Vocational Rehabilitation Stroke Study Day Mayday Hospital April 2010

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1 Vocational Rehabilitation Stroke Study Day Mayday Hospital April 2010 Croydon Community Neurorehabilitation Team Susie Kelleher Senior Occupational Therapist Michele Fowler Team Leader Principal Speech and Language Therapist 04/19/10 1

2 Rationale for Vocational Rehabilitation Enter training or work opportunities Remain in or return to existing job Identify and prepare for suitable alternative work options Plan withdrawal from work at an appropriate time Access appropriate alternative occupation or education NSF Long Term Conditions (2005) 04/19/10 2

3 People have many kinds of jobs 04/19/10 3

4 And another 04/19/10 4

5 Or even 04/19/10 5

6 Age Every year 110,000 people in England have a stroke and about 10,000 of these are of working age (16-65) (Dept Health 2005) 04/19/10 6

7 Why return to work? Financial Self esteem and maintaining roles Promote health and well being Develop skills and abilities Socialisation Something to talk about Reason to get up in the morning Back to a future 04/19/10 7

8 Back to a Future with vocational rehab What abilities do you need to return to work or regular daily activity? What legislation/guidelines are there? What schemes are available in the community? What rehabilitation can be offered in Croydon at present? What are the limitations? 04/19/10 8

9 Abilities needed Personal care Travel/mobility Planning and organisation Physical ability Communication Dexterity Computer skills Many varied specialist skills related to job 04/19/10 9

10 Legislation/Guidelines Disability Discrimination Act 1995 (DDA) Incapacity Benefit Reform 2003(DWP) Employment Support Allowance Fitness for work GP sign off National Service Framework for People with Long Term Conditions 2005 Health Care for London Standards for Stroke 04/19/10 10

11 What are the factors that predict a return to work following stroke? Vestling et al 2003 found that: Those who can walk independently Have non manual jobs Have preserved cognitive abilities are more likely to return to work 04/19/10 11

12 Other factors Intrinsic factors - Personality (motivation, self confidence, self esteem and assertiveness, emotional vulnerability) Beliefs and attitudes about illness and recovery 04/19/10 12

13 Other factors contd Social barriers Benefits system Job market Attitudes towards stroke Others understanding of hidden impairments 04/19/10 13

14 What services are there in Croydon to help stroke survivors get back to work? Community Neurorehabilitation Service - different pathways if in employment or unemployed 04/19/10

15 If patient has a job that they want to go back to: Assessment physical, communication, cognitive Understanding of the demands of their job How do these match up? 04/19/10

16 04/19/10 16

17 Intervention Work site visit and liaison with manager, HR, Occupational Health Anxiety management Travel practise Report and recommendations for adaptations to role (DDA) 04/19/10 17

18 Case Examples /19/10 18

19 What is out there to help people find work? Jobcentre Plus Specialist VR centres e.g.rehab UK, Wolfson, Banstead Place Volunteer Bureau Croydon Employment Support Service 04/19/10 19

20 Job Centre Plus Schemes DEA for those on Jobseekers Allowance Reed (in Croydon) for those on ESA Work prep Work step New Deal for the Disabled Access To Work Job Introduction 04/19/10 20

21 The future Longer term follow up to troubleshoot problems Resolving problems once back at work Education to employers and others Develop wider interagency working Resources for work skills assessment and intervention Provide evidence for long term effectiveness 04/19/10 21

22 The Bottom Line Return to work after stroke should be an integral part of rehabilitation and not an afterthought. 04/19/10 22

23 References Department of Health (2005). National Framework for long term conditions. London: HMSO Department of Health (2005). The Disability Discrimination Act 2005 London: HMSO Radford K.A., Walker M.F. (2008) Impact of Stroke on Return to Work, Brain Impairment. Vol. 9 Number Vestling M. et al (2003) Indicators for return to work after stroke and the importance of work for subjective well-being and life satisfaction Journal of Rehabilitation Medicine 35, The Stroke Association (2006).Getting back to work after stoke. London: 04/19/10

24 Some may not need to work again but it is not always about money 04/19/10 24

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