Living with stroke

Many stroke survivors struggle with the challenges of everyday life. They may be overwhelmed by invisible difficulties such as fatigue and memory and concentration problems. The person affected by stroke and their G.P. need to work with different bodies to find out what to concentrate on going forward. However, at some point the following question will arise: How can I keep up contact with my workplace and colleagues? What will it take to go back to work?

For occupational rehabilitation to work, all relevant players – i.e. your employer, the NAV office in your municipality, the municipality’s health and care services, the specialist health service, bodies offering occupational rehabilitation, etc. – need to be involved as early as possible.

The success of occupational rehabilitation depends on a number of factors. Some of the most important ones are:

• The extent and severity of your physical, cognitive, and communication difficulties
• Your age
• Your occupation, type of position, and responsibilities
• What you want and how motivated you are
• Your employer’ and colleagues’ approach to your situation, and the staff policies at your place of work
• Whether it is possible to adapt conditions and sometimes what you do at your workplace, including in some cases whether you could perform other duties at work
• What other work opportunities there are
• The content, quality, and extent of occupational rehabilitation

For stroke survivors who are studying or have recently completed their studies, the permanent consequences of the stroke should be assessed before occupational rehabilitation is offered.

The person’s type of work before the stroke is also important. There is a need to assess whether they can return to the same type of work as before. If you are a transport driver and your sight has suffered due to the stroke, your work will be affected. If the stroke has caused physical disability, e.g. if you need a wheelchair, this may affect whether you can take up your work again. At some time your ability to function needs to be assessed in relation to work.

This includes how you function physically and cognitively and how your mental health affects your work.

If it is difficult to do your job after you had a stroke, there are a range of provisions that can help you. A variety of professions may play a role in assessing the situation, including occupational therapists, psychologists and/or physiotherapists. In addition, NAV will enter the picture.

The employer’s duty to accommodate the work situation

Under section 22 of the Equality and Anti-Discrimination Act, employees with disabilities have a right to suitable, individual facilitation of their workplace and their duties, to ensure that they can keep their work and have the opportunity to progress on a par with other employees.

The employer’s accommodation obligation is strict, but it does not apply if it involves a disproportionate burden on the employer. The costs for the facilitation measures, the employer’s financial situation, and other circumstances that would make it unreasonable to impose such a duty on the employer, must all be included in the assessment.

It is possible to file a complaint concerning inadequate facilitation arrangements with the Norwegian Anti-Discrimination Tribunal.

IN: PC – photo – Shutterstock

Protection against dismissal after a stroke

Pursuant to section 15-8 of the Working Environment Act the employer may not dismiss you in the first 12 months of sick leave. The provisions of the act are applicable if the reason for the dismissal is incapacity to wok due to disability. After 12 months’ sick leave, the employee is covered by the normal protection against dismissal. This means that any dismissal must be objectively justified.

Having been on sick leave (full or part-time sick leave) for 12 months is not sufficient objective justification for a dismissal. In addition, the employer must have complied with their duty to facilitate your work situation, and it must be clear that you will not begin to work again (full-time or part-time) in the immediate future.

The main objectives of rehabilitation

The main objective of rehabilitation is to help people who have suffered an injury or a disease return to an active lifestyle and participate fully in society. Stroke survivors, especially those with moderate to severe disabilities and with communication difficulties, are at risk of social isolation. The objective of the rehabilitation process is therefore successful integration into society. This means that rehabilitation shall help prepare the person affected by stroke to participate in those areas they want to engage in and help them fulfil the social roles they want to have.

Stroke patients with after-effects limiting them in social intercourse should be offered the required training to master the activities they want to participate in. The circumstances surrounding stroke survivors must be adapted to enable them to live as independently as possible, on their own terms, and enjoying good quality of life. Smaller municipalities sometimes cooperate across municipalities to offer group services, sometimes also including other relevant patient groups.

Patient and user groups are also important arenas for social involvement.

Source: The Norwegian Directorate of Health