Written By: Dr. Deborah Little
One major question I am asked frequently relates to patients with brain injury wanting to predict when they may return to work following their brain injury. The answer to this question is quite complex. Part of this is how the science has been conducted. It has four major problems:
- Mild TBI has many origins, and the symptom profile for those with long-term consequences is varied.
- Levels of pre-injury function in different aspects of the work environment are generally not available. For example, how well did the patient communicate with other workers before the injury? How tolerant was the patient at dealing with frustration? Without these answers we don’t really know what deficits are due to the injury and what are consistent with work life before the injury. It could be that the patient had no tolerance for frustration (for example, how long it takes to order paper) both before and after. The outcome of this is that many doctors and specialists will attribute that lack of tolerance to the injury itself.
- Although employers are mandated to make adjustments for disabled employees, guidelines for how to make adjustments for mild TBI are not yet credible and many work environments have difficulty determining what types of adaptations are appropriate. Without clear two-way communication with the appropriate business official, this can lead to a negative outcome.
- Rehabilitation professionals use very diverse and sometimes unvalidated assessments of suitability for return to work. This means it’s very hard for us to combine data across studies to really understand what factors predict return to work.
All of this combines to make predicting when someone should return to work, what skills they need to be re-trained on, and what support systems they need in place exceptionally difficult. This is even more so for moderate or severe brain injuries.
As we approach brain injury awareness day, keep in mind that what might be considered simple – like return to work after a concussion – should be monitored and attention paid to the patient to identify challenges, if any, they have once they have returned to work. It is equally important to encourage your loved one with a brain injury, if they and/or you notice changes in function, to seek out appropriate medical and rehabilitation advice before returning to work. This will lower frustration levels and help reintegration into the work environment more successful. Specialists in brain injury are here at UTHealth to help.