Returning to work after a stroke is a topic that I see mentioned a lot across social media. While the majority of strokes happen in people over the age of 65, strokes can and do happen to people of all ages. Per the CDC, 34% of people hospitalized for stroke were less than 65 years old in 2009.
Stroke survivors are getting younger (I categorize “young” as 65 or under). If you’re a young stroke survivor, you’re likely dealing with different problems than older survivors. You may have children who are still at home, you may be caring for aging parents, and you may want to return to work.
“Returning to work after stroke continues to be an important milestone of recovery for patients; however, it is poorly understood by the healthcare community. Work has been established as an achievable outcome for stroke survivors. The importance of work to health and well-being can also not be understated.” (Harris, 2014).
Although I am part of the healthcare community as an occupational therapist, I have a clearer understanding of the steps needed to help someone successfully return to work. In some settings, occupational therapists work alongside vocational rehab to help someone get back to work. Part of my expertise lies in assisting survivors to determine if returning to work is feasible based on the issues they’re dealing with. If it is, I can help someone prepare for a new job and provide support during the transition back to work.
When thinking about returning to work after having a stroke, here are some of the main factors to keep in mind.
The Americans with Disabilities Act (ADA), which was passed in 1990, makes it a requirement for employers to make reasonable accommodations for someone with disabilities to work a specific job. Reasonable accommodations will vary from job to job and employer to employer. However, if someone can perform the necessary functions and requirements of the job with reasonable accommodations, they should be allowed to fill that position.
Reasonable accommodations can be different based upon your specific needs. Physically, you may need a long-handled or built-up tool to do your job. You may need the ability to take short rest breaks during the day, or you may need to work shorter hours when you first return.
Cognitively, if you’re dealing with short-term memory, attention, or concentration issues after your stroke, accommodations you may need include: reminder apps; ability to wear noise-canceling headphones to reduce distractions; clearly labeled items in the workspace; a decluttered workspace; visual cues to provide directions around the workspace; etc.
It’s important to talk through what accommodations you might need with your employer to successfully work your job.
When Can I Work?
While many survivors will return to work, not all will be able to. Many factors impact someone’s ability to return to work after a stroke. These factors include the severity of a stroke, lingering limitations, length of time in rehab, mood and emotional state, family and social support, driving ability, etc.
It can be helpful to have input from your doctor, your rehab team (if still in therapy), and your family/friends when making this big decision. They may be able to give you a more objective perspective on whether or not you’re ready to go back.
In addition to getting input from those around you, it will be important to look at the specific issues you’re dealing with. Some survivors experience difficulty with physical issues, while others have primarily cognitive changes after a stroke. It’s necessary to understand how those changes will impact your ability to perform a job you used to do or a new one you’re applying for.
You may qualify for vocational rehabilitation services. These services are provided by your state’s social service department. Vocational rehab provides several valuable services like counseling and guidance, training, job placement, job support, and transportation, in some cases.
Making The Transition
If you and your loved ones have determined you’re ready to go back to work, there are a few things you can do to ensure a smooth transition.
Visit your workplace before the first day. This will help you acquaint yourself with the building’s layout, meet the people you’ll be working with, and overall feel more comfortable in your work environment.
Before starting, get back into healthy sleeping habits that support your new work schedule. If you have been staying up late and sleeping in, it’s better to correct that sleep pattern a couple of weeks or months before you start work.
Get back into a daily work routine. To some, that may look like waking up at a certain time, taking a shower, getting dressed, completing grooming tasks, making breakfast, and then heading out the door.
If your employer is flexible, try gradually building up to the work schedule you want. For example, if you’re hoping to get back to 40 hours a week, work 10 hours the first couple of weeks. Then build-up to 20 hours for a few weeks and so on.
Returning to work after a stroke can be a very stressful experience. You’re likely returning to a stimulating and busy environment (especially if you’re in an office, factory, restaurant, etc.). If you’re still dealing with chronic pain, sensation, and mood issues after stroke, it’s easy to become overwhelmed by new stimuli.
There will be different aspects of stress when returning to work. It will be important to learn how to manage stress related to actually being on the job and relearning how to balance home/work life.
That’s a big ask. Focus on the things that you can control and obtain any accommodations your employer will allow. A stress management plan is a valuable tool to keep your stress levels to a minimum while making the transition back to work. This plan will help you determine ahead of time what things you need to do to keep stress at bay, how to respond in the moment, and what to do after a stressful event.
If you’re able to return to work after your stroke, try to take things slowly. Don’t expect too much of yourself too soon. Utilize the adaptations and accommodations your employer is willing to provide. Engage in activities to keep your stress level down. You got this!