Lupus: Vocational aspects and the best rehabilitation practices

Abstract

BACKGROUND: Lupus (systemic lupus erythematosus; SLE) is a chronic autoimmune disorder, and is usually diagnosed initially in early to middle adulthood, which is the prime career-building phase of individual's life. Persons with lupus report considerable financial burden not only because of healthcare costs but also because of compromised ability to engage in paid work due to illness as lupus can have a significantly negative impact on a person's work participation, including loss of employment and reduced working hours. Rehabilitation counselors must be knowledgeable about the critical physical and psychosocial impacts of the illness and potential employment problems that the illness may cause. With this knowledge base, rehabilitation counselors can better assist individuals with lupus with obtaining and maintaining employment, economic independence, and balancing their life demands with their changing health care needs. OBJECTIVE: This paper first provides an overview of lupus and functional limitations that it may impose, followed by relevant vocational rehabilitation interventions, including workplace accommodations and education. CONCLUSIONS: We emphasize consumer advocacy, anticipatory coping and illness management, accommodations on the job, and need of active involvement of employers in problem solving as key elements of successful vocational rehabilitation for people with lupus.

‘When I asked for help and support it was not there’: current NHS employment practice and its impact on people with systemic lupus erythematosus

“…This could be included in position statements of academic lupus organizations and charities [ 30 ], and the medical faculties of vocational rehabilitation and occupational health need to highlight, for example, counter-productive employment practices, such as the Bradford factor and the ill-health retirement regulations [ 19 , 25 ]. High-quality research is needed to test early employment support [ 20 , 27 , 31 , 32 ] that will overcome the current barriers that people with SLE and other FICCS face in trying to live as healthy, productive and normal lives as possible, which will benefit not only themselves but also the NHS and wider society.…”