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Returning to Work
After a Stroke
Presenter: Tricia Gueulette, June 27, 2019

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Agenda

 While You Are Off Work After a Stroke

 Planning Your Return to Work
 Your Rights At Work
 Volunteering a Retraining
 Resources
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While You are Off of Work After a Stroke

 Will I be able to go back to work?

 How long will I be off of work?
 Timing
 What should I tell my employer?

Will I be able to go back to work?

With the right care, support and advice many people do return to work. Whether you are able
to return to work and how long it takes will depend on
the effects of your stroke, the type of care and support you received, what work you were doing
before and the amount of support your employer can
give you.

How long will I be off work?

Every stroke is different, and every recovery is different. Someone who had a mild stroke could
return to work within a week or two, while others may return after months or a couple of years.
There’s no set pattern, and no comparison against which you should measure your recovery.
Talk to your doctors, nurses, and
therapists about what you can expect. The most important thing is to take things as they come
and keep doing your rehabilitation.

Strokes affect people in many different ways and symptoms may change over time. You should
return to your GP right away if you experience new symptoms.

Timing
It’s important not to rush back to work too quickly following a stroke. For many, financial or
other pressures mean they want to go back full time
as soon as possible. However, it’s important to do so only when you feel well enough, have
received support and have a plan in place with your
employer for your return. You might get advice from professionals, your employer and your
family who might all have differing opinions about your return to work
after stroke. Remember, you are the expert in your own needs so try to retain control over
decisions about returning to work. Many people find that work helps
with their recovery. It can give a sense of purpose and focus to your day, provided you can cope
with the demands of the job.

What should I tell my employer?

If possible contact your employer yourself. Tell them that you have had a stroke, that you are
improving with rehabilitation, and that you will contact them again. Ideally, you should specify
when you will next be in touch to discuss your return. If you need advice, your GP or
occupational therapist can help you come up with a time frame.
When you speak with your employer, ask for a copy of their policy for returning to work after
sick leave. It is also useful to ask for a copy of the job description for your current role, or any
alternative roles that you are considering. Make sure you keep in touch with your employer. This
should help you feel
less isolated and ease your worries about returning to work. Talk through your thoughts,
concerns and options with someone you trust and who will
support you in making your decision to return. Many employers will be supportive of your
return to work. Unfortunately, some may lack the knowledge or experience for supporting
people back to work after a stroke and may be unsympathetic.

Each time you speak to your employer, only give them the facts they need. Helpful information
to give your employer could be:
• the date of your stroke
• your likely date of discharge from hospital
• a date that you’ll be back in touch with them to discuss how you are recovering.

Try not to be speculative, emotional, or give the impression that your condition is worse than it
is. It may be helpful to talk through what you
intend to say to your employer with a friend, family member, or healthcare professional first.
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Dealing with the Effects of Stroke While

You are Preparing to Return to Work
The effects of stroke can include:
 Cognitive problems: these include problems with thinking,
memory and concentration
 Personality changes: this can mean increased irritability or
becoming shy due to loss of confidence
 Physical problems: for example, difficulty moving around or
using your arms or legs
 Emotional changes: for example, feeling tearful or anxious
 Aphasia: difficulty speaking or understanding language, which
can also affect reading and writing
 Fatigue: extreme tiredness which doesn’t get better with rest.

Changes to personality may be particularly difficult for colleagues to adjust to. Try to
acknowledge these changes as they come up and explain it’s an effect of
the stroke and that this may get better over time. A number of the effects of stroke can’t be
seen (such as anxiety or cognitive
problems). We call these ‘hidden’ disabilities but they can make a big difference to the way a
person deals with everyday experiences. Very often people aren’t
aware of these effects until they are back at work.
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Emotional and Personality Changes

Tips for managing emotional changes at work

 Frequent reviews will help both you and your employer.
This will allow you to identify issues early on and put in
place any changes that are needed.
 Ask if your organization can offer any counselling or
emotional support through an Employee Assistance
Program
 Ask your GP about emotional support and counselling or
find out about services you can refer yourself to

A stroke is sudden and shocking, and affects every part of your life. It’s a lot to deal with, and
everyone deals with it differently. Sometimes, when things
seem difficult, anxiety and frustration can make people feel that they’re unable to cope or can
stop people from returning to work. It is important
that you think about whether your expectations, skills and stamina match up to the work you
want to do.
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Planning Your Return to Work

 What do I need to do?

 Create a return-to-work plan. Your vocational
rehabilitation specialist or occupational therapist should
be able to help you with this in conjunction with your
employer

Look at going back to work as part of your recovery, rather than the end of your recovery. When
you feel you may be ready to return, your employer should work with you to identify what your
needs are and what adjustments they can make to help you. Think about a phased return: a
gradual return to work starting off part time
and building up to full time hours, to ease back into work gently.

If you have an occupational therapist, they can talk about the work you were doing before your
stroke and help you to set realistic goals about returning.
They can advise on aids or equipment that you may need. You may be able to get access to a
specialist vocational rehabilitation team if there is one in your area.
Speak to your occupational therapist or GP to find out more.

Create a return-to-work plan

Returning to work doesn’t necessarily mean returning to the same job with the same roles and
responsibilities. Even if you can no longer do exactly
the same role you did before, there may still be other options to explore. A return-to-work plan
is a plan of action that details someone’s support needs following a stroke. Planning for your
return and looking at how you will manage the effects of the stroke means you are more likely
to stay in work once you return.
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What’s in a Return-to-Work Plan?

 No need to go into lots of medical detail – just a summary
of the effects of the stroke
 Look at each effect in turn and think about practical steps
you can take to address each one
 Try using these headings for your plan:
 Your Tasks
 Hours of Work
 Review
 Communicating to the Staff
 Breaks
 Time off for Appointments

The focus should be on what you can do rather than what you can’t. Take a look at your job
description with your line manager or human resources
officer. Talk about the tasks you can do to start with, and what you feel you could work up to
later. Try to think about practical solutions to things that
might be difficult for you, such as using equipment or lifting objects. Share your ideas with your
employer and try to work together to come up with
solutions.

Hours of work
You could look at the option of phasing your return. This means starting part time and gradually
increasing the number of hours and days you work.
Think about what may work best for you, such as starting later if you need longer to get up and
out of the house.
You may need longer breaks to help you manage any fatigue.

Review
This is important as it helps you see how you are managing your tasks and also lets your
employer feedback about how they feel things are going. Think about how this will take place,
and agree the time frame and expectations. It could be informal, such as 20 minutes every week
with your line manager, with brief notes taken.

Communicating the stroke to the staff team

You can help decide how to share information about your stroke with other members of staff.
You may choose not to tell them you have had a stroke, just that you will return part time and
that your tasks have changed. Another option is an email could be sent to your team from your
line manager, with text that has been agreed by you.

Breaks
Many people will need to have more frequent breaks to help beat fatigue, such as five minutes
after every hour worked.

Time off for appointments

If you need time off for hospital appointments or therapy, bring this up early on and get it
agreed with your employer.

Take a flexible approach

Some effects of your stroke get better but new ones could come up. By factoring in time to
review how things are going you can flag up if some tasks are unmanageable or
when you feel well enough to take on more or different tasks. This doesn’t have to be formal, it
can be over a cup of coffee for half an hour on a Friday with your manager to see how the week
has gone. It can be a good idea to keep brief notes and summarize any actions- you or your
manager can do this but make sure you agree them.

Changes at work
There may have been changes within your organization while you were away on sick leave. If
possible, find out about any changes and their likely effects on you or your position before you
go back to work, and talk to your manager if you are concerned.

Keep a Diary
This can be very simple, just a log of any key dates such as when you took on more or different
tasks and how they went. This can help you to see how you are progressing and re-build your
confidence.

Talking to colleagues about your stroke

You may be understandably nervous about how colleagues will react to you and the fact you
had a stroke. Remember it’s your choice whether you discuss your stroke with
colleagues. Sometimes being open and answering questions can help people to understand and
be more supportive. Don’t be embarrassed or apologize for the effects of your stroke. It can
help your colleagues if you explain what a stroke is and how it has affected you, particularly if
the effects are ’invisible’.

Talk to other stroke survivors about going back to work

Hearing how others overcame barriers to return to work and sharing your experiences with
others of a similar age can help you deal with feelings of isolation. It can also give you ideas on
what to do if you experience similar problems.
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Your Rights at Work

Under Canadian human rights law, employers have an
obligation to adjust workplace rules, policies and practices
that have a negative impact on employees or job applicants
with disabilities. In other words, employers have a duty to
accommodate disability in the workplace. An employer’s
failure to accommodate an employee or job applicant’s
disability may result in a claim of discrimination under
B.C.’s Human Rights Code.

 British Columbia employers have a duty to accommodate

disabled employees to the point of undue hardship.
This duty requires an employer to do everything that is
"reasonable," even if it is a "hardship."

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Reasonable Accommodations might

include:
 Getting more time to complete tasks
 Getting help from a support worker
 Starting work later to avoid rush hour
 Finishing work earlier to avoid rush hour
 Changing tasks to suit what a person can do
 Changing targets or getting support from other colleagues to meet targets.
 Speaking to the staff team on a stroke survivor’s behalf to let them know
 about the stroke
 Working four out of five days per week
 Getting support with travel to and from work
 Being allowed to take time off to attend hospital appointments
 Regular meetings with your manager to see how the tasks set are going
 Working in a quieter office

Be clear about your support needs

The duty to make reasonable adjustments only applies when someone has a disability as
defined in the Equality Act. It does not apply if the employer could not reasonably be expected
to know that a person is disabled. It is therefore very important to be honest about the effects
of your stroke and keep in contact with your employer. The way your stroke affects your work
should be documented in your return-to-work plan and reviewed regularly
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If Things Are Not Going Well

 Going back to work after a stroke can be difficult

 Be patient with yourself
 May wish to consider different career options

If things are not going well

For many stroke survivors, being back in work after a long time off sick can be difficult, no
matter how well-prepared they feel before they go back. They report
that tasks that were easy before the stroke become more difficult afterwards, and that regaining
skills, confidence and stamina can take a long time.
Don’t give yourself a hard time if you feel unable to continue in the job or occupation you were
doing before your stroke. You could stay in the same company but in a different role. Now might
be a good time to look at your options and consider a career change.
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Volunteering and Retraining

 Rethinking your options – career change? If you decide to

start a new job search, see it as an opportunity to choose
a new career. Don’t feel limited! Play with new ideas
about what you might like to do.
 Give yourself time
 Some stroke survivors see it as an opportunity to re-
evaluate their lives and retrain into a new career
altogether
 If you don’t feel able to go back to work, volunteering can
be a great way to keep active and build confidence!

There are plenty of options available for people who feel they cannot go back to the work they
were doing before the stroke. You might decide to look for a new job. You could try
volunteering, or re-train for a new career.

How volunteering can help you:

• lets you explore new hobbies and interests
• helps build new skills or develop skills you haven’t used in a while
• allows you to meet new people, to help deal with feelings of depression and isolation many
people face after a stroke.

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Quick Guide to Volunteering

 Think about your skills and interests - What appeals to you? Are you a
keen gardener? Do you like working with the public? Pick something
that you enjoy doing and that interests you.
 If you are unable to travel long distances due to fatigue or mobility
difficulties, think about what exists in your local area.
 Think about how often you would like to volunteer. It can be a good
idea to start once a week and build up to more if you feel able to.
 Think about your energy levels and travelling time. You could start
with
 Four-hour shifts and build up to longer periods.
 Ask what training is available. Many organizations have a dedicated
volunteer team. As you are giving up your time, you will often be
rewarded by training sessions and other volunteer resources.
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Vocational Rehabilitation
 Assessment: goal is to assess functional and cognitive capacity,
to look at your transferrable skills based on your your work and
life experiences, look at your existing skill set, your ability to
learn new skills and to look at your interests and aptitudes.
 Planning: after the assessment phase, your vocational
rehabilitation specialist will help you to create a plan (much
like we already discussed). Will you be returning to your old
job? Will you look for a new career? That will all be discussed.
Together you will create a personalized plan that identifies all
the steps to find and secure work in your chosen field. This plan
can include:
 Support for educational upgrading or post-secondary training
 Help in preparing for and finding a job, such as improving
interview and job search skills
 Job search help

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Vocational Rehabilitation (con’t)

 Implementing the Plan: Once you have a plan in place,
your vocational rehabilitation specialist should help you to
implement that plan and check in with you regularly.
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Support and Resources for Employment

 Vocational Rehabilitation Department GF Strong
 Work BC Centres (WorkBC.ca) can help with:
 Discovering job options
 Pursuing post-secondary education
 Get funding or assistive adaptations for your education
 Gain the work experience, job skills and technologies you
need to do the job you are interested in pursuing
 Job Search and Job Placement
 Create or expand your own business

Vocational rehab services located at G.F. Strong Rehab Centre offer vocational counselling
support and assessment to improve clients’ employment potential by developing a return to
work plan, determining work accommodations, and exploring suitable job options. Medical
diagnoses include: spinal cord injury, acquired brain injury including stroke and traumatic brain
injury, arthritis and other rheumatic diseases, amputation, neuromuscular skeletal conditions.
Referrals must be made by a physician or allied health professional.

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Other Resources
 Stroke Network of Southwestern Ontario has an online self
assessment for thinking about returning to work after a
stroke: http://www.swostroke.ca/rtw-self-assessment-
introduction/
 Heart and Stroke Foundation Return to Work Readiness
checklist:
https://www.heartandstroke.ca/stroke/recovery-and-
support/back-to-work