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Accommodations for Migraine in the Workplace
Accommodations can not only help make working through a migraine attack more bearable, but they can also help prevent migraine attacks, which is, of course, the best option.
Accommodations are never one-size-fits-all.
Each person has unique triggers and symptoms of migraine. To find which accommodations may work for you, create a list of both of these areas. For example, perfumes and a lack of sleep may trigger an attack. Once the attack has started, bright lights become unbearable. To mitigate these factors, we would need to think of accommodations for flexible scheduling on days where sleep is limited, as well as creating strategies to deal with scents and lighting issues.
The Job Accommodation Network suggests brainstorming accommodations by two categories: By Limitation (Headache/ Other Pain, Light/ Noise Sensitivity, Stress Intolerance) and By Work-Related Function (Light, Noise, Stress.) (1)
Once you have your list created, crosscheck your needs with the suggestions made by Paula Dumas in her SAFER Plan for workplace accommodations for migraine. (2)
S– Scent Protection
A– Audio Protection
F– Flexibility
E– Escape Options
R– Reduced Light
Scent Protection
Osmophobia, or sensitivity to smells, is a common symptom of migraine attacks. In addition, scents can also trigger a migraine attack.
1.) Enforce a fragrance-free workplace. Request that employees and visitors refrain from wearing any perfumes, cologne, or scented beauty products.
2.) Swap any scented soaps or air fresheners with unscented options.
3.) Install air purifiers.
4.) Replace any cleaning products with unscented versions.
5.) Position the employee away from kitchens, microwaves, trash receptacles, white boards, and other highly fragrant areas.
Audio Protection
Phonophobia, or sensitivity to sounds, is also both a trigger and a symptom of migraine attacks. Understand that migraine brains are hyper-reactive to outside stimuli, so when an employee confides that any of these senses become unbearable during an attack, know they are not exaggerating. Most people avoid having a conversation about migraine because it remains highly stigmatized. If an employee is requesting an accommodation – it’s likely because it is significantly affecting them.
1.) Provide noise-cancelling headphones.
2.) Install sound absorption wall panels.
3.) Consider thick rugs or curtains to help dampen the echoes in an office.
4.) Request that employees mute non-urgent sound notifications on email, text messages, etc.
5.)Provide a private area or an area far from high-traffic areas for the employee to work.
Flexibility
The pandemic proved that many jobs can be completed effectively from remote locations. Telework allows employees with migraine to have a much larger degree of control over their triggers and symptoms. For example, an employee can work from their bedroom with blackout curtains over the windows, noise cancelling headphones around their ears, and an ice pack around their head without embarrassment or the obligation to justify their pain to other employees.
1.) Make telework an option, and allow this employee to work from home even if the request needs to be made at the last minute. Migraine attacks often occur without warning, so advanced permission may not be possible.
2.) Consider granting this employee permission to join in video conferencing with their video off. The energy it takes to look presentable during an attack can detract from an employee’s already reduced energy, making them less productive overall.
3.) Flexible scheduling can be incredibly empowering for an employee with chronic illness. Allow the employee to work an adjustable schedule. For example, if an attack occurs in the morning, the employee can rest to ensure they are able to make up the work in the evening.
Escape Options
For many of us, all we want during a migraine attack is a silent, dark room- and some relief, of course.
1.) Many offices provide wellness rooms where employees can nurse or just relax. If these are not available, a restroom may do the trick. Some employees may prefer the privacy of sitting in their own car until the worst of the attack passes.
2.) Providing curtains or room divider panels can allow privacy for your employee to be able to work through the attack without the added pressures of feeling like they have to put on a bright face or exchange pleasantries with other employees as they walk past their desk.
3.) Allow the employee to leave the office to take off the rest of the day or to work from home. Depending on the employee’s symptoms and medications, a ride may need to be arranged via a ride-sharing app, even if they took their own car or public transportation to work that morning.
Reduced Lighting
Photophobia, or sensitivity to light, is one of the most common symptoms and potential triggers for migraine attacks. Depending upon the person, different types of lighting like fluorescents, strobes, LEDs, and bright sunlight may be worse, so their input is critical to creating the most effective environment.
1.) Allow the employee to wear sunglasses, hats, etc. in the office without having to explain themselves to their coworkers.
2.) Provide light filters to any overhead fluorescents, or allow these to be turned off and replaced by incandescent desk or floor lamps. Even just having these lamps turned on in addition to the fluorescents can help dampen the effects of the flickering.
3.) For computer monitors, provide anti-glare filters and ensure the highest refresh rates possible. (3) Adjust the screens to the warmest options by turning on night shift (4) or downloading programs like f.lux. (5)
4.) Adjust your screen brightness. The typical recommendation is to match the screen brightness to that of the room, but your preference may vary.
5.) Provide blinds or curtains for bright windows.
The most important aspect of identifying effective accommodations is listening to your employee and having them consider their own individual needs. What works for one employee with migraine may do nothing for another employee with migraine. Do not assume you know better than the employee, but ensure they are comfortable enough to speak up and request what they need to do their job to the best of their abilities.
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Accommodations are typically low-cost and highly effective. Learn how to request accommodations here.
1-Accommodation and Compliance: Migraines, Job Accommodation Network, <https://askjan.org/disabilities/Migraines.cfm> 2-Dumas, 2021, 19 Ways to Accommodate an Employee with Migraine, Migraine Again, <https://www.migraineagain.com/19-ways-to-accommodate-an-employee-with-migraines/ > 3- Change your display refresh rate in Windows, Microsoft, <https://support.microsoft.com/en-us/windows/change-your-display-refresh-rate-in-windows-c8ea729e-0678-015c-c415-f806f04aae5a> 4-Turn Night Shift on and off manually, Apple, <https://support.apple.com/guide/mac-help/use-night-shift-mchl97bc676d/mac#:~:text=Turn%20Night%20Shift%20on%20and%20off%20manually&text=a%20darkened%20room.-,On%20your%20Mac%2C%20choose%20Apple%20menu%20%3E%20System%20 Preferences%2C%20click,Displays%20%2C%20then%20click%20Night%20Shift.&text=Select%20Manual%20to%20turn%20on,until%20you%20turn%20it%20off.> 5- Get f.Lux, f.Lux, < https://justgetflux.com/>