Someone who has a relatively minor brain injury, such as a concussion, can still suffer with debilitating symptoms such as dizziness, headaches, irritability, depression, fatigue and memory problems. Although these symptoms are unlikely to last more than a few weeks, they can sometimes persist for longer, years even.
More severe head injuries tend to cause more complex and long-term problems that can persist even beyond a period of rehabilitation. Common symptoms following a brain injury include:
- Physical changes – such as impaired mobility, balance and coordination, weakness, uncontrolled movements, sensory impairment.
- Behavioural changes – for example, disinhibition, impulsiveness, obsessive behaviour, irritability and aggression, lack of initiative, becoming ego-centric.
- Cognitive effects – such as memory problems, language loss, reduced concentration, slower information processing, repetition, impaired reasoning, impaired insight or empathy.
- Executive dysfunction – affecting planning, organising and problem-solving skills.
- Emotional changes – change in personality, mood swings, depression, anxiety, anger, frustration and PTSD.
- Communication problems – speech difficulties, social communication skills, reduced insight.
It is also common for people with brain injuries to suffer with depression and experience a degree of social isolation. This can be for many reasons including changes in their personality, feeling like a different person after the injury, or changes in behaviour that can negatively affect relationships. Fatigue is also very common and this can contribute to feelings of isolation if it stops someone being able to go out and do things they used to enjoy.
Effect of coronavirus
Employers may find that following more than six months of dealing with Covid-19 and possibly working from home alone, their employee’s feelings of isolation, depression and/or anxiety have increased.
Employers are required by health and safety legislation to protect employees and others from harm. The main requirement here is to carry out risk assessments.
Under the Equality Act 2010 employers have a duty to make reasonable adjustments for disabled persons, whether that is by amending company policies, changing the way things are done, adapting the physical environment or supplying aids and equipment or technology that helps the disabled employee to perform their role as well as if they didn’t have a disability.
Physical disabilities are often easier to identify and make adjustments for. The difficulty with brain injury symptoms is that they are often hidden and it requires the employee to explain their needs to you. Employers can consider asking for an assessment by a specialist occupational therapist, which would be beneficial to help both the employee and employer understand what adjustments are needed and what is possible in the circumstances.
An employer will need to consider whether their employee can still perform in their current role following their brain injury, perhaps with adjustments. This is also true in light of Covid-19. If the employee is deemed vulnerable and needs to shield, for example, it may make it impossible for them to carry out their duties while working from home. If it is not possible to make adaptations, employers must consider whether there are alternative roles that are suitable.
A medical assessment before the employee’s return to work will inform whether the employee is capable of returning to their previous role. It is likely that the employee will have had some assessment reports as part of their treatment or rehabilitation that they might be willing to share. For new employees, employers could offer a work placement or probation period that could be used to make sure both parties are happy with the arrangements.
The key is to speak directly to the brain injured employee, consider their individual needs and provide a supportive working environment where they feel able to discuss the effect their injury has had on them. They may not want to share details of their injury or their symptoms with colleagues, and it must be kept confidential unless not doing so poses a health and safety risk.
Keep in touch regularly to assess their needs and to check whether adaptations are working or if different solutions or more adaptions are needed. This is especially relevant if they are working from home and facing additional challenges stemming from Covid-19, such as feelings of isolation, increased anxiety or depression.
Sally Simpson is an associate solicitor in the adult brain injury department at Bolt Burdon Kemp