Brain injury information for employers

A brain injury can result in a combination of disabilities that require accommodations, but these are typically low cost and easy to implement.  

Important questions  

• What are the limitations caused by the brain injury? 
• How much do they affect the person and their performance? 
• What specific tasks will be affected? 
• Has the person been asked about their accommodation needs? 
• What accommodations are available? 
• Will the person be asked about their effectiveness?

Physical limitations are accommodated with the use of ramps, handrails and disabled parking spaces. All paths should be cleared of unnecessary equipment and furniture. 

Visual problems are accommodated with the use of large print, powerful fluorescent lights, increased natural lighting and glare guards on computer monitors. Vision specialists are available for advice, particularly for employees who have lost part or all of their vision. 

Maintaining stamina during the workday is possible with flexible scheduling and longer or more frequent work breaks. Employees might have extra time and a self-paced workload to learn new responsibilities, with others available to cover for breaks and necessary time off. Job sharing and working from home are other examples of flexibility. Employment coaches are a way to support employees in the workplace. 

Maintaining concentration is easier if distractions in the work area are reduced. Typical accommodations include space enclosures, a private office or allowing the use of white noise or environmental sound machines. Increase natural lighting and reduce clutter in the employee’s work environment. Let the employee play soothing music using a headset. Plan for uninterrupted work time and divide large assignments into smaller tasks and steps. Try restructuring the job to include only essential functions. 

Organisation and deadlines are easier with daily ‘to do’ lists. Calendars can be used to mark meetings and deadlines. Helpful reminders can be sent via memos, email or weekly supervision. Use a watch or pager with timer capability or an electronic organizer.  Assignments can be divided into smaller tasks and steps, with mentors available to help with goal setting and daily tasks. Work might be reviewed on a weekly basis to ensure goals are on track. 

Memory deficits can be managed by providing minutes of meetings, or allowing the employee to record them. Notebooks, calendars and sticky notes are used to record information for easy retrieval. Employees may need both written and verbal instructions, as well as extra time for training. It is easier to remember where things are kept when they are labeled, colour coded or listed on a bulletin board. Instructions can be written on or near equipment when necessary.  

Problem-solving deficits are common after a brain injury and can be accommodated in various ways. Picture diagrams like flow charts show problem-solving techniques. Jobs can be restructured to include only essential functions. A supervisor, manager or mentor should be available to answer any questions. 

Working effectively with supervisors is achieved through positive praise and reinforcement. Written job instructions and clear expectations of responsibilities and the consequences of not meeting them are very helpful. Allow for open communication to supervisors and establish written long term and short term goals. Develop strategies to deal with problems before they arise and develop a procedure to evaluate the strategies’ effectiveness. 

Difficulty handling stress and emotions can occur after a brain injury. Employees may need to seek support through counselling and employee assistance programs. Accessing outside support during work hours may be required, such as calling a doctor. Provide sensitivity training to co-workers and allow the employee to take a break to use stress management techniques to deal with frustration. 

Attendance issues might arise from regular medical appointments or due to managing fatigue. Employees may require leave for health problems, a self-paced workload and flexible hours. Working from home or part-time work schedules can help. 

Issues of change can arise after brain injury to due the need for extra time to adapt. Keep open channels of communication between the employee and the new and old supervisor in order to ensure an effective transition. Provide weekly or monthly meetings with the employee to discuss workplace issues. 

Many thanks to the Job Accommodation Network for their kind permission to adapt an article from their website. The original article written by Kendra M. Duckworth can be viewed at https://askjan.org/disabilities/Brain-Injury.cfm