Analysis: Organisations and managers need to be prepared with clear policies on how to proceed when a worker reveals they have a serious illness
Nobody teaches you how to respond when a colleague tells you they have cancer. Nor MS, nor Crohn's, or any of the conditions that can change how a person relates to their job and their workplace. There is no module on it in management training and rarely any section in the employee handbook so people tend to fall back on instinct. They respond sympathetically, the conversation ends quickly, and nothing much follows from it.
When I wrote last year about whether workers should tell their employer about a chronic illness, dozens of people got in touch with me. Many of them had navigated a disclosure conversation that went politely but led nowhere. Some had never disclosed at all and were dealing with their illnesses in silence. One person described the moment they told their manager about a diagnosis and watching the body language shift in real time, sensing that the unspoken reaction was closer to 'how is this going to be a problem for me?' than 'how can I help?'.
These experiences are not all that uncommon. Census 2022 showed more than one in five people in Ireland reported having a disability, meaning a lot of people are dealing with a serious health issue at any given time in most organisations of any size. When they finally choose to share that information, the reaction they receive will shape their working life from that point on.
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From RTÉ Radio 1's Drivetime, how parents should talk to their children about serious illness
Sympathy, empathy or compassion
When someone shares news of a serious illness, our instinct to say something sympathetic is universal and generally sincere. We respond with 'I feel for you', 'this must be terrible' or 'I'm sorry'. The problem is that sympathy, however genuine, tends to centre the feelings of the person hearing the news. You express concern, you feel something and then life carries on. Empathy goes further by attempting to understand the other person's experience, but even that can become a dead-end if it stays at the level of understanding.
What really makes a difference is demonstrating compassion. This involves going beyond feeling and listening and actually doing something. Most workplace conversations about illness never get to that point. They stay warm and well-meaning and completely inert.
You can hear the difference in practice. 'I'm so sorry, let me know if there's anything I can do' is well-meaning, but it places the entire burden of working out what support looks like onto the person who has just disclosed. 'I appreciate you telling me, let's work out together what you need to keep doing your job effectively' demonstrates compassion and is the beginning of an actual plan. That distinction matters more than most people realise.
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From RTÉ Radio 1's Today with Sean O'Rourke, the importance of empathy
What managers tend to get wrong
Managers carry particular responsibility because they have the authority to make practical changes that colleagues do not. The research on how managers handle health disclosures is not particularly encouraging. The most common pattern is what might be called sympathetic inaction, where concern is expressed, an open door is offered, and then nothing changes.
Another person told me their manager said all the right things in the initial conversation and then never raised it again for eight months. They were left to navigate their situation alone while nominally having support available.
There is a pattern in the research on chronic illness and employment that comes up repeatedly. Workers with ongoing conditions get quietly moved away from high-profile projects and handed work that is seen as less demanding but also carries far less visibility. When their performance dips, as everyone's does from time to time, it gets read as a symptom rather than a bad week. None of this necessarily involves bad faith. Much of it emerges from a manager's discomfort with not knowing what to do, combined with the absence of any organisational framework for doing it well.
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From RTÉ 2FM's Louise McSharry show, living with Crohn's/Colitis disease
What actually helps
Possibly the single most useful thing a manager can do after someone discloses an illness is sit down with them and ask what support they need to continue doing their job. This conversation happens rarely. What often happens is a vague offer of help, and then an unspoken expectation that the person would come back when they had figured out what they needed. The trouble is that someone who has just received a diagnosis may not know yet what they need, and in the absence of organisational policies or guidance, they are unlikely to know what their employer is willing or even able to offer.
An employee with MS might need intermittent leave to manage flare-ups or get to physical therapy. Someone else might need a parking space closer to the building, or the option to work from home on days when getting to the office is not realistic.
Most of this is basic stuff like adjusted workloads during treatment, flexibility around appointments, a conversation about what full capacity will look like once things settle. For someone going through cancer treatment, that kind of attention is often what determines whether they stay in work or quietly disappear from it. It also should not be a one-off, as circumstances change, treatment changes, and the support has to keep pace and be revisited.
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From RTÉ Radio 1's This Week, returning to work after cancer
Organisations have a role here too. Irish employment equality legislation frames "reasonable accommodation" as an organisational duty, but most workplaces leave the response entirely to individual managers, without training or any structured guidance in place. If someone gets meaningful support, it usually depends on who their manager happens to be. Building even a basic framework for how organisations and managers should respond would do more than most organisational wellbeing programmes currently achieve.
There is almost no European research on whether accommodation actually keeps people in work, but a US study published in 2019 tracked workers over four years and found that those who received accommodations were almost 20% more likely to still be employed. That is a significant gap and there is no reason to assume the pattern would be fundamentally different here.
There is a principle in political philosophy that you should design any system as if you might end up on the receiving end of it. Most workplaces have not done that. If they had, managers would know what to say after a disclosure, and more importantly, what to do in the weeks and months that follow. That almost none of them do should tell us something. Most managers mean well; they just have no structure for acting on it. Organisations need clear policies on how disclosure conversations are handled, what support is offered, and how it is followed up.
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The views expressed here are those of the author and do not represent or reflect the views of RTÉ. If you have been affected by issues raised in this article, support information is available online.
