Living Life Beyond a Stroke

Living Life Beyond a Stroke

The Odds on Stroke 

There are not too many people in the world who have not heard of stroke. Sadly, too many people have had personal experience of stroke, either themselves or through a loved one. The Irish Heart Foundation (IHF) estimates each year approximately 7,500 people in Ireland have a stroke. Additionally, an estimated 30,000 people are living in the community with disabilities as a result of a stroke. 

Through awareness campaigns, policy solutions, improved recovery outcomes and support groups, the IHF did see a reduction in these numbers, evidenced by the 2016 national audit of stroke services carried out in partnership with the HSE National Stroke Programme. 

Spreading Awareness—FASTFace, Arm, Speech, Time

However, in 2021, an MRBI poll showed only one in five people in Ireland knew the most vital action to take in the event of a stroke—with 43% unaware of any of the four key signs. 

In response to the figures, which coincided with a re-launch of their Act F.A.S.T. campaign, the Irish Heart Foundation voiced concern at the “shockingly low” awareness of stroke as a medical emergency. 

Do You Know What a Stroke Is? 

A stroke happens when blood flow to the brain is stopped

Each person’s experience of stroke is unique to them, as are their recovery and potential for returning to work. However, with improving recovery outcomes, more stroke survivors are achieving a return to work. 

There are a number of influencing factors that can either enable or disable a person’s recovery. These include but are not limited to: 

  • Fast access to appropriate healthcare 
  • Ongoing liaison with support services 
  • Workplace environments and potential accommodations 
  • Job demands 
  • Employer flexibility 
  • Personal circumstances (including age, family support, and finances) 

Is a Return to Work After a Stroke Possible? 

Yes, it is possible.
Yes, there are challenges, but it can be achieved.

In the 2016 National Survey of Stroke Survivors, the Royal College of Surgeons conducted  focus groups with stroke survivors to discuss their challenges in planning a return to work. They shared the most common problems limiting ability to work were: 

  • Mental fatigue (84%) 
  • Physical fatigue (78%) 
  • Difficulties thinking (78%) 

When Is the Right Time to Return to Work After a Stroke? 

The answer is unique to each individual and sometimes there are opposing thoughts between healthcare professionals and the individuals themselves. 

It is difficult to strike the right balance between returning to work prematurely or delaying a return to focus on recovery. 

Financial considerations may influence when a person returns to work, particularly if they are the principal earner for the household. Other influences on the timing to return to work include self-perception, motivation, a person’s perceived value of their work, social relationships within the work environment and family support—are family supportive or over-cautious and opposed to a return to work? 

What Helps With Recovery After a Stroke? 

Participants in the focus groups described vocational rehabilitation as being of “critical importance” and being inspired by familiar places such as the workplace to engage in the rehabilitation process. 

So, my question for you is this: How can your organisation provide this inspiration to increase employment outcomes for stroke survivors? 

Returning to work after a stroke can be a complex process, BUT—whether you are an employer, manager, or team lead, or you are working across the various disciplines of Human Resources, Health and Safety or Employee Wellbeing etc.—have you considered that a return to work can be part of a person’s recovery

Are you unsure where to start? I have put together some suggestions to help you: 

  1. Open and honest communication—Supportive employers and work colleagues are key to facilitating a return to work. 
  2. Patience—A gradual phased return to work is particularly important. Bear in mind the possibility, during their reintegration to work, stroke survivors may lose confidence in their ability to re-engage with their job and/or colleagues. 
  3. Understanding—Do you understand what influencing factors impact stroke survivors’ decisions? Eg. During recovery and to maintain financial security, stroke survivors often engage with and may rely on the social welfare system, which is confusing to navigate. There may be a fear factor or resistance about returning to work too early and thereby losing benefits. Or they may return earlier than they should, as they are under financial pressures but unable to sustain work and thus increase their risk of becoming unwell again. 
  4. Reasonable Accommodations—What environmental workplace adaptations and task adjustments can help facilitate and sustain a return to work? 
  5. Diversity and Disclosure—For some people, there is uncertainty regarding the disclosure of having a stroke to employers. Although sharing information regarding stroke would help identify appropriate adaptations and enable colleagues’ to be understanding and supportive of workplace difficulties from the perspective of the person with stroke, there is the possibility that an employee may be perceived differently or excluded. What does your organisation do to prevent this? 

How Can Employers Adapt? 

As workplaces open up again and staff return to physical attendance, a revision of health and safety policies is required by the Transitional Protocol January 2022 (updated version of the Return to Work Safely Protocol 2020). 

Are there policies or training provided in your place of work to support a person who may be having a stroke? Does everybody in your organisation know the following?

  1. Stroke is an emergency situation. 
  2. If you recognise any of the signs of a stroke, call 112 or 999 immediately. 
  3. Effective stroke treatment is hugely time dependent. 
  4. The faster you act, the more of the person you save

While stroke is looked upon as a disease of the older person, did you know that over a quarter of the cases in 2020 were in people aged under 65 years of age? 

Taking Care of the Carers 

In talking about stroke and return to work, it is equally important to understand the recovery process. Every stroke survivor needs additional help whilst recovering, and spouses or other family members are heavily relied upon initially. This can require spouses/family members to transition from full-time employee to part-time or full-time employee with caring responsibilities. 

Census 2016 reports 195,263 people (4.1% of the population) provided unpaid care to others, an increase of 8,151 (4.4%) from 2011.* 

Is this addressed in your workplace? Perhaps it has not been discussed before. It is quite possible colleagues in your workplace are looking after family members, keeping it to themselves, but at risk of increasing stress in their life as they try to keep everything going. 

Imagine the positive impact on the lives of your employees if a temporary accommodation could be provided, by which they could share their need to provide care for their loved one, be able to cut back on work for a while and then return in full when they were able. 

June 7–13th is National Carers Week. Do you have guidelines in place for colleagues who may have to step into a caring role for a short while? It is a situation I have supported a person through in the past, I am sure it will not be the last time I come across it either. 

If you have questions on any of the points I have raised in this article, please do contact me to discuss how I can assist your organisation and colleagues. Click to select a time that suits you to talk through your questions with me: Connect4Work/30min call. 

*The Census also shows that 3,800 children under 15 years old provide care (1.9% of all carers). I did not realise that this would be such a high number—did you? 

 

Sources of Information: 

https://www.noca.ie/audits/irish-national-audit-of-stroke-inas

https://irishheart.ie/your-health/learn-about-stroke/

https://nda.ie/publications/employment/employment-publications/exploring-the-factors-related-to-return-to-work-after-stroke.html

https://www.rcsi.com/dublin/news-and-events/news/news-article/2014/04/national-survey-of-stroke-survivors-in-ireland-report-launched

https://www.stroke.org.uk/life-after-stroke/getting-back-work/planning-your-return-work