Before injury, people we spoke with worked in a variety of different careers and jobs. Some were able to return to these jobs, with reduced hours or doing slightly different tasks. Others were no longer able to do the same job and either changed career, did voluntary work, returned to education, remained unemployed or took early retirement. Most of those currently unable to work hoped to return to work in the future.
The length of time off work varied, depending on the type and severity of people’s injuries. Vocational rehabilitation programmes, occupational therapists, psychologists, Access to Work or similar charity schemes supported people’s return to work. Vocational courses allowed people to experience a structured work environment before returning to their job or finding a new position. People were supported to try different types of work, such as working in a supermarket or office, often unpaid, to see if they could do the job. Raymond’s wife organised for him to do a paper round, which he thought his colleagues would find amusing.
People faced different challenges returning to work. Those with brain injury talked about fatigue, problems with stamina and memory, sensory overload, concentration and mobility, and talking more than they did before injury. Going back to work was described as ‘scary’ (Raymond) for some as it differed from the safe environment of rehabilitation hospitals. Open plan offices could be busy and distracting and travelling to and from work exhausting.
Pain medication helped people with physical problems to do their jobs. People with spinal cord injuries said they needed to prioritise their health over their workload because it took longer to recover from health problems.
Some people did not always realise just how their injury might affect them and felt, looking back, they had unrealistic expectations trying to go back to work as soon as they could.
Returning to work gradually was sometimes beneficial. People worked for one or two days a week and began with basic tasks like filing and photocopying. Strategies, such as going into the office early when it was quiet, or telling their colleagues about their problems, helped. Bryan had a support worker who helped him with his job. Dave had started his own business because ‘the flexibility offered by working independently was attractive’.
Having a supportive, flexible and understanding employer was also very important to people. Some employers tried to understand how injuries affected their staff and were accommodating about sick leave and payments.
Others had less positive experiences. After Jane returned to work she was signed off on sick leave and eventually ‘let go’. Others told us that employers found it difficult to understand brain injury with its hidden effects. Christopher thought that having no visible sign of injury meant employers expected the ‘pre-injury you to go back to work’ and this was not always the case. Kenneth described feeling ‘written off’.
Colleagues could be supportive in different ways. Jack said his didn’t ‘mollycoddle’ him, Brian’s bought him a wheelchair and Sam said his got used to seeing him ‘whizzing around in a wheelchair. Jane said her colleagues patronised her by talking to her in a particular way when she was unwell with her brain injury, but failed to realise that she had recovered.
Sometimes people were unable to return to work as their injuries were too severe. Others were looking for employment but found it difficult to get, or hold on to, a job. People with brain injury told us they were unsure about whether or not to tell potential employers about their injury because of a lack of understanding about brain injury. They felt that their injuries had a negative effect on their careers and future prospects. Jane said she was ‘devastated’ at losing her job and felt a loss of identity that she thought her boyfriend shared. She said ‘I still find now that I’m asked what am I? What are my goals? I have to admit I’m at loss right now. I still don’t really know. I’d like to get a permanent job’.
Wesley thought his injury hindered his career progression. He thinks people should try to do what they’re good at after injury and not just take the first job that comes along. Juri’s injury causes him difficulties when it comes to job interviews.
Some people said they felt glad to be alive and accepted they would no longer be able to return to the same kind of work. Not going back to work could offer people the opportunity to explore new options and re-evaluate their lives. They began to think about what was important to them in life and said their views on their career and work-life balance changed. As DJ said, the ‘injury was not the end of the world’. People were also able to work in environments that they found more comfortable. For example, Jack was able to wear shorts in his new job and this was important to him after his leg was amputated. Christopher realised he no longer had to live in London because since leaving his job he can work anywhere. Some of the people returned to university and felt that studying gave them something to focus on whilst they were recovering and adapting to their impairments.
If paid employment was not possible (or financially worthwhile as salaries could interfere with insurance or compensation payments), people often worked as volunteers’ gardening, working in injury-related charities or church. This work could help increase confidence, provide a structure and purpose to their day, and the opportunity to meet other people.