Staying in work with brain injury

Maybe so…

🚧Challenge: If you have returned to work following a brain injury and are considering a change:

• Perhaps you no longer feel fulfilled in your current role?
• Maybe you experience decreased energy levels or fatigue easily?
• Could your strengths have shifted due to the brain injury?
• Do you envision pursuing a new career path?

💪Opportunity: These are all inquiries that can be addressed during career counseling.

• A career counselor can assist you through discussions and exercises to navigate career decisions.
• When selecting a career guidance center or counselor, consider expertise in career guidance post-health issues.
• This choice is personal.
• To do this, visit the Search career center website, click on 'find a career center,' and use keywords like 'disability' or 'disease.'

💰Support: Every 6 years, you are eligible for career assessments. You will only pay 40 euros for 4 hours of guidance if you reside in Flanders or the Brussels-Capital Region, have at least 7 years of experience, and are currently employed or self-employed.

A work disability refers to a mental, psychological, physical, or sensory condition that hinders finding or carrying out work tasks.A brain injury can constitute a work disability, with recognition determined by the VDAB.

🤝Collaboration: It is advisable to consult with your primary care physician regarding this matter. Your general practitioner can assist in completing the necessary paperwork and provide referrals to specialist doctors. Your neurologist or rehabilitation doctor can also assist in filling out the forms and outlining the reasons for your eligibility for employment support measures.

The health insurance fund's advisory doctor determines how long you can work through adapted work.

This is for a maximum of two years, but can be renewed afterwards.

🚧Challenge: Research indicates that remaining at work post-brain injury is often more demanding than returning to work initially.

While many studies focus on the return to work, some also explore the factors that hinder or facilitate sustained employment after a brain injury.

For instance, changes in personal circumstances (like family dynamics) or workplace dynamics (such as a new manager) can disrupt the equilibrium between your capacity and the demands placed on you. This imbalance may necessitate increased energy to sustain work activities. You might also realise that your current role is no longer suitable, either through self-awareness or feedback from loved ones or colleagues.

🤝Collaboration: We recommend collaborating with your healthcare team, health insurance fund's advisory physician, family members, and occupational physician to identify the optimal conditions for a suitable and sustainable work environment. Regular evaluations together can help ensure a healthy balance between your capabilities and workload.

💪Opportunity: If returning to work becomes overwhelming, consider adjusting the number of working hours or tasks gradually.

🚧Challenge: Warning signs that returning to work is challenging include fatigue, requiring evenings/weekends for recovery, or experiencing irritability post-workday. While under a phased return-to-work plan, you can discuss adjustments to your workload or hours with the health insurance fund's advisory doctor. As an employee, it is essential to communicate with your employer about potential reductions in workload or hours. While employers are not obligated to agree, the principle of 'reasonable adjustment' can guide discussions on the feasibility of requested changes.

💪Opportunity: Developing a relapse prevention strategy can aid in maintaining a healthy balance between your capacity and workload. Stay vigilant for signals of imbalance in collaboration with your work environment.

🤝Collaboration: In unity, if the return to work is deemed unmanageable, it is viable to explore the following alternatives in consultation with relevant parties:

• Modify your job responsibilities and work conditions, such as adjusting the hours of a phased return to work or altering your task assignments.
• Implement a period of respite (work break) to allow time for reassessing what constitutes suitable work and how to implement this effectively.
• Evaluate if adjustments in other areas can help restore equilibrium based on your preferences.
  • For instance, considering hiring cleaning assistance to reduce household responsibilities.

💰 Benefit: If maintaining part-time work is unfeasible, you will once more receive benefits (or disability benefits) directly from the health insurance fund, rather than through your employer or guaranteed wages from your insurance.

If you have inquiries regarding your career, reaching out to a career counselor is recommended.

Consider questions like 'What type of work would be a good fit for me?' or 'How can I achieve a better work-life balance?'.

A career counselor can assist you in exploring new job opportunities.

💰 Assistance: Every 6 years, you are eligible for career assessments.

During this time, you will only pay 40 euros for 4 hours of guidance if you reside in Flanders or Brussels, have a minimum of 7 years of work experience, and are currently employed or self-employed.

• If you are receiving a (disability) benefit, you must first seek approval from the return-to-work coordinator at your health insurance fund to engage in career guidance. The coordinator will provide you with a registration form to submit to VDAB for assistance.
• If you are a civil servant, the occupational physician must first deem you unsuitable for your current position before you can seek guidance from a career counselor.

• 💡Tip 1. Take more breaks and take them more often.
  • It might be helpful to take more breaks or take them more often, before you become too tired.
  • You might take a short break or an extra long break. (It is not always easy to leave your work).
  • You might take a break in a separate, quiet room.
  • Discuss the possibilities with your colleagues.

• 💡 Tip 2. Regularly evaluate your progress.
  • It is important to check with your doctor, your occupational doctor and/or your employer how work is going.
  • Are you managing your return to work?
  • How is work fitting in with your home life?
  • Reflecting on this with the relevant parties gives a balance between challenging and maintaining your load capacity.
  • 🧰Tool: keep a diary describing your working day: indicate all your tasks and for each task, add any specific challenges and/or specific tools/people that can support you.

• 💡Tip 3. Ask for support from friends and family .
  • Friends and family can support you with practical arrangements, e.g. someone can drive you to work or cook for you.
  • Friends and family can support you emotionally. They can listen to your ambitions for work.
  • Be kind to yourself. You need the courage to ask for help.
  • 🫶 Together: get support from brain injury experts who understand the impact on work.
    • This support is best continued when you are at work.
    • For example, someone from an employment service who is specialised in acquired brain injuries can support you at work.

• 💡Tip 4. Use strategies and/or aids.
  • During rehabilitation you learn coping strategies. Can you use these strategies at work?
  • Aids can be complex, but also easy to implement. For example, you can use a to do-list or post-its, you can programme activities into your smartphone ...
  • There is not one strategy or one aid that can help everyone at anytime. It might take some time to ascertain the most appropriate strategy/aid.
  • Be aware that it might be harder to use strategies and/or aids when you are tired.

• 💡Tip 5. Reflect on 'must have' and 'nice to have'
  • Start your working day with a to-do list.
  • For each activity, ask yourself: do I need to do this? Do I need to do this now? Is it important?
  • Determine the order in which you will complete the list.
  • Tick off what you have done.

• 💡Tip 6. Ask for regular feedback from your supervisor/manager.
  • Feedback can be useful for understanding your own abilities and challenges.
  • You can use it to track your progress.
  • Interpret feedback as a learning opportunity.

• 💡Tip 7. Ask for support at the right time.
  • If you notice that your work-life balance is disrupted or
  • If you are less motivated or
  • If your work is not going as you would expect, do something about it.
  • Some practical examples:
    • suggest to your employer , colleagues or occupational doctor that you organise certain subtasks differently.
    • ask a colleague for help.
    • contact your doctor/rehabilitation team . They can help you when you return to work, but also later on as you are trying to stay in work.

Effective communication plays a crucial role in the process of returning to work following a brain injury.Navigating life and work with a brain injury is not a solitary endeavor; the changes also impact your (work) environment.

🚧Challenge: Upon returning to the same work setting, the familiarity of your work environment from before your brain injury may lead to observations of changes in your behavior, personality, or coping abilities. Expectations from those around you may vary, with some anticipating improvement while others may expect you to be the same person as before the brain injury. Not all consequences of a brain disorder are outwardly visible, as others may only witness you during your best moments.

💪Opportunity: It is essential to communicate openly about the effects of your brain injury on your functioning, considering both visible and invisible consequences. For instance, sharing with colleagues, customers, employers, or managers that you experience fatigue can help them understand your need to reduce working hours.

🤝Collaboration: If articulating these challenges to your work environment proves challenging:Engage in discussions with your treating doctor/therapist.

• Consider preparing for the conversation in writing if needed. Utilizing a structured format like a diagram can provide a supportive framework and alleviate the burden of repeatedly formulating your message.
• Identify specific difficulties and propose solutions where feasible. For example, instead of broadly stating memory loss as an issue, suggest that your manager communicate important information via email. This approach minimizes confusion upon returning to your workspace.