Meaningful Occupation- Return to Work

1. Meaningful Occupation- Return to Work

2. Session Objectives • To define meaningful occupation. • To discuss the impact of stroke and disability on employment. • To raise awareness of the role of the O.T. in back to work issues. • To increase the knowledge of services/agencies available to support return to work.

3. Occupation • “Occupation refers to groups of activities and tasks of everyday life, which are named, organised, and given value and meaning by individuals and culture.” (Canadian Association of Occupational Therapists, 2002.)

4. Employment/Work • “To give work to someone and pay them for it” and “to keep (someone) occupied” (Oxford English Dictionary, 2002)

5. Types of Employment/Work • Paid • Voluntary • Meaningful, purposeful and productive

6. MODEL OF OCCUPATIONAL PERFORMANCE Institutional Environment Leisure Self Care Physical Spiritual Social Environment Cultural Environment THE INDIVIDUAL Affective Cognitive Productivity Physical Environment

7. Meaningful Occupation • Leisure – occupations for enjoyment i.e., socialising, outdoor activities, games and sports • Productivity – occupations that make a social or economic contribution or that provide economic sustenance i.e., school work, employment, homemaking, parenting • Self Care – occupations for looking after the self i.e., personal care, functional mobility and organisation of own time.

8. Factors influencing Meaningful Occupation • Environment Cultural Social Physical Institutional • Person Physical Cognitive Affective Spirituality

9. Why is employment/work important to the individual? • Source of income • Social inclusion • Sense of achievement • Economic contribution • Provides structure • Promotes mental wellbeing

10. Why is employment important to the economy? • Mental Health problems are now the leading cause of absence from work. • Nearly 3 million people are on incapacity benefits which amounts to 8 in every 100 who could work. • Over 21% of the population is currently economically inactive • About 40 million days at work were lost between 2001 and 2002 due to illness or injury (Vocational and Rehabilitation framework, Dep of works and pensions, 2004)

11. Research • Work has long term beneficial effects on symptom control and medication compliance. • Work plays an important part in clinical and social recovery. • Use of support services decrease. • Work reduces secondary disabilities caused by social and economic exclusion

12. Problems following stroke • Physical disability • Fatigue • Psychological issues • Cognitive issues • Loss of role • Social acceptance • Financial implications

13. OT Role & Back to Work • Carry out job and activity analysis • Ensure that tools, equipment &/or working environment are appropriately adapted • Intervention techniques to assist client to: adapt to disability maximise employment abilities meeting demands of employment encourage self direction.

14. OT Role & Back to Work • To develop work skills- (transfer of and learning of new) • To develop work behaviours- (time management, social performance) • To develop work tolerance- (pacing, grading of activity)

15. OT, Stroke & Back to Work • Physical deficits- i.e. unable to use a computer due to loss of function in upper limb. • Cognitive/perceptual deficits- i.e. unable to concentrate at work. • Psychological issues- i.e. low mood affecting motivation.

16. Disability Discrimination Act • Revised Oct 2004 • Employers are required to ensure they do not discriminate against disabled employees or job applicants because of their disability and may have to consider making reasonable adjustments to the work place.

17. Employers Responsibilities • Provide suitable furniture & access • Re-allocation of duties • Flexible hours • Time off for rehab or treatment • Provide info in an accessible format • Provide specialist equipment • Relocation to appropriate site.

18. Services available • Job Centre – Job Brokers - Back to Work Team SIBA – Specialist Incapacity Benefits Advisor DEA – Disability Employment Advisor

19. Services available • Access to work- practical advice and support relating to disability. • Next Steps – Career mapping, help with job applications, access funding • Balanced Futures – Psychological support, personal development, volunteer placements, job search

20. Summary • More working aged adults having strokes increasing need for work related services • OT’s have skills and knowledge to facilitate return to work but lack funding and posts • Huge implications and costs for Government, employer and employees

21. Summary • Meaningful Occupation is fundamental to the individuals health, well-being and economic contribution and therefore supporting people back into work is an important aspect of rehabilitation which is so often neglected.

22. References • Canadian association of Occupational Therapists. (2002). Enabling Occupation: an Occupational Therapy perspective. • Northern Ireland Committee of Occupational Therapists. (1992). Employment Assessment and Preparation in Occupational Therapy. • Department of Work and Pensions. (Oct 2004). Vocational and Rehabilitation Framework. • Khanna T., College of Occupational Therapists. (Jan 2005). Vocational Rehabilitation. • www.disability.gov.uk. (Oct 2004). Disability Discrimination Act. • www.jobcentreplus.gov.uk

23. Advisory/Support Services • Work Care – Rehabilitation and return to work support. Government initiative, research scheme. Tel: 0114 2788798 • Volunteer Bureaus – Voluntary placements. Tel: 01242 257727 • Guide – Local information service. Tel:01452 331131 • Job Centre – 01242 845000 - 01452 365100

24. Advisory/Support Services • Access to work- Tel: 01454 848500 • Next Steps- Tel: 01452 833655 • Balanced Futures- contact the job centre. • Back to Work Team- Tel: 01454 848586