Is it possible to work after a stroke: when to return to work, work by profession, in the country, do they work as a watchman after a stroke?

Return to work

The negative impact of a stroke on the patient’s condition depends on how severe the disruption of blood circulation in the brain was during the stroke and on the source of the lesion - the more the brain is damaged, the stronger the disturbances in mental, intellectual, motor and motor functions will be.

As a rule, the restoration of speech, motor and visual functions occurs gradually - the first improvements appear already after three days after the stroke.

But we must not forget that rehabilitation is a long process, and if you give the body a load too early, there is a risk of another stroke.

The patient's involvement in work activity should be gradual. After discharge and completion of the main recovery process, it is better to switch to a reduced schedule or switch to working from home.

Important! In order to accustom your body to work, you can start working a little in the country. This way, moderate physical force is used and the body gains endurance.

Returning to work after an attack

The desire to return to a full social life after a stroke is easily explained and understandable, but rehabilitation until the cognitive and motor functions of the body are completely restored sometimes takes years. Only in rare cases does recovery after a stroke occur quickly and after a couple of months the patient can return to his job.

After recovery, the patient must undergo a mandatory medical labor examination (VTE) in order to obtain a medical opinion on how ready the person is to return to work and under what conditions.

When can you start working?

As a rule, the minimum rehabilitation period after an ischemic stroke is three months, after a hemorrhagic stroke - six. If the doctor and examination have determined that the consequences of the blow have been completely eliminated , you can go to work.

For some patients, rehabilitation takes years. In this case, the patient is assigned a disability, which implies either the inability to work at all, or a transition to easier work that is not associated with nervous overload.

In any case, whether a person can go to work or whether it is worth continuing treatment is decided only by the attending physician.

What mistakes do students make when looking for a job?

Inflated salary expectations

Fact : according to surveys, students in Moscow expect to receive at least 70 thousand rubles when applying for their first job.
Expert opinion: “A young man who expects to earn 70 thousand, 100 thousand rubles and more should probably live in a vacuum. Because if you go to any “work” site or just ask around how much your acquaintances, friends, neighbors and relatives earn, then such a figure simply will not appear,” says Irina Svyatitskaya, head of the site for young professionals Career.ru.

Finding a job after receiving your diploma

Fact : 56% of students responded that they were unable to find a job due to lack of work experience.
The naked truth: if previously it was the norm to look for a job after the 5th year of university, now it is not recommended to wait for a diploma. Large companies willingly select talented students after the 3rd year. It happens that after the first year, companies collaborating with universities are looking at students.

Hope for a red diploma

In reality: Most employers are not interested in the color of the diploma or grades in subjects. Interviews and testing provide a complete understanding of how a person studied, what he knows and can do.

Where to get experience?

Fact : Companies often refuse to hire students without work experience, even for internships.
What to do: It will be difficult to look for your first job at 21-22 years old, so it is advisable to get at least a little experience in your specialty before receiving your diploma - do an internship, an internship, or work during the summer holidays.

Assessing the possibility of returning to work

After the first stage of rehabilitation, doctors and the patient themselves determine whether such serious consequences remain as:

disturbance of speech perception - does the patient understand the speech addressed to him, can he independently read and understand the meaning of what he read;
loss of coordination;
absent-mindedness, inattention;
partial or complete loss of hearing or vision;
difficulty swallowing food or drinks;
impairment of motor activity.

If at least two of the listed symptoms do not disappear, there can be no talk of returning to work.

Passing a medical labor examination

The examination involves a complete examination of the patient who has suffered a stroke in order to prepare a medical report on several points:

can a person go to work now or does sick leave need to be extended;
if the patient is ready to work, under what conditions can he perform it;
start date of employment;
possibility of disability.

The examination is carried out, as a rule, by several doctors - a therapist, a neurologist, a cardiologist, and an ophthalmologist. All previously obtained ultrasound or MRI results are collected, the patient undergoes tests, is interviewed by doctors, and the neurologist conducts standard tests for reaction and memory.

Important! It is imperative to obtain an opinion from an eye doctor - after an impact, vision can be greatly impaired, so it will be impossible to return to some professions.

What doctors check first:

Have your mental abilities been restored?
psychological condition;
to what extent visual and speech functions are impaired;
muscle tone;
state of the cardiovascular system;
Are there any coordination problems?

If the consequences of a stroke are minor, the VTE issues a work permit. In some cases, if the patient has not fully recovered, but is ready to start work, the commission and the employer may offer an easier employment option:

reduced working hours (for example, half the rate);
transfer to another position with easier working conditions;
transition to working from home or on an individual schedule (for example, every other day).

Note: If the condition of a person who has suffered a stroke does not allow any complex activity and his health is severely compromised (for example, some brain functions have not fully recovered, vision or hearing is severely impaired, limbs are partially or completely paralyzed), then VTE may not issue a work permit and recommend the patient apply for disability.

Characteristics of disability after stroke

CHARACTERISTICS OF LIMITED LIFE ACTIVITIES

The degree of disability depends on the characteristics of the neurological deficit, the severity of mental disorders, and is largely determined by the stage of DE. In stage I, life activity is more often limited due to impaired adaptation to external influences (fluctuations in atmospheric pressure, temperature, etc.), physical and mental stress, work stress, etc. In stage II and especially III of DE, life activity is determined by coordination and motor impairments (ability to move) to varying degrees. Paroxysmal disorders (crises, transient ischemia) additionally limit the vital activity and ability of patients to work. The patient's social adaptation is difficult due to a decrease in the possibility of acquiring new knowledge. With dementia, the ability to behave adequately is impaired, then everyday skills are lost, and self-care becomes impossible.

The criteria for assessing the working capacity of patients with chronic cerebrovascular insufficiency due to hypertension and atherosclerosis are as follows.

Criteria for recognizing patients as able to work: favorable course of the underlying vascular disease; chronic cerebral circulatory failure of the 1st degree: mild focal symptoms, rare mild and moderate cerebrovascular crises and minor mental disorders in chronic cerebral circulatory failure of the 2nd degree, provided there are no contraindicated factors in the work.

Criteria for establishing disability group III: progressive course and prevalence of vascular disease; persistent arterial hypertension with high blood pressure values; chronic cerebral circulatory failure of the second degree with moderate dysfunction of the central nervous system, crises (of moderate frequency and severity, rare severe, rare moderate severity in combination with frequent mild ones), severe neurasthenic and asthenic syndrome or moderate psychoorganic syndrome.

These dysfunctions of the central nervous system in people in professions with significant physical or neuropsychic stress, due to a decrease in adaptive capabilities, lead either to the need to reduce the volume of production activity, or to the need to transfer to another job with a reduction in qualifications. The basis for determining disability group III is contraindicated factors at work - unfavorable weather conditions (changes in temperature, humidity), increased neuro-emotional tension and stress, excessive physical activity (lifting and carrying heavy weights, holding them), working with occupational hazards of neurotropic effects.

Criteria for establishing disability group II: rapidly progressive course of vascular pathology; a combination of hypertension with atherosclerosis, a complication of stage II coronary insufficiency; chronic cerebral circulatory failure II and III degrees with severe impairment of motor, cerebellar, vestibular, visual functions and speech, crises (frequent moderate and severe, moderate frequency severe, as well as a combination of crises of moderate frequency and severity with frequent mild and rare severe with frequent mild or moderate severity), repeated strokes, pronounced changes in intellectual and mnestic functions (pronounced psychoorganic syndrome), and therefore adaptive capabilities for work are sharply impaired.

Criteria for establishing disability group I: chronic cerebral circulatory failure of the third degree with pronounced motor and cerebellar disorders (hemilegia, pronounced heminaresis, severe ataxia), severe speech disorders (motor and sensory aphasia), severe parkinsonian syndrome, as well as pronounced organic changes mental health, up to and including dementia, requiring constant outside care or supervision.

Contraindicated types and working conditions

Basically, in stage I DE, work in a caisson, a hot shop, under conditions of significant physical and neuropsychic stress, exposure to toxic substances, on the night shift, in possible stressful situations, or the need to make responsible decisions is contraindicated.

Basically, in stage II DE, work related to the need for adequate situational behavior, precise coordinated movements, long walking and neuropsychic stress is contraindicated.

Thus, when making an expert decision, it is necessary to indicate clinical, physiological, psychological and social factors.

When drawing up an individual plan for social and labor rehabilitation for patients with chronic cerebrovascular insufficiency due to hypertension and atherosclerosis, it is necessary to take into account not only the stage and course of the disease, the degree of CNM and the severity of impaired central nervous system functions, but also the patient’s main profession, his professional skills, special and general educational training , working conditions and the patient’s attitude towards the possibility of continuing to work.

It must be taken into account that work with significant physical and neuropsychic stress is absolutely contraindicated for patients with chronic cerebrovascular insufficiency.

Persons with heavy unskilled and low-skilled physical labor who have a low general educational level (loaders, carpenters, plasterers, etc.) should be employed in lighter physical work. Persons with skilled physical labor that require moderate or light physical stress (drivers, crane operators, mechanics, machine operators, electricians, etc.) should be advised to leave their profession if the disease has an unfavorable course and is accompanied by cerebral crises. If during the course of the disease the indicated complications are not detected, and the work performed by the patient is light in terms of physical stress (up to 2.4 kcal/min), then professional work with a decrease in the volume of production activity should be recommended.

In cases where the patient cannot be recommended to work in his specialty, during employment it is advisable to recommend performing work using professional skills, since retraining or retraining of patients with vascular diseases of the brain is extremely difficult. For example, drivers can perform the work of a mechanic or fitter, machine operators can also perform plumbing work or the work of a quality control inspector. The safest people in their profession are mechanics. However, this category of patients must be provided with easier working conditions in a timely manner (recommend minor plumbing work under shortened working hours).

Persons of mental work with significant neuropsychic stress (managers, chief designers, chief engineers, etc.) should be employed in work using professional skills, but only in work that requires moderate psycho-emotional stress. Persons with mental work who work in professions with moderate neuropsychic stress can work in their profession for a long time. However, in order to maintain and develop compensatory mechanisms, they need to be recommended to work in specially created conditions or at home. For example, disabled intellectual workers may be recommended to work in an advisory capacity, and manual workers may be recommended to perform minor assembly work.

able-bodied patients

This category includes patients with stage I and, less frequently, stage II DE with a favorable course of the disease (relative stabilization, slow progression) and satisfactory results of therapy; in case of moderate dysfunction, rare and mild PNMK (in the case of rational employment or implementation of work restrictions on the recommendation of the expert commission (EC) of the clinic).

What job can you not return to?

Even if the medical commission has recognized the person’s readiness to begin professional activity, it is necessary, in order to avoid a second blow or complications, to exclude the presence of harmful factors in the profession or at the workplace, such as:

greatly increased or decreased air temperature;
working for a long time on your feet or in one extremely uncomfortable position;
the presence of stress, the possibility of physical fatigue;
interaction with harmful, toxic substances.

That is, heavy physical labor, work as a truck or bus driver, managerial positions associated with constant stress, work as an industrial climber or foundry worker in a workshop become unavailable to patients - at least for several years after a stroke.

For example, it is possible to work as a watchman after a stroke, because it does not require much effort. But the position of a security guard, for example, in a store, is contraindicated: you need to stand on your feet for a long time and be very attentive.

Important! There is no need to rush to return even to light work, which is in one way or another associated with increased psychological stress . Any stress can cause a jump in blood pressure, which will trigger another stroke.

4 types of “eternal” students with poor chances of finding a job

Common lazybones

A common type with a complete lack of motivation to study. Typical behavior is skipping lectures, ignoring the educational process, resulting in difficulties during the session. In rare cases, during exams, a lazy person reveals his potential, shows charisma and intelligence. Most often, this species does not delve into the profession and does not think about the future. The result is prosaic: without skills, knowledge and experience, he faces difficulties in finding a job, although what hinders him more - habitual laziness to look or poor preparation - is a moot point.

Unmotivated bison

Males are rare. This species attends lectures and seminars, crams material and does well on exams. He does everything his parents tell him - he has no thoughts about the future. His goal is to study for the sake of learning. After four years, it turns out that the student knows nothing about real life and does not understand what he wants.

Diligent student

The description most suitable for this category is “eternal student.” A diligent student feels great within the walls of the university, he likes everything - the profession, the teachers and the educational process itself. As a result, training is delayed: this type can study for 10-12 years and then, with a successful combination of circumstances, remain working at the department.

Individuals with excellent student syndrome

Individuals with excellent student syndrome, or nerds, in pursuit of high grades in all subjects, live in the paradigm of “A’s = praise, D’s = punishment.” They strive to maintain their status as excellent students with all their might and expect employers to welcome them with open arms. But this does not happen - in practice, no one is interested in the color of the diploma or memorized definitions of unnecessary terms.

What does a promising student look like? Those who think about their career in advance, understand the value of practical experience and don’t get hung up on cramming have a good chance of finding a job!

Depression

Patients who have suffered a cerebral hemorrhage are very often susceptible to severe depression or apathy.

A person cannot come to terms with the fact that things that he used to do with ease (for example, driving a car, working on a computer, cooking or the usual morning jogging) become inaccessible or are given with great difficulty.

Important! If there is no support from loved ones, then thoughts about one’s own uselessness and the consequences of the blow - decreased vision, physical weakness, impaired coordination and memory - lead to severe depressive conditions.

The patient may refuse not only work, but even rehabilitation, which will inevitably lead to a worsening of the condition and further disability.

We invite you to watch a useful video on the topic: