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"A man’s work is his dilemma: his job is his bondage, but it also gives him a fair share of his identity and keeps him from being a bystander in somebody else’s world." - Melvin Maddocks
If you ask people to describe themselves, often they will talk about their job or career. Work is a tremendously important aspect of how people define themselves. When work is taken away, people describe feeling like a piece of them has been taken away.
For people with brain injury, returning to work plays a critical role in recovery. Whether the brain injury is mild or more severe, many obstacles can prevent people with brain injury from successfully finding and keeping a job. Looking for job leads, keeping track of appointments, and going on interviews suddenly become overwhelming. On the job, performing routine tasks and interacting with co-workers may become a problem. Forgetting a meeting, giving a customer the wrong change, or not understanding a co-worker’s joke may lead to losing the job.
But I have only suffered a mild brain injury – surely this is not going to stop me going back to work! Is it? Following a mild brain injury, a person may have a dazed, vacant stare and appear "out of it" for a few minutes. Immediately following a mild brain injury, headaches, dizziness, and slurred speech are common. A person may have difficulty answering simple questions and be disoriented. Over the next several hours, days, or weeks, these symptoms typically disappear and a person is able to return to normal functioning at home and at work.
However, sometimes a person will continue to have symptoms long after a mild brain injury. These changes may be permanent and affect all aspects of a person’s life.
The symptoms can be grouped into problems with thinking, personality/behavior, and physical functioning:
Thinking Changes:
· Memory problems
· Poor concentration
· Distractibility
· Difficulty making simple decisions
· Problems with organization
Personality and Behaviour Changes:
· Lack of motivation
· Sad and/or depressed
· Anxiety
· Irritability
Physical Changes:
· Headaches
· Dizziness
· Balance problems
· Fatigue and/or weakness
· Sleep disturbance
Studies have shown that while most people will be able to return to work without difficulty following a mild brain injury, as many as one-third will experience considerable difficulty; resulting in reduced productivity, frequent job changes, and being reassigned to a position with lowered levels of responsibility.
What is the effect of moderate to severe brain injury on my chances of returning to my work?
In moderate and severe brain injury cases a wide range of cognitive, physical, emotional and behavioral changes may occur. As we have seen, earlier in this book, the effects of brain injury can be complex and impact all aspects of a person’s life. Recovery is measured in weeks, months and years. The effects of brain injury are long lasting and recovery may be incomplete. It is important to remember that the effects of brain injury will vary greatly from person to person. Although some people with severe brain injuries experience only mild long-term difficulties, other people may require care or special services for the rest of their lives. Returning to work following a moderate or severe brain injury is a particular challenge. A person may have one or many issues that relate to the ability to find and keep a job.
Some areas of concern that may impact upon a person with brain injury’s ability to find employment include:
Thinking Issues:
· Memory and learning
· Ability to process new information
· Focus and concentration
· Decision making ability
· Sensory overload
· Organizational skills
· Planning skills
Behavioral/Emotional Issues:
· Depression and/or anxiety
· Difficulty reading social cues
· Lack of self-awareness
· Impulse control
· Impatience
· Mood swings
· Inflexibility
Physical and Perceptual Issues:
· Fatigue
· Weakness
· Headaches
· Difficulty with vision, hearing, or speech
· Balance
· Difficulty with motor or physical skills
Here are some tips for dealing with some common problems following an acquired brain injury.
DIFFICULTY REMEMBERING INFORMATION
You may have difficulty remembering tasks from day to day or instructions about job seeking tasks. You may also have difficulty remembering new information, which affects learning. You might forget job interview appointments or follow-up appointments.
Tips:
• Establish a routine of daily job seeking tasks. Write down information in a "job-seeking notebook".
• Refer to your "job-seeking notebook" often.
• Use a day planner or calendar for recording interview dates or appointments.
• Have a family member or friend provide a reminder about appointments.
• Ask a family member or friend to call you on the morning of a scheduled interview.
DIFFICULTY FOCUSING AND PAYING ATTENTION
In any busy place there are lots of distractions. It is easy for someone with a brain injury to
have difficulty paying attention in this kind of environment. You may appear uninterested, to people around you, but in fact what is happening is that you are having problems following conversations.
Tips:
• Work in an area with limited distractions.
• Be aware of surrounding noises that may interfere with your concentration, such as radios, other people talking, etc. Try to limit these noises as much as possible.
• If you feel you have become distracted during a conversation don’t be afraid to ask the other person to repeat the point again.
• If you have more energy in the morning, or afternoon, make sure you go for interviews or meetings at those times.
DIFFICULTY WITH STARTING THINGS
As a result of a brain injury, you may have difficulty beginning activities. It may appear to others you are not interested or motivated, but the reality is that you probably need assistance to begin working on tasks.
Tips:
• Establish a routine of daily job seeking tasks.
• Break down activities into simple steps. Complete one task at a time before beginning the next.
• Make a checklist of activities that need to be completed each day.
• Check off each task that is completed.
• Establish time frames in which each task should be completed.
• Ask family members or friends to give you reminders and encouragement.
DIFFICULTY WITH ORGANISATION AND PLANNING
In order to find employment, you must be able to plan a job search. This may be difficult for you if you have problems with organization and planning.
Tips:
• Break down the job search plan into simple steps i.e. plan different activities for each day of the week. For example, on Sunday look in the want ads and circle job leads, on Monday make phone calls, on Tuesday send out CV’s, etc.
• Develop a checklist to use to ensure that each step of the plan gets done.
• Review the plan often to make sure that it is understood and that it is working.
DIFFICULTY WITH MAKING DECISIONS
Following a brain injury, you may have difficulty making decisions. Identifying which job leads to follow, deciding what to wear for an interview, or answering interviewer’s questions may be difficult. It is possible you may act impulsively and not think through the relevant options.
Tips:
• Talk to a family member or friend and get them to help you to identify what the options are for solving a particular problem.
• Discuss with them the advantages and disadvantages of each option.
• Write down the possible options, along with the pros and cons to each.
• Learn to "stop and think" before making a decision.
• Discuss with your family or friend the types of questions that can be expected on
a job interview and figure out with them your best answers to these questions.
• Role-play the interview with them and ask them to give honest feedback. Rehearse until you are comfortable answering a variety of questions.
DIFFICULTY WITH SELF AWARENESS
A person with a brain injury may have difficulty developing an accurate understanding of their strengths and weaknesses, particularly those areas that have changed since the brain injury.
Tips:
• Discuss your strengths and weaknesses with people who know you (family members and friends).
• If you lost your job after the brain injury, and are unsure as to why, ask a family member or friend to approach your previous employer to discuss the issues that arose. This could be done through email or letter or telephone.
The biggest and best tips of all!
You have to be aware of your limitations. This is crucially important. By following the above tips you will at least have made a good start. A lack of awareness of your problems after a brain injury will negatively impact on your ability to perform a job. You must be fully ready to return to work after a brain injury. First, acknowledging your limitations and strengths is a very important step. Understanding how your limitations can impact on functioning in the work environment is very essential as well as learning how to compensate for such limitations. In addition, a willingness to accept a change in employment status or job tasks could be helpful in the first stage analysis of returning to work.
It is therefore important that you meet with a vocational rehabilitation professional before re-entering the work environment to explore various work choices consistent with your abilities. A vocational rehabilitation professional helps people with disabilities to understand their capabilities and assist them in developing sound vocationally and socially rewarding lives.
A simulated work trial could be helpful and will also allow you to see first hand your capability. Also there are vocational/educational rehabilitation programmes which help individuals with disabilities become independent through education, training or employment.
Supported employment is an approach used to improve return to work following a disability, whether from a brain injury or any other type of disability. Skills training and support at the job site by a job coach or employment specialist are beneficial to individuals returning to work. Individuals are helped to overcome their inability or helped to retain skills. Also social, physical and behavioral impairments that could adversely affect performance are addressed.
Strategies are developed to suit individual needs. Changing the work environment to accommodate the individual and his/her limitations is helpful. Written and visual instructions are other useful tools. Job coaches are good sources of support for on the job. They can help to alleviate anxiety and fears about performing the tasks and also to work along with employers to educate them about the individual’s limitations. Joining job clubs could also be helpful, if there are any near to you. There you get to meet other individuals who may be experiencing similar types of issues, and being able to share.
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