Improving the chances of returning to work after brain injury

Nearly one-third of all brain injuries occur in adults of working age who were employed before their injury. You may have clients who fit this description. Most want to return to work, but if and when they do depends on the severity of the injury, what parts of the brain were impacted, and the progress of rehabilitation.

Many people view their job as part of their identity and independence. Almost half of survivors under age 65 are able to return to the workforce, either in full- or part-time roles. In this article, we explore the benefits of returning to work, the factors that improve the chances of workplace re-entry, and how Constant Therapy fits neatly into a rehab plan whose goal is to return survivors to work. Finally, we provide a list of useful resources to help survivors address return-to-work issues.

What are the benefits of Returning to Work After a Brain Injury?

Studies have shown that a return to work for brain injury survivors improves overall quality of life and can offset some of the financial issues associated with the injury. Returning to work can also provide focus, help individuals feel productive, add structure to the day and increase social contact.

At a macro level, lost wages and increased dependence on government and other financial support contributes to the yearly cost of brain injury. When survivors are able to return to work, it reduces the cost employers face of lowered productivity due to unfilled positions and hiring and training replacement staff.

When is the Right Time to Return to Work?

When and if a survivor can return to work after brain injury depends on the severity of the injury, the individual’s symptoms, and the effectiveness of rehabilitation programs. Other things being equal, people with more challenges in functioning after brain injury will have more difficulty returning to work.

According to a 2008 study from Mount Sinai Medical Center, you will “find poorer outcomes for those persons who have more severe injuries, experience fatigue, are dependent on others in their activities of daily living, have transportation challenges, who evidence significant emotional issues and poor neuropsychological functioning, such as problems with memory, sequencing, and judgment.”

If an individual’s goal is to return to work, they should work closely with their Speech-Language Pathologist (SLP), Occupational Therapist (OT), and/or Physical Therapist (PT) to help set realistic goals and assess progress. The therapy team may also be able to refer the individual to a vocational rehabilitation team that can help further prepare them for returning to work. It’s also possible that survivors may not be able to return to the same job with the same responsibilities if their abilities have changed. Other options may be available.

What happens when survivors go back to work before they are ready? Studies show that inadequate treatment, inadequate rehabilitation, and failure to fully prepare the individual and employer are the biggest factors for unsuccessful attempts to return to work. And unfortunately, early and repeated job failures can have an unwanted emotional or psychological impact.

What Factors Improve the Chances of Returning to Work?

Research has found support for these post-injury service elements in helping individuals get back to work:

• Providing vocational rehabilitation services early in the rehabilitation process.
• Creating a supportive work environment.
• Supplying assistive technology when needed and training in its use.
• A phased return-to-work approach (eg., volunteering, self-employment, part-time, or consulting).
• Providing rehabilitation such as cognitive, speech, or language treatment.

There is substantial evidence supporting the effectiveness of cognitive, speech, and language therapy for people recovering  from a brain injury.  In this form of therapy, skilled clinicians provide therapeutic activities intended to improve function or train compensatory strategies to manage symptoms.  An individual’s therapy program is tailored to their specific goals and may target a variety of skills such as word retrieval, comprehension, paying attention, memory, problem solving, or planning.   

Enter Constant Therapy.

How Constant Therapy Helps with Cognitive & Language Rehabilitation

Our evidenced-based mobile app can provide the cognitive, speech and language rehab that survivors of brain injury need to get back to work. Constant Therapy uses artificial intelligence and data analytics to deliver each user a personalized brain exercise program that targets areas like memory, attention, problem solving, math, language, reading, writing and many other skills needed to function well at work.

For individuals who are rehabilitating, Constant Therapy provides:

• Access to cost-effective unlimited exercises anytime, anywhere to supplement therapy sessions and continue practice after discharge from therapy.
• Better outcomes through increased frequency of a evidence-based personalized program.
• Immediate feedback on task performance motivates increased utilization.

For Payers or Providers, Constant Therapy:

• Reduces lost productivity and costs by returning employees to work sooner.
• Helps trim more costly medical expenses by allowing patients to access exercises at home instead of more expensive alternatives.
• Improves case management and care coordination by enable access to meaningful utilization and performance data.

9 Questions to Ask when Individuals are Thinking about Returning to Work

As individuals move through their rehab program and get closer to returning to work, these questions should be asked together with the clinician, case manager, patient, and caregiver. Answers to these questions can help determine the IF, WHEN and HOW decisions regarding returning to work.

1. Is the individual physically or cognitively going to be able to perform their job?
2. Can they first trial volunteering to practice use of strategies learned in therapy and assess current status?
3. Do they want to work full-time or part-time? What makes sense for their physical, cognitive, or communication status?
4. Do they want to go back to the same employer, job, and responsibilities? Or, try a different career?
5. What are their transportation needs, and how will they be met?
6. What is their physical work environment like? Will it meet their needs?
7. What do they need to communicate with their employer? Who is the primary contact when talking about illness at work?
8. What is the level of support and understanding of brain injury, at their work?  Can they start part-time and gradually increase their hours?
9. What is their disability benefits situation? How does it change when they go back to work?

A Curated List of Important Resources About Returning to Work

Finally, we’ve researched the most helpful resources for those thinking about getting back to work. Consider providing this list to clients and caregivers.

• Job Accommodation Network (JAN) – a service of the Office of Disability Employment Policy, U.S. Department of Labor. Can assist both survivors and employers with online and over-the-phone return-to-work information, like effective ways to accommodate certain disorders in the workplace, access to the Searchable Online Accommodation Resource (SOAR), which lets users search accommodation options for specific deficits, and information about legal rights when returning to a job after a brain injury.
• Disability.gov – a federal government site that contains disability-related resources on programs, services, laws, and regulations to help people with disabilities lead full, independent lives.
• Equal Opportunity Publications – this portal includes opportunities for diversity recruitment, an online job board, and Career Expos for women, members of minority groups and people with disabilities.
• The Campaign for Disability Employment – a collaborative effort between several disability and business organizations that seeks to promote positive employment outcomes for people with disabilities. The site offers education and outreach tools designed to engage employers, people with disabilities, family, and educators, and the general public.
• Stroke Rehab Guide – Prepared by the American Stroke Association, the information here can guide you and your family through the rehab decision-making process, including back-to-work decisions.
• Constant Therapy – Our mobile app has 100,000 evidence-based cognitive, speech, and language exercises across more than 80 task categories that can be used in clinic or at home as part of rehabilitation plan after brain injury.

References:

• American Heart Association. (2018, January 25). Working before and after stroke is good for brain health. ScienceDaily.
• Mount Sinai Medical Center (2008). Return to Work After Traumatic Brain Injury. TBI Research Review.
• Parente, R., & Stapleton, M. (1999). Development of a cognitive strategies group for vocational training after traumatic brain injury. NeuroRehabilitation, 13 (1), 13-20.