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Charlotte Bates and Eleanor Gregan | 20 May 2022

How to support an employee with a long term, or terminal illness

The Good Guides Series

It is hard to describe the heartbreak and fear colleagues and leaders face when an employee shares they are suffering from a long term or terminal illness. Supporting an employee who is going through this is challenging for everyone in the workplace. For leaders, it can be daunting trying to provide this support while understanding the legal obligations that apply and balancing the needs of the organisation and other employees. Unfortunately there is no tried and tested step by step process that employers can follow to tick the right boxes.

The idea for this Good Guide came from a member of our LinkedIn community, who asked us to outline how employers can still create a good experience for employees at such a tumultuous time. We felt this difficult topic is definitely worthy of a Good Guide.

We are in this together

It is important for workplaces to approach these situations with empathy, fairness and kindness (see our Good Guide article on Building Empathy). We use the word “workplace” and not the words “you” or “employer” purposefully; if the employee wants support from work, then our view is support on a collective level could make a real difference to the employee’s experience, and also to their engagement with their work. It is likely the employee’s colleagues and friends at work will want to be involved and offer support, and harnessing their collective energy can make a real difference for the sick employee.

We often hear “but I don’t know how to help”. This is to be expected, because at the end of the day, the way people want or need to be supported will be different for everyone and their particular health circumstances. We hope this Good Guide supports you to identify the best ways to support an employee facing these circumstances.

The legal stuff

There are some fundamental obligations that all employers must comply with which should underpin your approach to supporting a sick employee.

Key legal obligations:

Good faith

You must “deal” with your employee in good faith, which requires both of you to have trust and confidence in each other, and be active, responsive and communicative with each other.

The most important step to comply with this obligation is to take the time to talk to your employee – find out what they need from the business, their leader, and their colleagues, and what their immediate concerns (if any) are. As the employee’s illness progresses, keep engaging with them to understand their changing needs.

Health and safety

You need to provide the employee with a safe and healthy workplace. To best do this, it may be necessary to understand the employee’s diagnosis and prognosis and find out if there are any limitations that come with that and what you might need to do to support that employee.

If an employee has been off work due to illness but wants to return to work, you will need additional medical information to ensure they are well enough to come back to work, and if so what they can and can’t do, and what you can do to support them.

You may get the information you need from the employee themselves, or you may need to contact their doctor or whanau to find out more. As this is their “personal information”, you need the employee’s consent to access any medical information or before making contact with their doctor or whanau to find out more. We recommend this consent is obtained from the employee in writing.

Their job

Just because an employee is diagnosed with an illness, even if it is terminal, that will not automatically mean the employee can no longer do their job or that the employer has the right to terminate their employment.

If you start to think the employee is no longer capable of performing their role because of their illness, and you can’t hold their role open for them, discuss this with the employee in the first instance but be aware you may need to start a formal process to terminate their employment based on medical incapacity. The process should be designed with the particular employee at the heart of it – e.g. when and where the meetings take place, what support, and be in line with your employment agreement. This is a difficult process and one you should seek advice on.


Do not treat the employee unfairly or less favourable than someone else because of their illness. However, there will be times when you will be justified in treating them differently, e.g., if they can no longer do their job because of their medical issues.


It is likely your employee will need to take leave during their illness. Any leave taken should be in accordance with the Holidays Act and their employment agreement. It is open to any employer to also offer employees additional paid or unpaid leave.


If an employee shares their health information with you, that is their “personal information” and there are onerous privacy obligations. However, talk to your employee about who might need to know they are unwell and what information they would be comfortable being shared with others in the organisation.

Other support

But what about some more practical steps that people in the workplace can take? Here are some helpful ideas to think about when considering what that support could be while the employee remains in the workplace:


Do: Talk to the employee to understand what support they think they need, and consider if you can provide this, and if not, what other support you might be able to provide.

Brainstorm with the employee and their colleagues about what other support could look like (such as colleagues cooking them a meal, arranging for their house to be cleaned or their gardening to be done).

Research what external support is available through other agencies and communities.

Consider other ways of showing support, such as raising awareness on a particular illness (e.g. by raising money for the relevant charity).

Don't: Presume that you know what support the employee needs or offer support of a personal nature without checking with them first.


Do: Ask the employee who they would like to communicate with about their health issues – this could be their manager or another leader they feel more comfortable with.

Also check who they would like to be told about their illness (both in the workplace and potentially external stakeholders such as clients/customers) and how they would like this to be done. It is likely, as their illness progresses, updates will then need to be provided to the team. It is helpful to talk to the employee about this in advance so you are both on the same page about what and how this information will be shared.

If an employee is on sick leave, ask them how they would like to be communicated with – they may not want to check work emails/phones and prefer to use a personal phone. In serious cases you may need to communicate with an employee’s family member and this may need to be agreed at the outset.

Don't: Stop communicating with the employee because they are on extended leave – it is important they still feel connected to the workplace and their colleagues.


Do: Be flexible; the employee’s situation may change quickly, and a great employer will adapt and flex with those changes where it’s reasonable to do so.

Don't: Work with the mindset of “one size fits all”, because in this situation “one size fits one”.


Do: Treat the employee as normal if that’s appropriate. For example, if the employee is on sick leave or reduced hours, continue to include them in social events, just like any other employee. If the employee decides not to attend, then that is their choice.

Don't: Exclude the employee from work matters and social events because you think it might be “too hard” for them, or that they might not want to come, etc.


Do: If the employee is continuing to work, regularly review their workload to ensure it’s manageable, and if not, work with the employee to agree any changes such as a temporary reduction of hours or a temporary re-distribution of work, etc.

Don't: Presume that the employee will speak up if work is becoming too much for them.


Do: Think about whether there are any additional benefits that you could provide the employee or their family/friends. For example, additional EAP sessions for family/friends, discretionary sick leave to ease any financial burden, covering their travel costs to and from work and health appointments, etc.

Don't: Presume that the employee will ask for additional benefits or anything else.

We also know that an employee’s illness and absence can have a real impact on an organisation, so while the actions listed in the “do” column are important, we encourage businesses to do what is reasonable for them, and what they can realistically afford in terms of time, cost, and resourcing.

Making the tough decisions

Unfortunately, there may also be times when an employer cannot continue to hold a role open for a sick employee. If you’ve treated your employee with empathy and kindness, starting a conversation about the possibility of parting ways should be easier. There are several steps that need to be followed before you can end an employee’s employment for medical incapacity and we recommend seeking advice as every case is different.

You’ll also need to turn your mind to the support that the rest of your team may need to cope with an ill colleague while ensuring the business continues to operate smoothly and efficiently. Talk to the team regularly about the issue and allow them to share how they are feeling, providing them with support such as EAP if they need it. Check in on workloads and the resourcing in the team in case they are picking up extra work and are feeling overwhelmed. At all times, lead with empathy and kindness.


There will always be a lot to consider when you are supporting and managing an employee with a long-term or terminal illness. However, placing the employee at the heart of every step and treating them with empathy will go a long way to make sure they feel supported as much as possible.

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