Can job crafting help the terminally ill?

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25 Mar 2024

Stephen Bevan

Stephen Bevan, Principal Associate

Follow @StephenBevan

For people living and working with cancer their employers are legally obliged to make reasonable adjustments to their jobs. This is about accommodating their changing capacity to perform the physical and cognitive parts of their jobs so that they can stay in work for as long as possible. While most employers manage to do this well, some find the whole process a real chore and a source of considerable resentment or even conflict, especially between line managers and employees. 

In a survey of over 1200 working age, cancer survivors The Institute for Employment Studies (IES) and the social enterprise Working With Cancer found that many respondents were still living with physical or cognitive limitations at work which were likely to benefit from workplace adjustments of some kind. For example, 93% reported fatigue, 68% brain fog, 54% pain, 60% anxiety, 55% loss of confidence and 43% peripheral neuropathy. This led to the number working full time falling from 73% to 46% once they returned to work, even though the percentage who were the primary breadwinner in their household fell only marginally from 58% to 51%. In too many cases returning to work can also mean that cancer survivors struggle to get access to fulfilling or meaningful work. As one returner told us:

‘While working in effect part time (due to chemo), I’ve faced low expectations from managers and I’m not given challenging or meaningful work. Because I am not present or very visible at work these days, my manager has also taken credit for some of my contributions.’

At their most rudimentary, so-called ‘reasonable’ adjustments can sound like they are just part of the array of concessions which an employee has managed to extract from their employer. In reality, a good practice solution should involve imaginative approaches to job redesign where the employee has played an active part in reshaping the job to accommodate their changing, or fluctuating, abilities. Ideally, for employees with secondary, advanced, metastatic or even terminal cancer it should be possible for employers to offer adjustments which conform to the principles of job crafting - an approach to job redesign which is more explicitly led by the needs and aspirations of the employee.

There are several dimensions of ‘crafting’ which allow the demands of the job to be ‘ramped up’ or ‘ramped down’ depending on the needs of the employee to do a job which is more challenging or developmental, or which requires the intensity of the job to be reduced temporarily to accommodate a health need.

‘Task’ crafting, for example, may mean the employee gets to make changes to some of the tasks in their job by increasing the amount of challenge they face to enhance their motivation and learning. Conversely, they may temporarily shift to some less challenging tasks to decrease those job demands which might hinder performance or reduce their wellbeing.

‘Relational’ crafting might involve changing the social resources available to an employee by securing more support, feedback or coaching or by securing more autonomy, responsibility and challenge in the job to operate more independently.

‘Cognitive’ crafting can ensure that employees are supported to revisit the purpose and scope of their roles to gain a refreshed perspective on the wider contribution and impact the job makes. For example, junior or ancillary employees in healthcare might benefit from a clearer understanding of how their jobs contribute directly or indirectly to improving patient care. Doing this in a way which improves their sense of ‘agency’ and aligns them more to the meaning and purpose of their role can, for some employees, help them to feel more engaged and empowered.

Most recently I have been pursuing a personal interest in how job crafting can provide a lens through which we can look at ways to improve access to meaningful work among those of us with a terminal illness. In a project with the What Works Centre for Wellbeing and Marie Curie we were able to put together a practical guide for managers and HR professionals to help them support employees who have received a terminal diagnosis. It meant that, in my own professional life as a researcher I was able to ‘work around’ the fatigue and treatment linked to my own terminal diagnosis by ‘crafting’ my role differently.

For example, working on a project which involved conducting several detailed case studies, I agreed with my colleagues that my best contribution would involve designing the template for the case studies and writing up a section of the final report which drew out the main research findings and lessons rather than writing up each of the case studies themselves. This also offered me an opportunity to offer ‘coaching’ support to a more junior member of the team on how to write up a research case study.

I’ve found that having a terminal illness has meant that I don’t want to feel patronised by my colleagues as they worry that they might expose me to excessive pressure or onerous deadlines, for example. For my part, I’ve wanted to make sure that I’m still able to ‘add value’ to a project and to offer ‘know how’ to my colleagues as they design new studies and look for novel insights from their data. It’s here that I can play devil’s advocate or act as the ‘grit in the oyster’ as new project ideas are kicked around. I know that I’m never again going to be the primary player in any future research project as my health impedes my ability to contribute. I’m OK with this and it’s great to be even peripherally involved as I make the kind of phased exit from work over which I feel I have a dignified and consensual degree of control.

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Any views expressed are those of the author and not necessarily those of the Institute as a whole.