Come Back to Community and Work After Traumatic Brain Injury

Abstract

The incapacities resulting from TBI may interfere in the performance of daily life activities, work, and social life. Inclusion in work is important to the extent that in addition to being a source of income, it is a central element in people’s lives and a significant space for social integration and self-fulfillment. In this way, an overall rehabilitation program that encompasses professional/vocational aspects is important in the daily lives of those who suffer TBI; however the access to this type of program is still limited, especially in Brazil. The professional/vocational rehabilitation seeks to articulate the actions developed in the overall therapeutic process with those that are focused on the organization and working conditions that must to be prepared to receive the worker with a new health condition. The end purpose is not only to return to work but above all to remain in the job. To illustrate a model that could be one of these professional/vocational rehabilitation programs, in this chapter, was presented the process of development of the professional/vocational rehabilitation pilot project (PPRVP) performed in a pioneering manner in cognitive rehabilitation outpatient clinic (“Ambulatório de Reabilitação Cognitiva (ARCO”), linked to the Neurological Department of “Hospital das Clínicas da Faculdade de Medicina da Univesidade de São Paulo” (HCFMUSP) – Brazil. This program, developed by occupational therapists, attended patients with TBI who were already followed up by the ARCO and was developed from specific actions: (1) anamnesis, (2) preparation of individuals for returning to work, and (3) contact with the company of origin to facilitate the return and professional accessibility, in addition to periodically following up the individuals in the process of return to work. After the implementation of the PPRVP, some difficulties were identified for the inclusion of patients in the work marked: insecurity and functional limitations resulting from the sequelae of the TBI; difficulty in dealing with and accepting these limitations; family problems not related to the patients; scarcity of work vacancies; low accessibility to the places of greatest job offer; lack of motivation; brazilian legislation not favorable, low educational level and professional inexperience of the patients; absence of support or family protectiveness; lack of independence for performing daily life activities. Potential aspects of the Program were: awareness of the importance of work in a Cognitive Rehabilitation Outpatient Center, discussion with the Outpatient team about the criteria for referral for professional/vocational rehabilitation; creation of an individual space (OT and patient) for receiving the questions related to work; and creation of partnerships with institutions that could help with seeking work vacancies. The authors considered that the PPRVP presented limitations and potentialities that could guide the respective improvement and help with the construction of other programs of this nature.