‘Components for successful life in the community’ and ‘living with an acquired brain injury’ were the topics of the day-long event organised by the Northampton Acquired Brain Injury Forum (ABIF) and supported by Shoosmiths’ serious injury team.
The key themes discussed on the day were brain injury and driving, returning to driving and employment with a brain injury as well as the technology that may help.
Expert speakers included Emily Topliss and Mark Kennedy, who shared their inspirational lived experiences, specialist occupational therapists (OT) Emma Yates and Nadine Sowinski, of Northamptonshire Community Brain Injury Service, Clare Jones, lead OT at Regional Driving Assessment Centre (RDAC) in Solihull, Vicky Gould, OT at Total Neuro Rehab, and Jon Graham of Physio Function. The event was led by chair of Northampton ABIF Dr Keith Jenkins.
Brain Injury and driving
Emily Topliss described herself as a ‘stroke thriver’ – survival was not enough, one of her goals was to get back to driving after she suffered a stroke at age 48, whilst on a business trip to Kazakhstan.
After 15 months of recovery and rehabilitation, Emily took a test to see whether she was fit to drive. She failed. She says her spatial awareness ‘was shot’ and the fatigue she felt because of her stroke was completely debilitating (she had to rest even after putting one sock on).
Not to be deterred Emily invested in a mobility scooter, which helped improve her spatial awareness and was a ‘proactive passenger’ in the car with her husband, thinking about how she would manoeuvre the car in certain situations.
Emily was advised to have driving lessons in an adapted car so that she could get used to the different controls and way of driving. Unfortunately, she was unable to find an instructor with an automatic car, let alone one with adaptions, so the driving lessons never happened. She did retake her test, however, and passed. Driving, she says, gave her back her self-esteem and confidence and the freedom to live an independent life.
Mark Kennedy also suffered a brain injury - he collapsed while on holiday, hitting his head. His brain injury was not diagnosed immediately and the impact of it was not obvious, even to him. Mark had a busy job that required him to drive up and down the country delivering motivational courses in schools.
It was only when he returned to work that he really noticed the impact of the injury. He remembers that ‘the fatigue was horrendous’, on one occasion stopping at a motorway services for a short break and waking up almost 2 hours later. The fatigue is still triggered by having to concentrate in heavy traffic, flashing blue lights, sun flickering through trees and the glare of the sun on a wet road. He has also become sensitive to noise in the car.
Both Mark and Emily agreed that fatigue and cognitive issues (thinking, reasoning, and remembering) were the biggest issues for them in returning to driving. Clare Jones, Lead Occupational Therapist at RDAC in Solihull, noted that an individual is supposed to self-notify the DVLA if they have a notifiable condition (brain injury is one), but it often depends on the doctor you have seen to make that clear.
RDAC’s assessment centres undertakes driving assessments for people with a variety of disabilities and adaptations. Their clients are often referred by medics, solicitors, and case managers. Clare acknowledges the difficulty in finding driving instructors who can help people with adapted vehicles, so RDAC has set up a driving school with advisors who are experienced in working with people with a variety of additional needs; they also have a fleet of adapted vehicles. The service is only available in four centres in England currently, so Clare advised also contacting BSM and DDI (Disability Driving Instructors) who can both offer help.
Returning to work after a brain injury
Both Mark and Emily spoke about their experiences of returning to work after their brain injuries. Mark was self-employed, which was the impetus for returning to work immediately, plus the fact that his brain injury wasn’t visible. His fatigue led to anxiety and low mood, and his performance at work suffered, although he was not able to see that himself. Eventually he and his employer went their separate ways and Mark set up his own business with his wife. He had support from the government’s Access to Work scheme and can now organise his work life to better suit his needs. Mark said: “Brain injury doesn’t stop you - but it changes you.”
Emily was only a few weeks into her ‘dream job’ before her stroke. Her employer was very understanding, and she initially went back to work 10 hours a week, working from home. Sadly, she was made redundant in a reorganisation and had to start signing on, which was a challenge.
Emily advised how she was expected to reproduce a signature every two weeks, which should look similar each time. Emily is left-handed, and her stroke caused reduced function in her left side.
She began applying for jobs but avoided any that required handwritten applications. She noted that as part of the application process many organisations have a box to tick to identify yourself as having a disability, in some organisations this guarantees you an interview. Emily became demoralised by always getting interviews but losing out on offers because she didn’t ‘have as much relevant experience as other applicants’. She also noted that employers often appeared to have ‘[walking] stick phobia’ when they realised, she was disabled. She stopped ticking the disability box because she wanted to be invited to interview on her own merits.
At interview, she also found that she was the one that had to initiate conversations with potential employers about her disability and any reasonable adjustments that would be needed. She needed to find an employer who understood what working with someone with a disability is like. Fortunately, she found one in Northampton General Hospital, where she started working as a Governance Administrator, which has led to her being seconded to the stroke team, where she is currently acting as a Peer Support Officer.
Emily admits she would have benefited from an Occupational Therapist (OT) to guide her through the return-to-work process.
Specialist OTs Emma Yates and Nadine Sowinski, who work at the Northamptonshire Community Brain Injury Service, and Vicky Gould an OT at Total Neuro Rehab spoke to us about their role in helping people return to work after a brain injury.
Emma explained that going back to work is often a big part of someone’s rehabilitation, giving them structure, purpose, a sense of wellbeing and confidence. As Vicky points out, one of the very first questions people ask when they meet someone new is ‘what do you do?’, so work can be closely linked with someone’s sense of identity. The process of returning to work can be lengthy and has its ups and downs, but Nadine advised that the most successful cases she’s worked on are where there is engagement from the employer. For her, the key to success is honest and open communication, and transparency.
Technology that can help
Jon Graham from PhysioFunction provided examples of a variety of devices that can be used in rehabilitation and longer term to aid mobility for patients with neurological issues (including brain and spinal injuries). He was accompanied by Justin Ashton a friend and client, who talked about the Functional Electrical Stimulation (FES) device he uses to help correct his walking, which has enabled him to return to work.
Sharine Burgess, partner in Shoosmiths’ serious injury team and joint head of the Northampton office said: “Shoosmiths are proud to support ABIF Northants by hosting events like these. As a lawyer, acting for clients with serious and complex brain injuries, I recognise the importance of bringing people together from across the brain community to share knowledge and experience with the aim of making a positive difference to the lives of ABI survivors - or rather thrivers as Emily would say!”
This information is for educational purposes only and does not constitute legal advice. It is recommended that specific professional advice is sought before acting on any of the information given. © Shoosmiths LLP 2023