MEANINGFUL Employment Is Not Impossible For People With Epilepsy

Having a condition such as epilepsy does not make a person any less employable.

Employment is one of the important pieces of the puzzle that completes adulthood.

Clinically, the ultimate goal of a person with epilepsy is to achieve seizure freedom. However, 40% of those with epilepsy continue to have seizures despite optimal treatment.

Historically, people with epilepsy were commonly perceived to have greater challenges in obtaining or sustaining a job.

Does this mean that people with uncontrolled seizures could not work in this day and age?

A study in Malaysia (Lim et al, 2013) revealed that as much as 50% of people with epilepsy who had full-time employment were having at least one seizure a year.

A multinational study by Baker et al. (1997) revealed that a large percentage of people with epilepsy were able to retain successful careers in the open labour market.

The adjusted employment rate of people with uncontrolled seizures, excluding students, housewives and those with learning disability, were as high as 82% in Europe, 76% in Africa and 73% in Asia, with only slight differences (6-16%) from people with well-controlled seizures.

In comparison with age-matched normal population, the employment rate of people with epilepsy was only 22-24% less.

We are currently studying the factors affecting employability in Malaysia by interviewing 21 people with uncontrolled seizure.

The participants viewed that having adequate training, cognitive and physical function, ability to continue working after a seizure, to travel to work and to cope with stress are important elements in successful employment.

Besides challenges related to seizure, people with epilepsy need to face similar challenges in employment as those without epilepsy. However, this also indicates that employment is possible if people with epilepsy learn to equip themselves with these abilities.

Most studies have focused on the negative factors affecting employability in people with epilepsy, such as stigmatization, low self-esteem, high seizure frequency, high injury risk and so on.

Instead of repeatedly focusing on the reasons for employment failure, it might be more meaningful to study the positive factors leading to successful careers in people with epilepsy, particularly those who’re still having seizures.

In our study, positive factors were more commonly found among participants who were full-time employed at the time of interview compared to those were unemployed.

When they are asked, “Why work is important for you?”, those employed tended to reply for a “future goal” and “self-satisfaction”.

This indicates that self-determined motivation is an important factor affecting employability among people with uncontrolled seizures.

This is supported by a study by Tremblay (2009), based on a self-determination theory by Deci & Ryan (1980), which showed that those with self-determined motivation had higher job satisfaction and organisational commitment.

In fact, during our interviews, the participants were more concerned about the attitudes of their closely related persons such as family members, employers and the colleagues, rather than the public. Support given by these people was a great motivator for some of them to pursue their careers.

Therefore, based on the findings in our studies, we proposed a model of how people with uncontrolled seizures can have successful employment.

In this model, it is stressed that those with epilepsy must first be assessed for their ability to work according to the type of employment they are looking for.

The second step is to identify and create positive factors of employment. People with epilepsy should be encouraged to develop self-determined motivation by finding the meaning and goal of having a job.

Overcoming the challenges in epilepsy needs courage, faith, strength, hope and epilepsy awareness.

The Malaysian Society of Epilepsy (Persatuan Epilepsi Malaysia) is a group of people having or caring for those with epilepsy. The group includes people with epilepsy, their family members, doctors, nurses, healthcare workers, and of course volunteers.

Its main aim is to improve the quality of life of people living with epilepsy.

• Prof Dr Lim Kheng Seang is a Professor and Consultant Neurologist at University Malaya Medical Centre. He is also the Honorary Advisor of Persatuan Epilepsi Malaysia.