Every October, the U.S. Department of Labor’s Office of Disability Employment Policy celebrates National Disability Employment Awareness Month to recognize the workforce contributions of people with disabilities.
Those workers include people living with spinal cord or brain injury.
Returning to work after rehabilitation for these life-changing injuries is filled with challenges.
But with the guidance of vocational case managers and others, many have overcome the challenges and now make vital contributions to their employers and communities.
They have also become more financially independent and are living full, productive lives.
At Shepherd Center in Atlanta, vocational case manager Debbie Page counsels patients and employers on strategies to accommodate disabilities in the workplace.
She and her colleagues have witnessed many successful returns to work, and Debbie is sharing her insights today with Shepherd Center Radio listeners.
Selected Podcast
Tips for Returning to Work After Rehabilitation for a Spinal Cord or Brain Injury
Featured Speaker:
Debbie Page, MS, LPC
Debbie Page, MS, LPC, CCM, is a vocational rehabilitation case manager at Shepherd Center, where she has worked for eight years. She has worked in the field of medical and vocational rehabilitation since 1989. She earned a master’s degree in rehabilitation counseling from Georgia State University. Debbie is a licensed professional counselor and a certified case manager. She is specialized in visual impairment, brain injury and spinal cord injury rehabilitation. Transcription:
Tips for Returning to Work After Rehabilitation for a Spinal Cord or Brain Injury
Melanie Cole (Host): Every October, the U.S. Department of Labor's Office of Disability Employment Policies celebrates National Disability Employment Awareness month to recognize the workforce contributions of people with disabilities. Those workers include people living with spinal cord and/or brain injury. My guest today is Debbie Page. She is a vocational rehabilitation case manager at Shepherd Center. Welcome to the show, Debbie. Tell us a little about what's going in the world of disabilities and people re-entering the workforce after they've suffered a traumatic brain injury or spinal cord injury.
Debbie Page (Guest): Well, the world has come a long way in welcoming and enabling people to return to the workforce. I think Shepherd Center, as a hospital, is a good example whereas, 50 years ago hospitals like Shepherd didn't exist. And so, now there is a field of rehabilitation. There are physicians that specialize in rehab and occupational therapists, physical therapists, speech therapists, neuro-psychology. There is a whole team that works together to help a person to be able to return to work. The world has got an open mind to it now.
Melanie: I am so glad to hear that and it really sounds like it’s a multi-disciplinary approach. So, what do you do as a vocational case manager to help people get back integrated into mainstream or back into the workforce? What's involved?
Debbie: Well, at Shepherd, we like to meet with patients early on. So, even when someone is an in-patient here, we start that process so that they can understand that we want them to go back to work and that the family understands returning to work is an important goal so that they can be fully integrated back into society. And so, initially its education and information as to what type of resources are available to them. Sometimes, after patients are on the in-patient unit at Shepherd and then they are in either our acquired brain injury or spinal cord injury day program, they are sometimes able to return to work at that point. If they are, then we negotiate that return to work with their employers. That can involve education about the disability. For each person, it’s very different and also different accommodations need to be negotiated with each employer.
Melanie: What determines someone's readiness to go back to work, Debbie? How do you know that somebody is ready?
Debbie: Well, it's a very complex question and that's why a whole team of people of have to be involved in that. So, let's say that someone has a spinal cord injury. They have to be medically stable and then have progressed where they are not really benefitting from rehab every day because as long as they are benefitting, as long as, of course, they’re needing in-patient, that's primary. Then, when they go to a day program, that's typically full-time five days a week but they don't live at the rehab center. At Shepherd, we have apartments for families and for patients but they are living independently in those apartments. So, it depends on the job. So, let's say that someone works in customer service. Well, if they have a spinal cord injury, maybe only the lower part of their body is affected and so, their upper body is still good to use their computer devices and their telephone. So, perhaps what they have to accomplish before they return to work is to be able to drive and to transfer in and out of the vehicle and to have their vehicle adapted. That can sometimes be accomplished within 3-5 months from the onset of the injury. For some people, it takes longer. An example for how it might take longer is, let's say if someone had a common issue with spinal cord injury or spasticity. That may prevent them from driving. Especially if they lived in a community where there is no public transportation, then that would limit their ability to be able to be transported to work. Now, many of our patients have higher level injuries in that they are paralyzed whether it's complete or incompletely from the neck or the torso down. Those people may need to learn how to use adaptive computer equipment using speech output before they can be able to perform their job. Then, in negotiating with their employer a return to work, they would need an office space where they could maneuver a power wheel chair, which takes a lot more space than a manual chair. They would need to be proficient with their adaptive computer skills and that can take additional time. Then, there are some patients who, let’s say you are an HVAC technician and we do see that it’s a fairly common career. So, those individuals have to, whether they give estimates for heating and air conditioning or they install them, they have to be able to be at unprotected heights to climb and to crawl. Now, those individuals, for them to return to the workforce, they are going to need to completely re-train. That certification that they had to work in HVAC isn't helpful to them any longer. So, they are going to need to return and acquire another certification. Fortunately, in the United States, each state has a Department of Vocational Rehabilitation and those agencies are staffed by vocational case managers that have master’s degrees in rehab counselling. They are required by the Federal regulations to have master’s degrees. They have the staff that they can contract with or they themselves can provide an assessment and help someone sort out what might be a good next choice for them for a career and then, where in their area they can go to locate that training. There are resources available through each State Department of Vocational Rehab and through grants to pay for that re-training.
Melanie: So, if they are someone who can't go back to their old job--if they were somebody who was doing something very physical and that's no longer something they can consider, then what do you do with them about integrating them into a new type of profession if they want to go back to work?
Debbie: They will start with the state vocational rehabilitation. We have a good relationship in Georgia with our Atlanta office and they actually meet with our patients here. Most patients who would have that level of injury, we are going to be working with them on a plan for how they going to stay busy and stay fit while they are in our rehabilitation program. So, people may volunteer and the vocational services department can work with them on volunteer sites. We can help them work out schedules. We have, at Shepherd, life skills training where we can actually work with many of our patients in their home to make sure that they are able to carry over the skills they learned while housed at Shepherd into their community, into their actual home. We also work with people on learning how to use their public transportation systems so that if that's available in their community. In Atlanta, we are very fortunate to have an excellent public transportation system and paratransit. Paratransit is a bus that is curb to curb service. So, someone in a wheel chair, who is not accustomed to being mobile out in the community by themselves, they can have that bus come to their home and then pick them up and then deliver them at a work site, a volunteer site, a medical appointment, a gym--anywhere they need to go.
Melanie: That's fantastic information. In just the last minute, Debbie, please give your best information about that path back to work for people that have suffered brain injury or spinal cord injury and why they should come to Shepherd Center for their care?
Debbie: Because they'll receive comprehensive services. As soon as they walk in the door, they have physical therapy, occupational therapy. We have 38 recreational therapists--the largest recreational therapy department in the world. So, those recreational therapists are working with people not only a vocational activity but helping them to become independent out in a community in and around Shepherd and Atlanta and helping their families to understand how to troubleshoot issues that come up with wheelchairs, doing intermittent catheterizations out in the community. There are any number of needs and skills that only the patients have to have but family members. They have to have a comfort level in order to be safe out in the community with their family members.
Melanie: I certainly applaud all the great work that you do, Debbie. Thank you so much for being with us today. You are listening to Shepherd Center Radio. For more information you can go to Shepherd.org. That's Shepherd.org. This is Melanie Cole. Thanks so much for listening.
Tips for Returning to Work After Rehabilitation for a Spinal Cord or Brain Injury
Melanie Cole (Host): Every October, the U.S. Department of Labor's Office of Disability Employment Policies celebrates National Disability Employment Awareness month to recognize the workforce contributions of people with disabilities. Those workers include people living with spinal cord and/or brain injury. My guest today is Debbie Page. She is a vocational rehabilitation case manager at Shepherd Center. Welcome to the show, Debbie. Tell us a little about what's going in the world of disabilities and people re-entering the workforce after they've suffered a traumatic brain injury or spinal cord injury.
Debbie Page (Guest): Well, the world has come a long way in welcoming and enabling people to return to the workforce. I think Shepherd Center, as a hospital, is a good example whereas, 50 years ago hospitals like Shepherd didn't exist. And so, now there is a field of rehabilitation. There are physicians that specialize in rehab and occupational therapists, physical therapists, speech therapists, neuro-psychology. There is a whole team that works together to help a person to be able to return to work. The world has got an open mind to it now.
Melanie: I am so glad to hear that and it really sounds like it’s a multi-disciplinary approach. So, what do you do as a vocational case manager to help people get back integrated into mainstream or back into the workforce? What's involved?
Debbie: Well, at Shepherd, we like to meet with patients early on. So, even when someone is an in-patient here, we start that process so that they can understand that we want them to go back to work and that the family understands returning to work is an important goal so that they can be fully integrated back into society. And so, initially its education and information as to what type of resources are available to them. Sometimes, after patients are on the in-patient unit at Shepherd and then they are in either our acquired brain injury or spinal cord injury day program, they are sometimes able to return to work at that point. If they are, then we negotiate that return to work with their employers. That can involve education about the disability. For each person, it’s very different and also different accommodations need to be negotiated with each employer.
Melanie: What determines someone's readiness to go back to work, Debbie? How do you know that somebody is ready?
Debbie: Well, it's a very complex question and that's why a whole team of people of have to be involved in that. So, let's say that someone has a spinal cord injury. They have to be medically stable and then have progressed where they are not really benefitting from rehab every day because as long as they are benefitting, as long as, of course, they’re needing in-patient, that's primary. Then, when they go to a day program, that's typically full-time five days a week but they don't live at the rehab center. At Shepherd, we have apartments for families and for patients but they are living independently in those apartments. So, it depends on the job. So, let's say that someone works in customer service. Well, if they have a spinal cord injury, maybe only the lower part of their body is affected and so, their upper body is still good to use their computer devices and their telephone. So, perhaps what they have to accomplish before they return to work is to be able to drive and to transfer in and out of the vehicle and to have their vehicle adapted. That can sometimes be accomplished within 3-5 months from the onset of the injury. For some people, it takes longer. An example for how it might take longer is, let's say if someone had a common issue with spinal cord injury or spasticity. That may prevent them from driving. Especially if they lived in a community where there is no public transportation, then that would limit their ability to be able to be transported to work. Now, many of our patients have higher level injuries in that they are paralyzed whether it's complete or incompletely from the neck or the torso down. Those people may need to learn how to use adaptive computer equipment using speech output before they can be able to perform their job. Then, in negotiating with their employer a return to work, they would need an office space where they could maneuver a power wheel chair, which takes a lot more space than a manual chair. They would need to be proficient with their adaptive computer skills and that can take additional time. Then, there are some patients who, let’s say you are an HVAC technician and we do see that it’s a fairly common career. So, those individuals have to, whether they give estimates for heating and air conditioning or they install them, they have to be able to be at unprotected heights to climb and to crawl. Now, those individuals, for them to return to the workforce, they are going to need to completely re-train. That certification that they had to work in HVAC isn't helpful to them any longer. So, they are going to need to return and acquire another certification. Fortunately, in the United States, each state has a Department of Vocational Rehabilitation and those agencies are staffed by vocational case managers that have master’s degrees in rehab counselling. They are required by the Federal regulations to have master’s degrees. They have the staff that they can contract with or they themselves can provide an assessment and help someone sort out what might be a good next choice for them for a career and then, where in their area they can go to locate that training. There are resources available through each State Department of Vocational Rehab and through grants to pay for that re-training.
Melanie: So, if they are someone who can't go back to their old job--if they were somebody who was doing something very physical and that's no longer something they can consider, then what do you do with them about integrating them into a new type of profession if they want to go back to work?
Debbie: They will start with the state vocational rehabilitation. We have a good relationship in Georgia with our Atlanta office and they actually meet with our patients here. Most patients who would have that level of injury, we are going to be working with them on a plan for how they going to stay busy and stay fit while they are in our rehabilitation program. So, people may volunteer and the vocational services department can work with them on volunteer sites. We can help them work out schedules. We have, at Shepherd, life skills training where we can actually work with many of our patients in their home to make sure that they are able to carry over the skills they learned while housed at Shepherd into their community, into their actual home. We also work with people on learning how to use their public transportation systems so that if that's available in their community. In Atlanta, we are very fortunate to have an excellent public transportation system and paratransit. Paratransit is a bus that is curb to curb service. So, someone in a wheel chair, who is not accustomed to being mobile out in the community by themselves, they can have that bus come to their home and then pick them up and then deliver them at a work site, a volunteer site, a medical appointment, a gym--anywhere they need to go.
Melanie: That's fantastic information. In just the last minute, Debbie, please give your best information about that path back to work for people that have suffered brain injury or spinal cord injury and why they should come to Shepherd Center for their care?
Debbie: Because they'll receive comprehensive services. As soon as they walk in the door, they have physical therapy, occupational therapy. We have 38 recreational therapists--the largest recreational therapy department in the world. So, those recreational therapists are working with people not only a vocational activity but helping them to become independent out in a community in and around Shepherd and Atlanta and helping their families to understand how to troubleshoot issues that come up with wheelchairs, doing intermittent catheterizations out in the community. There are any number of needs and skills that only the patients have to have but family members. They have to have a comfort level in order to be safe out in the community with their family members.
Melanie: I certainly applaud all the great work that you do, Debbie. Thank you so much for being with us today. You are listening to Shepherd Center Radio. For more information you can go to Shepherd.org. That's Shepherd.org. This is Melanie Cole. Thanks so much for listening.