Stroke Recovery: Planning For Retirement And The Future

A stroke can have a significant impact on a person's ability to work, and in some cases, it may lead to long-term sick leave or even early retirement. The decision to retire after a stroke is a personal one and depends on various factors, including the severity of the stroke, the person's level of disability, and the support they receive from their employer. In this article, we will explore the topic of retiring after a stroke, including the legal protections in place for employees, the potential challenges and adjustments to returning to work, and the emotional and cognitive impacts of stroke. We will also discuss the role of rehabilitation in the recovery process and how it can influence a person's decision to retire.

What are my rights at work?

Returning to work after a stroke can be a challenging process, and understanding your rights is crucial. Here are some key points about your rights at work after experiencing a stroke:

Reasonable Adjustments

The Equality Act 2010 protects individuals from disability-based discrimination, including in the workplace. This Act states that employers have a duty to make 'reasonable adjustments' to support employees with disabilities. Reasonable adjustments are changes made to the workplace or how a job is carried out to enable a disabled person to work. These adjustments could include changing work times, providing specialist equipment, or transferring to a different role. It is important to note that employers are not obliged to offer disability leave, but time off for medical appointments may be considered a reasonable adjustment.

Communication with Your Employer

It is essential to maintain open and honest communication with your employer about your support needs and the impact of your stroke on your work. They may wish to speak with your healthcare provider to understand your needs better. Your employer should work with you to identify the adjustments they can make to facilitate your return to work.

Phased Return to Work

Consider a phased return to work, starting part-time and gradually increasing your hours and responsibilities. This approach can help you ease back into work and manage any fatigue or other side effects of your stroke.

Travel and Commute

If you have a physical disability or sight loss after your stroke, you may need support with your commute. Working from home, either full-time or part-time, could be a reasonable adjustment in such cases. Alternatively, you could explore options like funding from Access to Work or discounted public transport.

Disability Benefits

If you are unable to work due to the long-term effects of your stroke, you may be eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). SSDI is available if you have worked and paid social security taxes for five of the past ten years and are unable to work due to a long-term disability. SSI is available to individuals over 65, blind, or disabled to help cover their basic needs.

Job Search and Legal Support

If you cannot perform your previous job even with reasonable adjustments, you may need to look for alternative employment. Organisations like the Jobs Accommodation Network (JAN) can assist with job searches and legal questions related to your rights as a stroke survivor.

Remember, every person's experience with stroke is unique, and your rights at work will depend on your specific circumstances. It is always a good idea to seek professional advice if you have concerns about your rights or if you feel your employer is not fulfilling their legal obligations.

What benefits can I claim?

If you have had a stroke and it affects your daily living activities, such as cooking, washing, dressing, or mixing with other people, or your ability to get around, you should consider claiming Personal Independence Payment (PIP). In 2023, there were 74,596 PIP claimants with stroke listed as their main disabling condition. The success rate for PIP claims for stroke is 77%, compared to an overall average of 53%.

If you are out of work or on a low income, you may be able to claim Universal Credit. This benefit is replacing the following 'legacy' benefits: Income Support, income-based Job Seeker’s Allowance (JSA), Housing Benefit, Working Tax Credit, and Child Tax Credit. You can still make a new claim for Housing Benefit if you are over State Pension age or you’re in supported, sheltered, or temporary housing. If you receive the Severe Disability premium, you can also continue to claim some legacy benefits unless you have a change in circumstances. You can also claim New Style Job Seeker’s Allowance if you’ve made enough National Insurance payments.

If you are of State Pension age and on a low income, you may be able to get Pension Credit. It is separate from your State Pension and helps with living costs. Pension Credit comes in two parts: Guarantee Credit and Savings Credit. Guarantee Credit tops up your weekly income to £218.15 if you’re single. If you have a partner, it tops up your joint weekly income to £332.95. Savings Credit is an extra payment for people with some savings or a workplace pension. You can get £17.01 a week if you are single, or £19.04 if you have a partner. It is only available if you reached state pension age before 6 April 2016.

If your income is low or you are claiming benefits, you may be able to get a Council Tax Reduction (sometimes called Council Tax Support). This has replaced Council Tax Benefit in England, Scotland, and Wales. You can own or rent your home. How much of a reduction you get will depend on where you live and who lives with you, as well as your income and other circumstances.

If you are the only adult living in your home, you could get a Council Tax Discount. This is not dependent on your income. Some people, such as full-time students, are not counted when working out how many people live in a property.

If you have severe cognitive impairment, you may be able to claim a discount or complete exemption from your council tax.

If you are self-employed, you might have an insurance policy that offers to provide some kind of payment or income if you are seriously ill. Most policies cover some types of illness but not others. For example, most cover stroke but many do not cover stress. Many illness insurance policies have a waiting period before you can make a claim. Contact your policy provider to find out what you are entitled to.

What are the long-term effects of a stroke?

The long-term effects of a stroke depend on which part of the brain was affected and the severity of the damage. Strokes can cause physical, emotional, and personality changes, as well as changes to thinking, memory, and perception. Here are some of the possible long-term effects:

Physical Changes

• Difficulty with gripping or holding things
• Fatigue or tiredness, which can be caused by physical changes, medication, mood changes, depression, anxiety, or sleep disturbances
• Incontinence, which can be caused by medication, muscle weakness, changes in sensations, thinking, or memory
• Pain, including nociceptive pain (caused by actual or potential tissue damage) and neuropathic pain (caused by nerve damage)
• Restricted ability to perform physical activities or exercise
• Weakness or paralysis on one side of the body

Emotional and Personality Changes

• Mood changes, such as irritability or apathy
• Behavioral changes, including aggressiveness, disinhibition, and impulsiveness
• Depression, which is common in the first year after a stroke, especially in those with communication difficulties (aphasia)
• Anxiety, which can occur on its own or alongside depression, and is characterised by difficulty calming down, constant worry, panic, recurring anxious thoughts, and avoidance of anxiety-provoking situations

Changes to Thinking, Memory, and Perception

• Difficulty learning new skills, problem-solving, paying attention, orientation, and short-term memory
• Changes in perception, such as altered sensation on the affected side of the body, difficulty performing certain movements, impaired object recognition, and visual disturbances (e.g., hemianopia)

Communication and Everyday Life

• Speech and language problems, including aphasia (difficulty finding words or understanding speech), dysarthria (weakness of speech muscles), and dyspraxia (dysfunction of nerve connections between the brain and mouth)
• Changes in living arrangements, sexual function, relationships, ability to drive, work capacity, and level of independence

How can I get support from my employer?

Returning to work after a stroke can be challenging, and the support of your employer is crucial. Here are some ways to get support from your employer:

Understand Your Rights and the Law

Know your rights as an employee and understand the relevant laws that protect you. In the UK, the Equality Act 2010 protects individuals from discrimination, including disability-based discrimination. This Act requires employers to make 'reasonable adjustments' to accommodate employees with disabilities. These adjustments aim to remove barriers and enable employees to perform their jobs effectively. Reasonable adjustments can include changing work times, providing specialist equipment, or transferring to a more suitable role.

Communicate Your Needs

Be clear and honest about the impact of your stroke and your support needs. Keep in regular contact with your employer and provide updates on your recovery progress. Share information about the effects of your stroke, such as physical or cognitive limitations, and work together to identify adjustments that can be made. Remember that your employer cannot support you effectively if they are unaware of your needs.

Create a Return-to-Work Plan

Work with your employer to develop a comprehensive return-to-work plan. This plan should outline your support needs, the adjustments that will be made, and any changes to your role or responsibilities. Consider factors such as reduced working hours, a gradual return to work, or the need for additional equipment or aids. Involve your line manager, human resources representative, and occupational therapist in creating this plan.

Access Available Support Services

Explore the support services offered by your employer and take advantage of them. Some employers may have an occupational health service or provide access to vocational rehabilitation professionals. These services can assist you in returning to work, providing guidance and resources to facilitate your transition.

Stay Open to Dialogue and Feedback

Maintain open and frequent communication with your employer and relevant colleagues. Regular meetings or check-ins can help identify any challenges or adjustments needed. Be receptive to feedback and be willing to collaborate on finding solutions. This dialogue will also help your employer understand your evolving needs and make necessary accommodations.

Seek External Support if Needed

If you feel you are not receiving adequate support from your employer, seek external advice. Organisations such as the Stroke Association, Citizens Advice, or Acas can provide guidance and support. They can help you understand your rights, navigate workplace challenges, and ensure you receive the accommodations you need. Remember, your well-being and successful return to work are important, and support is available to help you achieve that.

What are my options for rehabilitation?

Rehabilitation is a crucial part of stroke recovery. While it may not reverse the effects of a stroke, it can help restore independence and improve physical, mental, and emotional functions. The goal is to help you relearn skills and adapt to any disabilities caused by the stroke. The type and intensity of rehabilitation will depend on your specific needs and the parts of the brain affected. Here are your options for rehabilitation:

Rehabilitation Team

Your rehabilitation team will consist of various skilled professionals who will work with you and your family to set short- and long-term treatment goals. The team typically includes:

• Doctors, such as neurologists, physiatrists, and internists
• Occupational therapists
• Speech and language pathologists
• Registered dietitians
• Social workers and chaplains
• Psychologists, neuropsychologists, and psychiatrists

Rehabilitation Services

Rehabilitation services aim to improve your independence and may include relearning essential skills for daily living. These services can be provided in various settings, including hospitals, long-term care facilities, outpatient facilities, or even at home through home health agencies. The specific services offered may include:

• Rehabilitation therapy nursing
• Occupational therapy
• Speech-language therapy
• Audiology recreational therapy
• Rehabilitation counselling
• Psychiatry/Psychology
• Patient and family education

Rehabilitation Timeline

Rehabilitation should begin as soon as possible, ideally within 24 hours of the stroke, and continue after release from the hospital if needed. For some, rehabilitation can be a long-term process, spanning months or years, depending on their condition and progress. The first three months after a stroke are considered the most critical for recovery, with most patients making significant improvements during this period. However, improvements are still possible after six months, albeit at a slower pace.

Choosing a Rehabilitation Facility

When choosing a rehabilitation facility, there are several factors to consider and questions to ask:

• Check with your insurance company to see if they have preferred providers or specific requirements for payment of services.
• Inquire about the cost of rehabilitation and whether your insurance will cover the expenses.
• Consider the location of the facility and its family visiting policy.
• Research the facility's qualifications, accreditation, and experience in treating stroke patients.
• Find out the therapy schedule, including frequency and duration.
• Ask about the availability of rehab team members, emergency handling procedures, and discharge planning and assistance.

Frequently asked questions