Stroke Survivors: Employment Opportunities And Challenges

A stroke can have a significant impact on a person's ability to work, with physical and cognitive effects such as loss of memory, trouble concentrating, speech or writing problems, muscular weakness, and emotional challenges. While some individuals may recover fully, others may be left with long-term or permanent impairments. Despite these challenges, it is possible for stroke survivors to return to work, and there are laws and support systems in place to help them. Under the Americans with Disabilities Act, employers are prohibited from discriminating against individuals with disabilities and must provide reasonable accommodations to enable them to perform their jobs. Similar laws exist in other countries, such as the UK's Equality Act 2010, which protects individuals with disabilities from discrimination in the workplace and ensures they have the same opportunities as others.

What are the physical and cognitive effects of a stroke?

A stroke can have a significant impact on the brain, leading to various physical and cognitive effects. The physical and cognitive consequences of a stroke are intricate and far-reaching, often requiring specialised care and rehabilitation.

Physical Effects of Stroke

The physical effects of a stroke depend on the location and extent of brain damage. Paralysis or loss of muscle control on one side of the body, known as hemiparesis or hemiplegia, is common. This can affect the face, arm, and leg on the affected side, leading to difficulties with movement, balance, and coordination. Additionally, individuals may experience sensory impairments, including numbness, tingling, or pain in the affected limbs. Vision and speech problems are also possible, further complicating communication and daily functioning.

Cognitive Effects of Stroke

The cognitive effects of a stroke are equally diverse and challenging. Problems with memory and thinking are frequent occurrences post-stroke, impacting the way the brain understands, organises, and stores information. This can manifest as difficulties with concentration, attention, and information processing. Specifically, stroke survivors may struggle with answering questions, planning, following conversations, recalling important facts, orientation, reasoning, and making judgments.

The ability to solve problems is often more prevalent in those who experienced a right-brain stroke. Additionally, individuals may exhibit safety-related behavioural changes, such as acting without regard for their own safety. Cognitive impairments can fluctuate, particularly during the initial six months after a stroke, and are usually most severe within the first year.

Diagnosis and Treatment

Diagnosis of cognitive problems after a stroke involves medical history assessment, followed by physical and neurological examinations. Screening tools such as the Mini-Mental State Examination and the Montreal Cognitive Assessment are widely used to identify cognitive impairments. Treatment focuses on coping strategies and rehabilitation rather than a cure. Occupational therapists play a crucial role in helping individuals learn coping strategies and adapt to their new challenges. Clinical neuropsychologists or clinical psychologists may also be involved in providing specialised care.

What are the employment rights of stroke survivors?

A stroke can change a person's life in many ways. Survivors often find themselves unable to speak, swallow, walk, or even use half of their body. These disabilities can make returning to a normal routine difficult, and for many, it makes it impossible to return to work. About 20% of strokes occur in people of working age, meaning many people find themselves suddenly removed from the workforce against their will.

Disability Discrimination

Disability discrimination is against the law. It happens when an employee is treated less favourably due to their disability. This treatment might be direct and obvious, or it may be the result of a policy that appears equal but actually disadvantages some groups. For example, requiring everyone to enter a building via stairs may be indirect discrimination. Harassment and victimisation can be viewed as types of discrimination if they are linked to a disability.

The legal definition of a disability in the UK is a physical and/or mental impairment that has a substantial and long-term effect on your ability to carry out daily activities. This includes the emotional and cognitive problems you might have after a stroke. You might not think of yourself as 'disabled', but the law is there to help everyone, including people with hidden disabilities like cognitive and emotional problems.

The Equality Act 2010 exists to protect people from all types of discrimination, including disability-based discrimination. It covers many areas of life, including work, travel and access to services.

Reasonable Adjustments

The Equality Act 2010 states that a disability should not stop someone from working or having the same rights and access to opportunities as other people. Employers have a duty to make 'reasonable adjustments' for employees who are disabled. A reasonable adjustment is a change to the workplace or the way a disabled person does their job to allow them to work. This may mean changing work times, transferring to another post, or providing specialist equipment to help with certain tasks. Reasonable adjustments do not have to be expensive or complicated. It's about looking at the barriers a person is experiencing and thinking creatively about removing them.

Employers cannot ask the disabled person to meet the cost of any reasonable adjustments. Employers should allow time to make sure reasonable adjustments can be made before an employee returns to work. Even if your difficulties do not meet the legal definition of a disability, your employer can still make adjustments to help you.

Examples of reasonable adjustments include:

• Getting more time to complete tasks
• Getting help from a support worker
• Changing the time you start and finish work to avoid rush hour travel
• Changing tasks to suit what a person can do
• Changing targets or getting support from other colleagues to meet targets
• Reducing working hours
• Being allowed to take time off to attend hospital appointments
• Regular meetings with your manager to see how the tasks are going
• Working in a quieter office
• Having help from an occupational health team

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. Therefore, it is 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.

Organisations that can help

Access to Work grants and support can help you if your health or disability affects the way you do your job, and your condition is likely to last 12 months or more. It gives you and your employer advice and support with extra costs that may arise because of your needs at work.

In some cases, it will be considered legally 'fair' for an employer to dismiss an employee due to long-term illness. In these situations, the employer is first required to consider as many ways as possible to help their employee back to work. If the employer decides to pursue an ill-health dismissal, they should:

• Obtain medical evidence (with the employee's permission)
• Arrange an occupational health assessment
• Prove that no reasonable adjustments can be made to enable the employee to do their job

If your employer fails to take the above steps, or if you disagree with your employer’s interpretation of the medical recommendations, you may be able to bring a claim for unfair dismissal. If you think your employer is behaving unlawfully, you should seek professional advice. You can get advice from a solicitor, a trade union or an organisation like Acas or Citizens Advice. If you need to make a claim to an employment tribunal, the time limit for making a claim is three months minus one day from the unlawful act. It’s important not to delay in getting advice.

The best way to avoid dismissal is to stay open and honest about your support needs and keep in contact with your employer about your recovery.

What are the financial and practical support options available?

Returning to work after experiencing a stroke is a big decision. It is important to understand how the effects of your stroke will impact your work life. Support and good planning are needed to ensure a smooth transition back to work.

There are various financial and practical support options available to stroke survivors seeking to re-enter the workforce. Here are some options to consider:

Financial Support:

• Benefits System: Financial help is often available through government benefits. These can include Statutory Sick Pay, Personal Independence Payments (PIP), Universal Credit, and other disability benefits.
• Employer Assistance: Your employer may be able to provide financial support or accommodate your needs by covering the cost of specialised equipment or modifications.
• Local Council and Organisations: Reach out to your local council and other organisations for potential financial assistance.
• Insurance Coverage: Understanding your insurance coverage is crucial. Review your insurance policy to determine if it covers the cost of medication or medical services related to your stroke.
• Grants and Loans: You may be eligible for grants or loans to help with one-off expenses or household bills.

Practical Support:

• Rehabilitation Team: Your rehabilitation team can help you review your strengths, re-learn key skills, and develop strategies to improve concentration and memory.
• Job Seeking Assistance: Services like Centrelink in Australia can provide job-seeking assistance and advice.
• Vocational Rehabilitation Agencies: These agencies can offer guidance and resources to help you return to the workplace.
• Discrimination Support: If you face unfair treatment due to your physical or mental disability, you can contact organisations like the Fair Work Ombudsman for advice and representation.
• Allied Health Services: Your general practitioner can refer you to appropriate allied health services that can aid in your return to work.
• Stroke Associations: Organisations like the Stroke Association in the UK and the American Stroke Association offer various resources, guides, and helplines to support stroke survivors in their journey back to employment.

What are the options for changing careers?

Changing careers can be a challenging but rewarding endeavour, and there are several options to consider when making this transition. Here are some detailed instructions and suggestions to help guide you through the process of changing careers:

Evaluate your current situation

Start by assessing your current job and identifying areas of dissatisfaction or aspects that you want to change. This could include factors such as work-life balance, salary, career advancement opportunities, or the desire for a more flexible schedule. Understanding your motivations for a career change will help guide your next steps.

Reflect on your interests, values, and skills

Take time to reflect on your academic, professional, and volunteer experiences. Identify your core values, interests, and areas of success. Consider how your skills and experiences can be transferred to a new career. This self-reflection will help you determine what you want to do next and how to market yourself effectively during the job search process.

Explore different industries and careers

Create a list of careers that interest you, both within and outside of your current industry. Utilize resources like the U.S. Bureau of Labor Statistics to identify growing job fields and research career options. Speak with friends, family, and professionals in your network to get their insights and opinions on the careers you are considering. This step will help broaden your horizons and provide a range of options to explore.

Research job prospects and create an action plan

Once you have identified potential career options, it's time to research job prospects and create a clear action plan. Look for job openings and understand the qualifications and requirements for your desired positions. Consider what additional education, certifications, or skill development you may need to make a successful transition. Set specific goals and create a timeline to work towards your career change.

Rebrand yourself and enhance your skills

Before applying for jobs, work on rebranding yourself to align with your new career path. Update your resume, cover letter, and social media profiles to highlight how your existing experiences and skills make you a strong candidate for the roles you are targeting. Identify any skill gaps and take steps to enhance your skills through online courses, workshops, or certifications. Consider taking on freelance or volunteer work to gain direct experience in your desired field.

Utilize your network and conduct informational interviews

Reach out to your professional network, including alumni from your school, coordinators, managers, and other connections. Informational interviews can provide valuable insights and help you make connections in your desired industry. Don't be afraid to ask for advice and guidance from those who have already made a successful career change.

Understand your rights and seek support

If you are dealing with the effects of a stroke or any other disability, familiarize yourself with your rights and the resources available to you. In the United States, the Americans with Disabilities Act (ADA) protects individuals with disabilities and ensures equal opportunities in the workplace. Organizations like the Job Accommodation Network (JAN) offer guidance and resources to enhance employability and support individuals with disabilities in the workplace.

Remember, changing careers can be a rewarding journey that allows you to pursue new opportunities and achieve greater fulfillment. By following these steps and staying committed to your goals, you can successfully navigate the transition to a new career.

What are the options for volunteering?

Volunteering is a great way to connect with your community and build relationships. It can also help individuals with disabilities feel more included and valued. There are many volunteer opportunities for people with disabilities, and here are some options:

Animal Shelters

Many people with disabilities have a special connection with animals. Animal shelters often need volunteers to help feed the animals, clean kennels, take dogs on walks, and more. This could even lead to job opportunities at a pet store, veterinarian office, or pet boarding facility.

Food Pantries

Food pantries always need help sorting and bagging groceries. This involves manual labour and heavy lifting, so make sure the individual is capable of performing these tasks.

Churches

Many churches have food pantries and are always looking for volunteers to help. This can be a great way for an individual with a disability to volunteer within a community that knows them.

Hospitals/Nursing Homes

Hospitals and nursing homes always need volunteers. Some tasks include cleaning patient rooms, stocking medical supplies, door greeting, delivering gifts to patients, and cuddling babies in the NICU.

Homeless Shelters

Homeless shelters rely on volunteers to help prepare and serve meals. This is a simple task that allows individuals with disabilities to interact with many people. Volunteers are also needed to clean up after meals, which includes throwing away rubbish, wiping down tables, and cleaning the floors.

Outdoors

A variety of organizations are working to make the outdoors more accessible for people with disabilities. Disabled Hikers, for example, is an organization led by people with disabilities that organizes trips and advocates for greater access. Other organizations include The Outdoors for All Foundation and Limitless Adventures, which provide outdoor recreational experiences for people with disabilities.

Local Organizations

There are likely active organizations helping people with disabilities in your community, such as local chapters of Volunteers of America, Easter Seals, Respectability, ServiceSource, and the Arc. These organizations often have remote or regional volunteer opportunities on their websites.

Frequently asked questions