Section 5. Returning to work after a brain injury. Vocational rehabilitation

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1 Section 5 Returning to work after a brain injury Section 5 Vocational rehabilitation Returning to work is a huge step. There are many options for those who are ready and it is important to get support in preparing to return to work. The combined effects of the physical, cognitive and behavioural changes described so far mean that many will be unable to return to work, at least to their former occupation. People will need to consider a range of options according to the extent of their difficulties. These could include returning to work with reduced hours, retraining for alternative work, or undertaking supported or voluntary work. The most severely disabled are unlikely to be able to manage a return to work and might consider other options such as attending a day services centre. (See Section 7 p.115 for useful contacts.) All the back to work research that has been carried out in recent years has consistently found that a lack of vocational rehabilitation is a major cause of people with severe brain injuries not being able to obtain or maintain employment. They may attempt to return to a job that is no longer suitable because they have not received advice on planning their return to work and the required supports are not in place. It is important to get support in preparing to return to work. A vocational assessment is recommended. In some areas, the injured person can get help from the NHS in accessing vocational rehabilitation through the community brain injury rehabilitation teams, particularly in relation to occupational therapy. Alternatively, contact the local JobCentre Plus and ask to see a Disability Employment Advisor, or get in touch with Momentum for advice. The world of work places enormous pressure on people and it is important to consider how this will affect the individual. The Brain Injury Handbook 73

2 Work performance problems Poor concentration and attention leading to distraction How many times do we have to focus or shift our attention in everyday life let alone a busy workplace? People with brain injury who had formerly to maintain and respond to more than one set of instructions or ideas may find themselves now unable to tolerate distraction. Long shifts where sustained concentration is required could also prove problematic. Poor memory Poor memory can lead to difficulties mastering new types of work. Even mild memory loss for managers, teachers, lawyers or secretaries can prove too high a burden to sustain employment in their fields. Slowed information-processing/thinking Slowed information-processing can lead to difficulty understanding complex information and subsequently acting upon that information, e.g. following instructions given quickly, carrying them out or relaying them to others. The above problems, either individually or in combination, can cause a permanent inability to perform as required in a job. Executive difficulties Inflexible thinking Seeing things in black and white can lead to difficulty following procedural rules and appreciating options or another s point of view. The person may seem to be showing traits of an anti-authority nature, whilst rigid thinking will often lead to argumentative behaviour that can prove irritating to workmates and supervisors. Difficulty in planning Difficulty in organising, problem-solving, making decisions, using judgement and initiative can all lead to an inability to work independently or in any work activity that requires multiple and complex activities. However, people lacking these skills may be able to find employment in jobs that have a routine structure. Loss of initiative, drive and spontaneity Loss of initiative can lead to an inability to carry out work-related tasks without being prompted. Anxiety Anxiety can lead to a loss of confidence and, possibly, to erratic behaviour. Low tolerance of frustration/noise/stress/others Low tolerance can lead to a quick temper, becoming easily upset and difficulty with working to deadlines. Fatigue or tiredness Tiredness can often make other problems seem worse. Poor concentration will contribute to mistakes and fatigue may result in days off work to recover. 74

3 Returning to work after a brain injury Section 5 Lack of insight and awareness Lack of insight and awareness can lead to unrealistic expectations of work capability and a possible insensitivity to others. Poor interpersonal skills at work, such as impulsiveness, mood swings, etc., can all be problematic. Reduced activities of daily living Activities of daily living relate to a person s ability to manage their everyday life, such as getting up on time in the morning, cooking, shopping, self-care, time management, managing money and transport, and so on. A reduction in these abilities can result in late or unreliable attendance. (See p for information on Momentum s vocational rehabilitation programme.) What factors influence a successful return to work? A number of factors impact on a successful return to work, including: The nature and severity of residual difficulties, particularly the degree of self-awareness and how well the person has adjusted to their disability The nature of the pre-injury occupation The timing and management of the return to work The employer and co-worker support Success in obtaining or sustaining employment depends on the person being able to do the job they must have the cognitive and social skills that the job demands. When considering a return to work, it is very important to be realistic about this and to take advice from the rehabilitation team. Unrealistic expectations due to reduced insight can present a formidable barrier to a successful return to work. There is no doubt that the degree of self-awareness and adjustment to difficulties is a critical factor in recovery. People who have accepted their difficulties practise strategies to compensate and adapt. They open their minds to alternative suggestions for employment if a return to their pre-injury occupation is not feasible. In short, a person must accept their new circumstances before they can learn to use alternative strategies and realise success again. It is extremely important to learn social skills to initiate a good working relationship with colleagues. Research has consistently shown that poor interpersonal skills are the biggest barrier to a successful return to work. The Brain Injury Handbook 75

4 Returning to your pre-injury occupation When thinking of returning to a previous job or position, there are many options to consider. Students Students may also experience particular problems returning to study. Even a mild injury can have a significant impact on students because of the demands on attention, memory and speed of thinking. Allowances may not be made because teachers may not be aware of the difficulties. Often, though, there is a student disability resource centre that can support the student. Severe injury may prevent continued study in higher education, which can be very difficult to accept since career aspirations can be affected. Management and professional positions Even a mild injury can have a serious impact on the executive skills required in the workplace. Professional and senior executives will have particular problems and face great difficulty returning to their pre-injury occupation for, as previously outlined, the executive skills are the ones most likely to have been impaired. Having to consider routine work can be devastating for an executive used to performing a variety of complex and responsible tasks. However, it need not be boring. A variety of jobs are possible if the opportunity is present to impose structure and diversification. Self-employed In the case of people who were previously selfemployed, it is important to be realistic and if a return to work does not seem viable, advice should be sought on whether it might be sensible to sell the business or perhaps employ someone else to run it. 76

5 Returning to work after a brain injury Section 5 Is it possible to go back to work too soon? It is quite natural to want to go back to work as soon as possible. However, people often make the mistake of thinking because they are feeling physically able to return to work, that they will be able to cope with the wider demands of the job. Many jobs are lost because the person returns to work too soon. Typically, they will overestimate their abilities and underestimate the effects of fatigue on performance. Many people expect to be able to work a full day straightaway, and finding out that this is not possible for various reasons can really damage confidence and self-belief. It is therefore an essential part of the work of any rehabilitation team to help the person identify the most suitable type of future job and the optimum build-up of hours over a period of time once all factors are taken into account. The Brain Injury Handbook 77

6 How can a return to work be managed? A gradual return to work is important, as are easier working conditions and tasks. This will allow the person to build up their stamina and capabilities; a situation that may need to continue for quite an extended time. Ideally, people returning to work should start with just a few hours per day, gradually building up time as stamina improves. However, before a gradual return to work is considered, there should be evidence that the injured person can maintain concentration and have sufficient stamina to work safely and effectively for a specified period in the working day. Easier working conditions may include a quieter working environment that is free from unnecessary distractions. Consideration will also have to be shown for any physical disabilities wheelchair access, adapted computers, etc. Such special aids can be obtained from the Disability Employment Advisor, based at the local JobCentre Plus, under the Access to Work scheme. Having someone to act in a mentoring capacity may be useful. While an employer or line manager might not be able to find the time to devote to this, having somebody take on this role might be mutually beneficial. None of us are the best judges of how we are managing with new tasks in our work. This is of particular relevance to somebody with brain injury, so the employer just has to use common sense in dealing with the situation. The advice to an injured person looking to reenter the employment market following brain injury is that it is often better to start off with some voluntary work or maybe a short college course, where strengths and weaknesses can be identified early. If the person is still based within a hospital or neurological centre, the occupational therapist will be able to refer them to the local Disability Employment Advisor who, in turn (depending on locality), can recommend Momentum as appropriate. Ultimately, a successful return to work depends on: A good match between the job and current abilities/skills Sufficient stamina to get through the working day or hours agreed Attention and concentration adequate to carry out work tasks Acceptable interpersonal/social skills Mentoring/job coaching 78

7 Returning to work after a brain injury Section 5 How can my employer and co-workers provide support? What about those who are unemployed pre-injury? The need for support from both a person s employer and co-workers cannot be overstated. It is very important that, at the very least, the employer or line manager or equivalent knows a little about the longterm effects of brain injury. With this knowledge, they will be able to provide support when and where necessary. Like many people, employers tend to view disability as a physical condition. When they see no obvious outward signs, such as a wheelchair, they might assume the person fine. Brain injury is often referred to as a hidden disability, and as such can easily lead to misinterpretation. For example, loss of initiative or fatigue can be interpreted as laziness. Additionally, the injured person may be asked to stay late at work. Their commitment may lead them rarely to refuse such a request, but the required tasks may not be completed to a satisfactory standard. Because of these examples of potential misunderstanding, Momentum has, for example, put in place a number of job coaches whose role is to educate and support the employer as well as the employee with a brain injury. Finding work is difficult enough for anyone, but there is no doubt that it is harder for people who have had a brain injury. The injured person may be unable to complete an application form pre-interview or may have difficulty sufficiently impressing an interviewer; they may suffer from a reduced speed of thinking or not have regained sufficient social/interpersonal skills to be able to undertake a successful interview. Make contact with the Disability Employment Advisor at the local JobCentre Plus when the time is right. They can be of invaluable help. Of course, starting work may be even more difficult for a young person who has not yet chosen a career or had a job pre-injury. Choosing a suitable career or occupation without prior experience of the employment market is an incredibly daunting task. Support is available from the local Connexions or Careers Scotland Service or from the JobCentre Plus Disability Employment Advisor. Alternatively, get in touch with Momentum. (See Section 7 p.115 for contact details.) The Brain Injury Handbook 79

8 Vocational rehabilitation at Momentum Momentum provides vocational rehabilitation programmes that assist people with brain injuries to move into employment or further education and training. Assessment Before a person begins Momentum s vocational rehabilitation programme, a comprehensive assessment is conducted. This involves a discussion with the person and their family to ascertain problem areas, aspirations for the future and financial concerns. This is followed by a formal neuropsychological assessment of cognitive strengths and weaknesses. This is an extremely important part of the assessment as it forms the foundation upon which the person s rehabilitation programme is built. It is the first stage in understanding the impact of a brain injury on their working life. A clear assessment is reached and a suitable programme developed that takes account of the individual s strengths as well as providing strategies for any areas of weakness. 80

9 Returning to work after a brain injury Section 5 Momentum was the first organisation in the UK to provide tailored vocational rehabilitation programmes for people with brain injury. Momentum offers a highly-structured programme designed to address the individual s needs, helping the person to regain social and economic independence. Great emphasis is placed on supporting people in rebuilding their self-confidence and, where necessary, to positively accept the person they are now as opposed to the person they once were. Central to this is helping them gain more insight into their difficulties so they can use compensatory strategies to enable them to achieve their full potential. As detailed earlier, the family plays a crucial role in rehabilitation and great value is placed on involving family members in the programme. At Momentum, the person with a brain injury, family and staff work in partnership to ensure the best approach in helping the person to achieve their goals. It is recognised that although the fundamental consequences of brain injury are similar, each person and the effect of each brain injury are very different. Services offered by Momentum for vocational rehabilitation Returning to work, or going to work for the first time, following a brain injury is a daunting task. Momentum has established services in England and Scotland where the primary objective is to assist people in getting a job following a brain injury. This work may be with a person s former employer or may involve retraining and finding an alternative occupation. Momentum offers support to employers and employees and also helps families to consider alternative choices. Momentum will help find the most appropriate work as well as offering help and support once a job has been found. Momentum s vocational rehabilitation programme for people with brain injury is divided into three main elements: 1 Assessment and vocational planning 2 Work preparation and work experience placements 3 Job-searching and support in employment The Brain Injury Handbook 81

10 1 Assessment and vocational planning: core elements Assessment and vocational planning is largely centre-based and consists of a number of elements. Cognitive remediation In this element, people are given exercises to improve cognitive abilities such as memory, attention, thinking, organising and planning. As well as trying to build upon existing skills, people are introduced to strategies that will help compensate for problems arising from their brain injury. They are encouraged to use these strategies across all situations until they become second nature. Work-related social skills Loss of good social skills resulting from a combination of cognitive and personality changes can be a crucial problem for people who have suffered a brain injury. This element is designed to raise self-awareness and develop social skills in a person s personal and professional lives. It also provides a forum for peer support. Not only do people assist each other within their team, but they also learn a great deal from each other in these sessions. For example, an individual with self-centred tendencies, inappropriate behaviour or poor social skills might recognise this fault more easily if witnessed in another. Issues that are covered include how to get on with others, how to develop personal communication, proper work attitudes, etc. These sessions also develop people s practical skills for everyday life including how to look after themselves, e.g. the dangers of alcohol, the importance of having a good diet and exercise, and preparation for the workplace in terms of time-management skills, problem-solving, interview techniques, etc. Vocational profiling and guidance People are supported in exploring their vocational strengths and areas of difficulty, and receive guidance regarding the best vocational options that they can consider in the following modules: IT training Counselling and behaviour management IT training People have the opportunity to learn a range of modern computer packages and work towards City & Guilds Computer Literacy and Information Technology (CLAIT) and European Computer Driving Licence (ECDL) qualifications. This is an important aspect of Momentum s vocational rehabilitation programme. It not only further develops employment opportunities but also demonstrates to a potential employer that the person is capable of learning new skills. Apart from increasing work potential, IT training helps improve a person s self-esteem. People who previously had little or no computer experience have not only talked about the feeling of achievement in relation to their new-found computer knowledge, but have been delighted with the increase in confidence that getting to grips with IT has provided. Computer training is very useful in a number of other respects. It can be helpful for those who have problems with spelling and writing, can reveal potential problems in the workplace such as following instructions and attentiveness, and it can also identify whether people are able to transfer the skills that they have learned into different situations. 82

11 Returning to work after a brain injury Section 5 Counselling and behaviour management This is offered to those who are experiencing particular problems in adjusting and/or who have particular behavioural problems such as anger rages. 2 Work preparation and work experience placements: core elements This element of Momentum s vocational rehabilitation programme involves the person gradually being exposed to the workplace under the supervision and guidance of their job coach. In tandem with this, sessions continue with the person in the centre to address individual needs as well as building upon and consolidating skills. Work placements are a vital component of Momentum s programme. Not only do they allow a person to explore vocational options but, importantly, they: mentor them and they will also be allocated a job coach who will arrange work placements and provide ongoing support in the workplace. The ultimate goal is to establish the person in full- or part-time employment, voluntary work or in further or higher education. Realistic job-matching Realistic job-matching involves on-the-job training and follow-up support. Great emphasis is placed on employer/co-worker education and support as well as in developing a receptive and supportive work environment for the person with a brain injury. Our job coaches will work to find suitable vacancies and liaise with the employer to support people in their work. Momentum can offer help in preparing people for the workplace if required or simply support and advise on how to undertake an interview and best present one s skills and abilities to an employer. Allow people to begin to experience normality again and build up their confidence in a supportive environment Uncover potential difficulties not seen in the centre and help people and their families to gradually understand the effects of brain injury on employability Enable people to identify a realistic future occupation 3 Job-searching and support in employment: core elements The final element of the programme focuses on finding suitable jobs for people linked with the type of work experience placements undertaken. Throughout the programme, people are assigned to a key worker who will The Brain Injury Handbook 83

12 Momentum s community services In addition to centre-based programmes, Momentum operates successful community services in the West Midlands, North East England, Grampian, South Lanarkshire, Glasgow, Ayrshire and the Scottish Borders. The following information describes Momentum s community services in broad terms. However, there are variations in services delivered depending on the area. The aims are: To deliver a community-based individual rehabilitation service, based on the social model of disability To deliver a flexible programme based on individual needs and identified achievable goals To enable the individual to have an integral role in programme-planning, goalsetting and the evaluation process To deliver a service plan with identified timeframes for goal achievement To deliver the service through a social worker, clinical psychologist and community rehabilitation worker, each with specialist knowledge To deliver the service on an individual and/or group basis to meet identified goals To deliver the service in collaboration with statutory organisations, providing a seamless service for the individual and carers To enable the individual to have an Individual Programme Plan with identified achievable goals and actions To deliver the service with the involvement of family/carers in the initial assessment process and in developing the Individual Programme Plans 84

13 Returning to work after a brain injury Section 5 How is the community services programme delivered? The community services programme is based on three phases of delivery: 1 Assessment/baseline phase This consists of a clinical interview with the community integration team leader and clinical psychologist. This covers a home assessment to see how the person lives in their own home and a community assessment that looks at how the person lives within their own community. This assessment also establishes relationships with the community rehabilitation workers and other members of the team. 2 Group phase This is based on group and individual work with the community rehabilitation workers. 3 Individual programme phase This varies depending on individual need but is based around transferring skills and applying strategies. Areas covered are brain injury awareness, leisure exploration, community social skills, life changes since brain injury, community living skills, as well as access to a cognitive strategies group and a family and carer group. Domiciliary care services Momentum is registered with the Care Quality Commission (CQC) in England and Social Care and Social Work Improvement Scotland (SCSWIS) to offer domiciliary care services in the home, with community rehabilitation workers offering long-term, one-to-one support. The focus of these services, which are tailored to the individual s needs, is to promote independence and to facilitate people s wishes to live at home, with support, and to remain active in their local community. Brain Injury ad 8/8/11 15:16 Page 1 Q.C. Bill Braithwaite Brain and Spine Injuries The Fight for Justice by Bill Braithwaite QC Personal Injury Barrister of the Year 2010 UK Acquired Brain Injury Forum Lawyer Innovator of the Year 2010 Since 1992, when he became a QC, Bill Braithwaite has been a consistently progressive commentator on major issues arising in catastrophic brain and spine litigation. Bill has a track record of innovation (backed by solid evidence), in relation to patients who have sustained catastrophic injury. He represents only claimants who have sustained catastrophic brain or spine injury, regularly finalising claims on an annual basis worth in excess of 50 million He has represented well over 1,000 claimants who have suffered such injury (more than any other UK lawyer) He is joint editor of Medical Aspects of Personal Injury Litigation and was Consultant Editor of Kemp & Kemp on The Quantum of Damages ( ) He travels the country seeing injured people and their families, at their convenience He believes passionately in the rights of those who have suffered catastrophic injuries, and their families Telephone: nd edition now available as an ebook To order a copy please The Brain Injury Handbook 85

14 The Queen Alexandra Hospital Home The Queen Alexandra Hospital Home that I dared not to dream of some months ago Specialist provision includes: or Brain injury 3.indd 1 15/12/ :56:10 1 Sewardstone Close Sewardstone Close is a purpose built sixteen bedded unit for people aged 18+ with an acquired brain injury. We offer residential and nursing placements including respite services and intermediate placements to clients with all different levels of physical or cognitive ability. For more information please contact Jane Heath. Enable Care 1 Sewardstone Close Sewardstone Road Waltham Abbey London E4 7RG enable 86 DC H EC Rehab Ad 120x177.indd 1 18/07/ :36

15 Returning to work after a brain injury Section 5 Shakila Rani's new-found confidence with Momentum Shakila Rani attends Momentum's brain injury service in Newcastle. At the age of two, she was diagnosed with encephalitis, an infection that causes inflammation of the brain. Now aged 19 years, she is hoping to gain employment as a receptionist. Since leaving school, I have found work hard to come by. I was asked to visit Momentum in Newcastle because it could help me gain the skills required to find work. At first I was uncomfortable with meeting new people, but I soon realised that the Momentum team could really help me. The day I started at Momentum was difficult and I felt shy and extremely nervous. During the first week we had lots of fun activities to do, which helped me get to know the people and staff. I soon made friends. My time at Momentum has involved cognitive training skills, brain injury awareness and stressmanagement sessions, as well as literacy, numeracy and IT. I've also received guidance on creating my CV and job-searching. My confidence has increased to a point where I feel much more prepared for work. I have been on work placements at local law firm Muckell LLP and in the office of the charity Disability North. At Muckell LLP I worked on my own and as part of the reception team, greeting clients, preparing and serving refreshments and organising and clearing meeting rooms. In addition, I worked in the post room and demonstrated that I was capable of working hard and able to complete a range of tasks independently. Whilst working with Disability North I supported the administration team. I also answered the telephone and dealt with customers. Alongside my work experience placements, I organised a bowling night as part of an enterprise project at Momentum. I designed the posters and tickets for the night using IT skills I had learned and I delegated tasks to others. This was very successful and we raised 380. This event demonstrates how I have developed my personal skills during my time with Momentum. I displayed the ability to organise myself and others, and also to work to deadlines to ensure all aspects of the event came together in time to produce a great night. Now I am working with my job coach to source an adult learning course in literacy and numeracy and working towards my goal of gaining employment as a receptionist. Momentum was a big step for me, but as my story shows, it was the best step I could have taken. The Brain Injury Handbook 87

16 Life after a stroke Charlie Wilson had a stroke in June 2008 which left him unable to walk, but with support from Momentum in Aberdeen and his family, Charlie is now back on track. He gives the following account of his experiences. I woke up early one morning feeling really unwell, dizzy and was unsteady on my feet. After being sick a few times, I went back to bed but everything was spinning around me. My wife called NHS 24 and a doctor came out to the house. My vision was blurred; I was incoherent and talking complete nonsense. The doctor quickly realised that I'd had a stroke. An ambulance was called immediately and I was rushed to Aberdeen Royal Infirmary, where I had a CT scan and received an injection for the blood clot in my brain. One of the consultants has since told me that had the injection not been administered when it was, I pretty much had an hour or so to live an extremely sobering thought. I awoke from unconsciousness in the recovery room of the hospital, feeling totally disorientated. A lot of medical people seemed to be milling around but my wife came in and reassured me. I had no sensation down the right-hand side of my body and couldn't walk. I lay in the hospital for the first few days thinking that I would never walk again. However, the consultants were very positive and with plenty of physiotherapy and determination to succeed, I made gradual improvements and eventually got back on my feet. 88 Initially, I also had real difficulty in pronouncing and remembering words. I had speech therapy whilst in hospital and I'm now able to talk reasonably well, although I still forget words. My eyesight was also completely gone from the right side of both my eyes and this is still the case today. However, my main problems are with memory and concentration difficulties, which have had an effect on my communication and confidence. Before my stroke I worked as a bar manager for a small group of local hotels and also assisted many businesses with commercial finance requirements. Prior to that I worked for a large bank as a commercial manager for around 20 years. As a result of my stroke I couldn't return to my previous job but I was looking to return to work in some capacity because sitting at home all day watching daytime television was not for me. My occupational therapist told me about Momentum, which helps people with rehabilitation following a brain injury and offers support in returning to work. I was open to trying anything to improve my life and started on Momentum's Pathways programme in Aberdeen in November of There, Momentum taught me how to manage the effects of my brain injury. The staff showed me ways to improve my concentration and

17 Returning to work after a brain injury Section 5 memory skills and taught me various other helpful techniques. Everybody's brain injury is different so it was a case of choosing what worked best for me. I now keep a diary and note down or record things I need to remember on my mobile phone. My wife then helps me to formulate everything on the house calendar. Momentum helped me to rebuild my confidence and to have a more positive outlook. Through its courses I also achieved some Scottish Qualifications Authority (SQA) qualifications in IT and went on to study for a European Computer Driving Licence. Helping to put together one of Momentum's newsletters also gave me a project to focus on to tune-up my computer skills. I organised some voluntary work for myself within the office of the Women's Royal Voluntary Service in Inverurie. Although working only one day a week, I could combine it nicely with Momentum and it allowed me to introduce myself gently to a working environment in order to gain more experience. Following that, Momentum helped me to look at my employment chances and to identify what suited me. It also provided assistance with my CV and sorted out a work placement with Aberdeen University in its accounts payable department. I was on placement for six weeks, two mornings per week and Momentum staff visited me on a weekly basis to make sure everything was going well. During my placement, I was interviewed for the post of a part-time accounts payable assistant and despite being one of many applicants, I was delighted to get the job four weeks after my placement started. I have now progressed on to a new job with the university working fulltime as a research grants co-ordinator. It is tremendous to be back working. It gives me focus in my day-to-day life and gets me out of bed. After my stroke, I had so much time on my hands but having a job helps to fill the days and gives me purpose. I have received incredible support from a number of organisations including Momentum and, without them, I would have been lost. I have also had a lot of help from JobCentre Plus. Finally, the support of my wife has been enormous. She has coped fantastically with the total upheaval of our family life, financial changes and probably changes to my own personality. I'm managing well in my new job but I know that Momentum is always there, if I need it. The Brain Injury Handbook 89

18 Person centred, flexible and comprehensive care... for people recovering from acquired brain injury and neurological disorders. Oak Farm Clinic, part of the Select Healthcare Group, comprises a 35-bed unit, a four bedroom single storey Lodge and a three/four bedroom bungalow. Situated in Taverham on the A1067 Norwich to Fakenham Road it is approximately five miles from Norwich city centre and within easy reach of all its amenities. It is registered as a Care Home (with Nursing) for Adults with Physical Disabilities with the Care Quality Commission*. The Unit provides a comprehensive service to clients recovering from acquired brain injury and neurological disorders. The philosophy of care is through a structured programme of rehabilitation and non-aversive where appropriate, long term support or planned discharge. Our approach to care also embraces social, psychological and recreational needs of service users and these are integrated into the care plan. The care provided is flexible and person centred, to ensure a structured and effective rehabilitation. The care is delivered through a multi-disciplinary team, comprising registered nurses, medical practitioner, rehabilitation assistants, occupational therapists, physiotherapists, speech and language therapists, neuro-psychologists and a consultant neurologist. The Unit is committed to partnership working with agencies in the statutory and non-statutory organisations. We engage proactively with our stakeholders to ensure that the care and needs of our service users are never compromised. We regard each of our service users as an individual, and through understanding their unique needs, personality and medical history, we strive to promote a programme of rehabilitation with health outcomes that enhance their quality of life. In addition, we consistently aim to maintain the dignity and self-respect of our service users, even in the face of challenging behaviours, which can be a feature of brain injury. Oak Farm Court Opening Summer 2012, Oak Farm Court is a 17-bed, two storey unit situated on the opposite side of the road to Oak Farm Clinic. The unit will be providing the same high standard of care for adults with acquired brain injuries and degenerative neurological conditions. If you would like to find out more why not pay us a visit, we would be delighted to show you around and answer any questions you may have, or alternatively please contact the Registered Manager below. Mrs Meryl Rushmere Registered Manager Tel Fax Web: Oak Farm Clinic Neuro Rehabilitation Unit, 274/6 Fakenham Road, Taverham, Norwich, Norfolk NR8 6AD *A copy of the last inspection report is available on request. 90

19 Returning to work after a brain injury Section 5 At Brain Injury Experts our focus is you and your family. Our objective is to help you achieve the best possible recovery -- physically, emotionally and financially. Our areas of expertise Road Traffic Accidents Coach Accidents Cycling Accidents Pedestrian Accidents Accidents at Work Accidents in Public Places Sports Injury Claims Accidents where a child has been injured Complementary Services Court of Protection/Deputyship Independent & Financial Investment Advice Help with Educational Needs Client Contact -- always available to answer your questions Benefits Advice We have a national team of experts spread across the country. Get in touch today to arrange a free initial consultation, and we ll take it from there. CALL FREEPHONE Calls from UK landlines are free. Calls from mobiles will be charged and costs may vary depending on your service provider. Simpson Millar Simpson Millar Solicitors LLP solicitors is a limited liability partnership registered in England and Wales with registered number OC Our registered office is: 27 St Paul s Street, Leeds LS1 2JG. Vat number: Regulated by the Solicitors Regulation Authority: Registration No: LISTEN UNDERSTAND ADVISE Brain Injury Specialists I could ask any question whenever and as often as I liked, never feeling I was an inconvenience and always feeling the people I was dealing with genuinely cared Iain Munro - Client Woking Guildford Godalming The Brain Injury Handbook 91

20 Giving back through volunteering Former Momentum service user Sean Maycock knows that there is a way forward after a brain injury. Now, he is giving something back to Momentum by volunteering at its brain injury programme in the West Midlands. Sean started his working life as an apprentice bricklayer with Anglo Holt Construction Ltd in Bromwich in the West Midlands. Over the following 11 years he worked his way up to be a site manager, working throughout the country for an extensive blue-chip client base. During this time he married and had two sons. His professional responsibilities grew and before long his career was firmly within the ranks of management. On 4 June 1999, whilst spending a rare child-free night out with his wife, Sean had a stroke. After eight weeks of initial recovery in hospital, he returned to a strong family base. His employer had kept in constant touch. Sean says, They played a large part in my rehabilitation in whatever way they could, be it social contact, private physiotherapy or a private health insurance policy. Their support was immense. Sean tried returning to work that year. It would prove to be too soon. He developed epilepsy as a direct result of his brain injury, and he faced a family tragedy when his father died, also having had a stroke, in May Sean continued to receive physiotherapy and occupational therapy but he was struggling with cognitive processes such as making decisions, problem-solving, day-to-day planning and retaining information. Sean went on to join Momentum's vocational rehabilitation programme in the West Midlands. Following successful completion of the programme, he rejoined Anglo Holt Construction Ltd. Later, in the summer of 2005, having been free from epilepsy for three years, Sean regained his full driving licence, and in June 2006 purchased a car. He recalls how the world seemed to be my oyster. In 2009, Sean decided to return to Momentum but this time as a volunteer. Now I would be able to give something back to people in the same situation as I was six years previously. In February 2009 I started voluntary work at Momentum West Midlands, sharing my experience with people who needed to talk. I am someone who just listens, assuring them that there is a way forward. 92

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