Discrimination Act and certainly I do feel that I've been discriminated against because of my disability. I can't play in the same ball park as the rest of my peers, and I feel that he should make some allowance for that when doing my end of year review.
Having said that, it's done and dusted and I'll just put it behind me and see what happens this year. I certainly have kept all of the e-mails and notes and things like this which I felt were discriminatory and they're all filed away with the Union that I belong to if ever they do try and decide to dismiss me because, because of this situation. They certainly couldn't dismiss me because of the rheumatoid arthritis, but they might say that I'm no longer capable of doing the job and there is an option to retire early on ill health, I'm fifty four at the moment and the retirement age is sixty where I work.
She went to her local college but found the teacher unsupportive and felt the teacher...
She went to her local college but found the teacher unsupportive and felt the teacher...
OK.
When I did my GCSEs.
Did you go to college or'?
I did go to college. I went to college in the September. They accepted me into local college. I went to do an administration course. Because I like to be on the computer and I like to type. I like to do things like that. And I thought you know an administration course is good. The only trouble was I had a teacher or tutor that wasn't very understanding. She wasn't very nice. She didn't like me because I was in a wheelchair, because she said I was a fire hazard. She actually said, 'You're a bit of a fire hazard in your wheelchair.'
She wouldn't let me join in onto some of the practical coursework because she said if I worked in an office, I wouldn't be able to bend over and pick up the paper on the floor. I wouldn't be able to pick a box. And I said, 'Well in this day and age if you've got a disability and they hire in an office, you do the practical thing and ask somebody to help to you with lifting things, or they don't give you things to lift.' She wasn't very nice at all. So I did report her because she was' I mean it was kind of like, they had facilities for disabled people because they had a group of us. So they'd give me ' I was on the fourth floor. They gave me a radio walkie talkie so if the fire bells went or anything I'd have to radio through what floor I was on. And then I'd have to sit in the stairway in the wheelchair in the fire exit thing which is in the stairway. And once they left me up there. 'She's all right, we'll just leave her.' They did have lifts and stuff but I did, I did report the teacher I had for being not very nice. And she actually said to me, 'Oh well you've done a lot of coursework, but I won't put you for the final exam because I don't think you're going to be able to work in an office.' So I left college. And I'm, I won't go back to that college because she soured me. She did. I'm like no I'm not going back to college, because she was horrible.
Who did you report her to?
The actual, I wrote a letter to the college. The bosses and I think' I wrote a letter in my own words. My mum didn't even know I was doing it. And I used one word, discrimination, and they all went, 'Oh no, she used the word, discrimination.' And they had, they had a meeting, literally two days after they received the letter. And I explained to them what had happened. And she was in the meeting and she tried to play off, 'Oh no, I didn't do any of that.' But I had witnesses. So she basically got told off for it.
And you went in there on your own without your mum on your own'?
My mum and dad came with me to the meeting. But they, I wrote the letter. And then I came down because my computer was upstairs at the time, and I said, 'I wrote this letter because I'm not happy with the teacher and stuff.' My mum said, 'Well if you want to do, if you want to send that, then send it.' Because she wasn't happy with the way they were doing things. But I was at the age where my mum couldn't go in and complain. I had to be the one to do it because I was, my mum was only, she only knew what I told her and what she'd heard. So I was the one that was kind of' I had to do it everything like from reporting and stuff because it was me who experiencing it. But you use that one word and they don't like it. And obviously yeah she got into trouble. But I won't go back to college. I did want to do an online course.
Several people we interviewed made the point that public organisations like the NHS, schools, local councils and universities made good employers. One young woman who works as a part-time nurse explained that during her second pregnancy the hospital accommodated her health needs and allowed her to work fewer hours. Another young woman who works at a university said that she has never encountered any problems when taking time off to go to hospital appointments and thinks that things are different in the private sector. A school teacher recently diagnosed (2007) indicated that her school allowed her to start late on the days she didn't have any lessons first thing.
Her previous school allowed her to arrive late on those days when she had free periods in the...
Her previous school allowed her to arrive late on those days when she had free periods in the...
OK. And the new employer also?
Yeah. Well I've had, I haven't had, apart from tiredness and sometimes my back and my shoulders will hurt, it's nothing like I was, nothing like I was. So they're aware of it. And they've said, 'If there's anything we can do, then just let us know.' But I haven't had to' have any time off. But it just means some days I'll leave earlier or won't be as able to get as much work done in a day as I'd like. But other days, I'll be great. So that's absolutely fine. So I haven't had to have' since it's been fine.
Last reviewed August 2016.
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