How do People get back to Work after Severe Head Injury? A 10 year Follow-up Study

Abstract

Sixty four patients, who were previously followed up about 3 years, 6 months post-injury, were investigated again 10 years or more after very severe head injury (post-traumatic amnesia more than 7 days). Of the total, 42% had re-established themselves in employment, a further 20% showed an irregular pattern of work, and the remainder had made little or no attempt to work at all. There were few changes in work status once 18 months to 2 years had elapsed since the injury, and the pattern of employment, once established, tended to remain stable. Settlement of compensation claims did not lead to improvement in work status, and in several cases the converse was true. The first follow-up study showed that support and “in vivo” training at work was essential in helping people back to work, and this could be effective even when there had been a severe brain injury with permanent disability. The longer term follow-up of these patients gave further support to the view that a gradual and supported return to work is essential after severe brain injury if a return to stable employmentis to be achieved. A number of guidelines are identified which can help people return to work.