The person with a significant Acquired Brain Injury may be unable to return to employment or education. According to Rehab Scotland less than 30% of head injured people will return to work without specialist rehabilitation and support. The physical, cognitive, communicative, psychological and/or, behavioural changes associated with Acquired Brain Injury may adversely impact on the person’s ability to return to work or education.
Physical impairments are usually visible and well recognised by employers and educational institutions. People are usually very accommodating and provide appropriate levels of support for the person with a physical disability. However, cognitive difficulties (e.g. memory, concentration, lack of insight) and communication difficulties may be less obvious as may a reduction in social skills and/or changes in personality and behaviour. These “hidden” difficulties may lead to increased levels of stress for the brain injured person and their employer/ educational institution, especially if they go unrecognised or the implication of these difficulties is not understood. If the person is not provided with adequate levels of support for their “hidden” disability, this may result in them being dismissed from employment, the person resigning from their job because of failure to fulfil their role or having to give up their programme of education.
If the person is able to return to employment or education they may require adjustments and adaptations to assist them to reengage with and maintain employment/education. They may benefit from:
- Specialist equipment for physical impairments e.g. special seating, wheelchair, technology.
- Support to travel e.g. taxi card, bus pass, Motability vehicle etc.
- Aids to support communication.
- Aids for memory and other cognitive difficulties.
- Advice and support to manage psychological and behavioural difficulties.
- Additional Support for Learning (ASL).
For employers the main difficulty arising from uncertainty about the potential to return to work arises from the need to re-allocate duties to another employee or new recruit, and for all to have an idea of the timescales involved. Recommendations that are limited to two week intervals from the time of asking do not facilitate long term planning. It may be more sensible to indicate that even in instances of good physical and cognitive recovery, a return to work is still limited by fatigue and the need for a complete assessment. Try to make predictions that apply for longer periods.
For the patient and their dependents medium term financial planning in the absence of income can also be facilitated by being offered advice based on longer term timescales. Similarly childcare or other carer roles can be better managed with a similar approach to prediction.
Assessment and advice from professionals (e.g. Speech and Language Therapist, Occupational Therapist, Clinical/ Educational Psychologist, Learning Support Advisor, Disability Advisor) may be recommended. These professionals can help to provide guidance to employers/ educational institutions regarding how best to support the brain injured person to return to work or education. It may be useful to consider a gradual return to work or education. A temporary or permanent reduction in responsibilities and/or hours may be helpful.
Disability Employment Advisors at local Job Centres Plus can also assist the brain injured person to find suitable alternative employment if necessary. Similarly Learning Support Advisors at Higher Educational Institutions may be able to help students return to their studies.
Vocational rehabilitation may support a return to education or employment. It may also help address specific problems, promote social and economic inclusion and may reduce the impact of psychosocial difficulties.
Headway – Returning to work after brain injury
Headway – Returning to education after brain injury