Preparing to Return to Work After a Stroke or Brain Injury

occupational therapy return to work with memory problems

While the degree of severity and lasting impact of a stroke or other brain injury affects every survivor differently, for many, there comes a time when you have made sufficient recovery to feel ready to return to work. However, your brain injury has likely left some permanent effects, so how do you prepare to meet these new challenges in the workplace?

Preparing to return to work after a stroke or brain injury requires patience and preparation. Identifying how your injury will affect your work and communicating your needs is vital. Changes are inevitable after such an injury, so returning to work is about making adjustments as easy as possible.

Even if you are eager to return to work after your injury, you are likely facing much uncertainty and anxiety about how exactly to do that. While we cannot hope to calm all your worries, keep reading to learn everything you need to know as you prepare to return to work.

How Do I Know I Am Ready to Go Back to Work?

Recovery from a stroke or brain injury is a long process. The last thing you want to do is push yourself too hard and destroy the progress you have made. Before planning to return to work, you should first and foremost consult your doctor and therapist to see if they believe this is a safe step.

Once you have recovered enough to perform daily tasks without aid, you may feel ready to return to work. However, there are some common side-effects from stroke and other brain injuries that you should watch for before deciding you are ready to return to work.


Once you are able to perform the actions you did before your injury, you may be eager to jump right back into your old job. While getting your ability back is wonderful, do not forget that you may need to build up your stamina again as well.

For instance, after a stroke, you may have trouble holding a pen and writing. Through recovery, you may recover this ability to write, but you will likely find that you cannot immediately do it for long periods. Stroke victims often have to slowly regain stamina even with simple tasks.

Even if you can perform the actions needed to return to work, you should first see how long you can perform these actions before becoming fatigued. If your fatigue is severe, you may want to continue the recovery process longer before trying to return to work.

If fatigue is a problem, you can also work with your employer to establish a gradual return to work plan. You could work part days or even only a few days a week to start. This would help you to overcome the fatigue without staying completely out of work for as long.


With fatigue, we were referring to physical exhaustion, but strokes and other brain injuries can result in faster mental exhaustion as well, particularly in the area of concentration.

Even after a long recovery, you may still find it difficult to concentrate at your former level. This problem may not even become apparent until you return to work.

Just as with fatigue going back to work gradually is an excellent way to combat concentration problems. It will allow you to slowly build your mental focus back rather than attempting to go back to normal immediately and ignoring your recovery needs.

OT goals to help with memory exercises

Behavioural Changes

One aspect of brain injuries that is often not discussed is the ability of these types of injuries to impact a person’s ability to navigate social cues, unspoken rules, and appropriate conversation.

Although these issues are a normal effect of brain injuries, they can often be much harder to manage. While your employer may understand your need to take more breaks, they may have a harder time understanding why you seem to forget the dress code or said something inappropriate to a colleague.

The best way to handle these issues is first and foremost to be aware. Before planning a return to work, talk with your therapist about how the injury may have affected your social behaviour. There could be no problem at all, or it could be a large concern. Either way, it is best to know before returning to a place where issues may arise.

If your therapist does see behavioural changes that may be a problem in the workplace, develop a plan of action. Know that this may involve some embarrassing conversations, but it is better to have a plan than to be fired for having a “bad attitude” or “inappropriate behavior.”

What Do I Need to Know Before Returning to Work with a Disability?

Because of the nature of strokes and brain injuries, it is likely that even if you are ready to return to work, you are still suffering some lasting effects from your injury. You may be ready to work, but returning completely to normal may not be an option.

Don’t let your injury’s long term effects stop you from living your life! Here is what you need to know about returning to work with a disability. 

Legal Information

Know that your employer does have a legal obligation to help ensure that your stroke or injury does not prevent you from returning to work. They are obligated to make reasonable adjustments to the workplace for a disabled employee.

Talk to Your Occupational Therapist

The first step is talking to your occupational therapist. Every injury is different, and with a wide variety of jobs, the connection between your injuries and your job can vary widely.

You and your therapist will need to identify in what way and how severely your injuries will affect your job. Whether it be lasting physical restrictions or difficulty concentrating, you need to be prepared to explain exactly how your injury has disabled you.

After pinpointing the potential problems, work with your therapist to figure out specific accommodations that you will need. This could be things such as more frequent breaks, a gradual return plan, and adjustments to your workspace, such as a different chair or desk.

Developing specific suggestions will help both you and your employer in creating a plan that will allow you to return to work safely and effectively. If you give your employer-specific ideas, they are much more likely to be able to ensure you can return to work.

Talk to Your Employer

Know that you are not legally obligated to reveal any of the details of your brain injury to your employer. However, having an open conversation can be beneficial to both sides.

If you keep your employer up to date on your progress and on how your injury will affect you once you return to work, they will know what to do once you are ready to return.

Many employers are happy to help their employees, but they may be unsure of how to do this. This is where communication can become vital and make the entire process much smoother. You can also consider connecting your employer and therapist if you are unsure how best to explain your needs.

Remember that though your employer is required to make reasonable adjustments, what exactly that entails can be hard for them to decipher. Be prepared to make suggestions and communicate your needs openly so that you can return to work safely.

In preparation for returning to work, you could even set up a return to work interview with your employer for a sit-down conversation about how returning will work and what your needs are.

What Do I Do If I Cannot Perform My Previous Job at All? 

In some cases, you may find that the type of injury and the effects you have sustained make it impossible for you to return to your previous position. At this point, there are two options available to you: find a new role at your employer’s or seek a completely new job.

Find a New Role

Before you begin searching for an entirely new job, consider your previous job in detail. What exactly can you no longer do because of the injury? Are there parts of your old job that you can still perform? How much of your previous role is doable, and how much has become totally unattainable?

Once you have thoroughly and realistically answered these questions, you can talk with your employer about altering your duties based on these answers. If your work role can drop tasks you can no longer do while adding things you can, you can remain at your job with a new position.

Even if you can no longer perform any of your old jobs, it is worth checking to see if there is another role you could perform at the same place. After all, you still know the company, so in many cases, you may be a far better choice for your company’s needs than completely new personnel.

If you know your injury has left you unable to work your previous job, do not leave it without checking into these options! You never know what is possible until you look.

Seeking a New Job

Maybe you already checked into altering your old position, or maybe you have simply decided that you want to move on to something different regardless. Either way, there are some things you need to know when job searching after a stroke or brain injury.

Just as when returning to your previous job, the first thing you need to do is identify what you can do, or perhaps more importantly, what you can no do. In discussing this with your therapist, it may help to ask them what types of jobs would work best with your injury.

After talking with your occupational therapist, you can check to see what support is available for you and in your area. There are work coaches, disability employment advisers, vocational training, and work clubs available.

When looking for a new job, be aware of the Disability Confident symbol. Employers with this symbol are committed to helping employees with disabilities. They may be more willing to discuss your brain injury than other employers.

If your injuries have severely affected how you function on a daily basis, consider that some retraining may be necessary. With support, you can find a job that works for you after your injury!

Things to Remember

First and foremost, accept that this may not be easy. Brain injuries are different from other ailments that can take you out of work for a while, so do not expect to recover and return to work as though nothing happened.

Here are a few things to keep in mind to make your journey in returning to work after a stroke or brain injury as smooth as possible.

Be Both Realistic and Positive

Brain injuries are a serious ailment that requires a long recovery process. You may not be able to do things as quickly or as effectively as you want, and that is okay! Listen to your doctor and/or therapist’s recommendations as to what you should and should not be attempting.

While you may want everything to revert to how it was before your brain injury, acknowledging your limitations will keep your goals realistic and help you to make decisions that will lead to real progress.

However, remember that being realistic does not mean being pessimistic. Keeping a positive attitude may be the most important thing in facilitating your return to work. Without self-motivation and drive, returning to work will go from a difficult to impossible task.

Thus be realistic about your limitations and goals, but strive to stay positive! We accomplish very little when we begin believing we cannot.

Seek Support  

In a similar vein to being realistic, realize that you will need support to make your transition back to work successfully. Even if you were suffering absolutely no side effects from your injury at all,  you would still need aid in transitioning back into your job after such a long period of absence.

To get the support that will actually prove helpful and meet your needs, you will likely need to seek it out yourself. Being active on your part will ensure that you get exactly the aid you need.

Remember that there are many forms of support available. From your occupational therapist to your employer, compassionate colleagues, and work coaches, there are a lot of support systems that you can access whether you are returning to your old job or seeking a new one.

Be Willing to Communicate

If you do not tell people what you need, there is little chance that you will get it. You are not required to tell anyone anything about your injury, but being honest about at least some of your situation will make things easier on everyone.

If you are struggling with memory issues, it may be beneficial to request that colleagues email you important information rather than telling you in person. Asking your employer for more breaks because of fatigue could help you be more productive overall.

Your employer and colleagues probably do not want to make your recovery and return more difficult, but they also probably have little idea of what they can do to help. Explaining your struggles and being open about what they can do to help will make for a better working environment for everyone.

Avoid High-Stress Situations at First

No matter how ready you may feel, it is not a good idea to immediately dive back into the fray upon returning to work. Request that when first returning to work after your injury that you not be given any high profile tasks or asked to make any enormous decisions.

The fact of the matter is that it will take time to discover how severely your injury will affect your work performance. If you place yourself in high-stress situations as soon as you return, you will likely not perform as well as you expect.

In other words, save yourself both discouragement and stress by taking it slow. It would not make sense to try to run a marathon after a broken ankle had just healed. Don’t do the same thing to your brain!

Possible Strategies to Make Returning to Work Easier

Although each situation is different, several strategies have been known to make returning to work easier for those suffering from a brain injury. Consider discussing these suggestions with your therapist and employer.

Practice at Home

One thing that makes returning to work difficult is that the skills you use at work are often unique. In other words, you likely are not performing the same tasks at home and work, so it is harder to judge how you will perform your work tasks during your at-home recovery.

If you want to know better what to expect with your work skills after your injury, try performing an at-home assessment once you feel ready to return. Running a practice session at home where you can test out various tasks and skills unique to your job will give you knowledge in advance about what changes you will need and potential problem areas.

Even if you discover that you are doing better than expected and that there are few issues, the practice will be worth it because it will help you return to work with more confidence.

A Gradual Return

Because brain injuries are wide-ranging and often affect people differently, there is no absolutely correct way to return to work. The right way is whatever works for you.

A gradual return can thus allow you time to work through kinks and develop strategies without creating extreme stress or fatigue. Doing a little at a time gives you room to figure out what will work for you.

A gradual return can be done in many ways. You could begin by working partial days, by working only a couple of days a week, or a combination. There are many different options that you and your employer can arrange so that you can have a safe and effective return.

A Quiet Workplace

Many people suffering from a stroke or other brain injury suffer from fatigue and overstimulation when returning. These problems can be mitigated by a quieter working environment.

Speak with your employer about what arrangements can be made to give you a quiet, stress-free environment in which to perform your tasks. This may be far easier to arrange than you think!

Working from Home

Although this may not be a realistic option depending on your job, if it is feasible, working from home could be a great solution in helping you adapt as you return to work.

If you can work from home, you can focus on adjusting to work itself after your injury without feeling stress about the environment as well. Working from home can also be a relief for those whose injuries make getting to and from work more difficult.

Buddy System

The scariest part about returning to work after recovering from a brain injury is often the uncertainty. Will you have trouble remembering things? Will you suddenly find things you used to do extremely difficult? Will you be able to concentrate?

Although only actually returning to work will answer those questions, some of the stress can be minimized through the use of a buddy. A trusted colleague can provide much-needed security in the uncertainty of returning to work.

A buddy can act as your initial contact upon returning to work. Instead of trying to engage and work with everyone at once, this person can act as your contact with the larger organization.

This system allows you to work with someone familiar with your needs, who can help you find a way back into your work life. Knowing that someone is looking out for you can go a long way into making you feel at ease, which will make returning to work that much easier.

Technological Aids

In our modern world, there are a lot of tools available that can help you to function in areas that might be weaker after your brain injury. Do not be afraid to use technology to make returning to your job easier!

For example, if you are having memory issues, you can use an online calendar and to-do list that will send you updates and keep track of everything for you. If you find your computation skills have suffered, there are many systems that can help you complete calculations.

There are simpler tools you can use as well. Wall calendars, alarms, and sticky notes are all simple items that can still provide tremendous aid. You do not need the latest technological advancement. Use whatever you personally find helpful.

It may be frustrating to have to use technology to accomplish things you normally did on your own, but these are simply tools that will allow you to better do your job. Many of these things are items people normally use to perform their jobs anyway.

A Daily Routine

Because brain injuries often impact our memory, establishing a daily routine has proven helpful for those returning to work after suffering a brain injury.

Ask your boss if it is possible to break your work duties into a daily schedule. This will not only help with any memory problems you may have but will also create more stability and less stress. The better you feel about returning to work, the more likely you will be to perform successfully.

Arrange for Feedback and Evaluation

Returning to work after a brain injury is not a one and done deal. Brain injuries are complex and have a lasting impact. One successful day returning to work does not indicate that there will be no problems in the days and weeks ahead.

This is not meant to be discouraging. It is only a reminder that there will be good and bad days as well as good and bad areas. To make the overall process of returning more successful, consider creating an arrangement for feedback with your employer and/or buddy (if you use the buddy system).

This feedback should be two way. It should give your employer an opportunity to examine your performance and give you areas for growth. This feedback is not about criticizing you but rather giving you a specific area to target. Being aware is the first step to making things better.

This feedback time should also give you a chance to give input to your employer. Thank them for their support thus far, and let them know if there are any changes or additions that you need to be made to your accommodations.

This feedback can be given in brief periodic meetings or through another system upon which you and your employer agree.


Recovering from a stroke or other brain injury is a long and tedious process. Returning to work may feel like finally putting all that behind you, but remember to be patient with yourself. Returning to work after such an injury is often a process as well, but with a support system and planning, you can successfully get back on the job!

Content Disclaimer

The information contained above is provided for information purposes only. The contents of this Blog article are not intended to amount to advice, and you should not rely on any of the contents of this Blog article. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this Blog article. OccupationaltherapyBlog disclaims all liability and responsibility arising from any reliance placed on any of the contents of this Blog article. 


I'm a Neurological Occupational Therapist and Founder of HT Neuro Rehab an Holistic & Person-Centred Adult Rehabilitation in London. I"m fully registered with the Health and Care Professionals Council (HCPC) and the Royal College of Occupational Therapists (RCOT). I have founded HT Neuro Rehab to provide clinical Occupational Therapy services to adults with neurological conditions, brain injuries, major trauma, upper limb retraining and rehabilitation, Prolonged Disorders of Consciousness (PDoC) and Functional Neurological Disorders (FND). My practice provides support, training, and guidance to both the patient and their families and caregivers. My goal is to enable each patient to achieve their personal ability, mobility, and independence goals while cultivating a long-term support network that is capable and prepared to engage in the rehabilitation journey.

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