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Returning to work after Acquired Brain Injury (ABI)

27 Nov 2018

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By Sarah Pearson, Vocational Rehabilitation Consultant at Remploy
There are approximately one million people in the UK currently living with the long-term effects of a brain injury. There are many different types and severities of brain injury including both ABI’s and Traumatic Brain Injury (TBI’s). Such injuries can be hidden and taking time to understand the effects on the individual is vital;

  • Concussion is the most common brain injury, and often described as a ‘mild’ injury.

  • A closed head injury occurs where there is impact without breaking the skull.

  • A penetrating head injury occurs when an object fractures the skull and enters brain tissue.

  • Diffuse brain injury occurs when the brain moves within the skull when the head is shaken, and damage might be caused in several areas where the brain hits the skull.

  • Brain contusion describes bruised or swollen brain tissue that occurs when the skull cracks or breaks and can be caused, for example, by a depressed skull fracture (fragments of a broken skull pressing against the brain) or a penetrating skull fracture (bone fragments enter the brain tissue).

  • Babies can suffer brain injury at birth, such as cerebral palsy.

  • An ABI is an injury that occurred at or since birth. Whilst that does include TBIs, it is more commonly used to refer to injuries due to, for example, an infection, tumour, stroke or even a medical accident.

Rehabilitation is a critical part of the recovery process for anyone who’s experienced a brain injury. Experts generally agree that the earlier the intervention, the greater the benefit. Any rehabilitation programme must of course be closely tailored to individual needs, as must continuing care beyond any initial intensive rehabilitation phase as no one brain injury is the same as another nor does it affect the individual in the same way as another individual.
Rehabilitation must also extend beyond the physical: people who have experienced trauma often need psychological and emotional support to adjust to changed circumstances that could become the ‘new normal’ and new approaches to their acquired new life.
As many people who suffer an ABI are of working age, there are benefits, for the patient, the workplace, and society, to finding factors that facilitate successful return to work (RTW). Research has shown that individually adapted rehabilitation is judged as important because the employees/patients were involved in their own rehabilitation and required individually adapted support from rehabilitation specialists, employers, and colleagues. A moderate level of motivation for RTW was needed. Awareness of the person’s cognitive and social abilities is essential, in finding compensatory strategies and adaptations. It showed that the vocational rehabilitation process is a balancing act in individualised planning and support, as a partnership with the employer needs to be developed, motivation needs to be generated, and awareness built of abilities that facilitate RTW.
Some practical adjustments that can help employees return to work after ABI are:

  • Take time to understand the elements of the ABI that the individual is managing and how that management can be supported via strategies in the workplace.
  • Create a sense of security for the individual but enabling one or two work mentors/buddies who can support, liaise and help engage the individual with the wider team.
  • Work to the existing or highlighted strengths of the individual to build confidence and motivation for work.
  • Use of technology to help overcome new challenges such as memory, executive functioning (ie. problem solving and planning, word finding, changing attention, self-regulation).
  • Looking at whether parts of the role can be removed or re-allocated on a temporary basis.
  • Having the correct work environment – an ergonomic chair can help with comfort if the ABI has left physical weakness or neurological damage to movement or levels of paresis, managing pathways, exits strategies and accessing facilities can reduce anxiety.
  • Allowing time off for medical appointments or check-ups.
  • Applying to Access to Work for help with travel to/from work by taxi (if needed) and for grants towards adaptive technology.

Remploy’s Workplace Adjustments team has worked with many employers offering advice on reasonable adjustments, guidance and support for employees working with or returning to work after ABI. With improved rehabilitation and greater awareness of the impact of ABI, it makes good business sense to ensure that the employee has the tools and support to be able to return to work successfully.
To find out more about how Remploy can help your business protect the most important part of your business… your people, visit our website or contact us for more information.
About Sarah
I am a Registered Occupational Psychologist and Physiotherapist. I have over 20 years’ experience in working with individuals and employers assisting with assessment, disability management, making adjustments and guiding life changes. I have worked with both public and private sector organisations and the military. In my current role, we’re responsible for the delivery of holistic workplace adjustments programmes to a client base that includes the BBC, BT and GCHQ amongst others to protect and develop their greatest assets, whilst enabling thousands of talented individuals to reach their full potential.
You may also be interested in reading our other blogs on workplace adjustments, including one on creating an inclusive workplace for employees with cancer and one looking at how best to create a return to work plan for people who have suffered a stroke.

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