When should a person with a spinal cord injury return to work?

As soon as possible; you can get back in there as soon as you're medically ready to leave the hospital. And definitely, our physicians, our team will help with that transition for everyone. That's a huge part of what we try and do is the transition into work-helping not only you as an individual get what you need to be to be as productive as you can be and get back to whatever it is you want to be doing. As well, the community around you needs to be aware, and be supportive and supply you with all you need in terms of accessibility, whether it's computers, whether it's ramps, whatever you might be going back to.

I think that varies widely. I’ve seen people go back very soon, I’ve seen people wait, and again it’s that trajectory of readiness. I think it’s important though to go back kind of in stages—in transition. Test the waters after you get out of rehab, see what the new normal is for you. Get into a routine that makes sense and then gradually bite additional facets of the pie, but don’t try to eat the pie all at once—it’s a big pie and it will be there for you. So, I like the idea of a gradual transition.

I like to see people get back to work as soon as possible. I think it’s really important to see yourself as a person, not a patient, not to become a lifetime patient. So you may need to go part time if you’re going to be continuing an active outpatient rehabilitation. It may take time before you have enough stamina to back to a full work schedule. And your work, it might be a paid job, it might be a volunteer job, your work might be as a family caregiver, but you should get back to your life as quickly as possible.

I tend to think that first year after a spinal cord injury -- it’s sometimes difficult to go back to work. For one thing, there’s a lot of rehabilitation that still exists as an outpatient and there’s a lot of growth that still occurs during that first year. But it’s also important to realize that there are a lot of anniversaries first for that patient whether it be a birthday, and of course, an anniversary of their injury. Certainly being able to get through that first year, and if at that point they’ve been able to stabilize all of their medical conditions, I think it’s a good time to start looking into going back to work and going back to other things in your life.

I think the answer to that is very individual based on the person. However, I’ll tell you in general my recommendation is after somebody discharges from initial rehab from a spinal cord injury, I recommend at least a period of a month or two to really establish a sense of stability and routine at home before they start thinking about jumping back into work.

We’ve been doing some interviews and focus groups about this, and what you hear with regard to the work lifecycle is you got to deal with those psychological issues first. You have to deal with the depression; you have to get through it. But, you also have to make sure you’re not bored, or get in the mind set of “I can’t do anything.” But you also have to relearn your body and what it takes to get showered in the morning, and get dressed, and do your pressure-releases and those develop a schedule. So, you figure out first how to relearn your body and its functioning on an everyday basis. And in a way you almost regret not doing it. You hear some folks who went back immediately, but then they missed out on going to therapy because therapy occurs during the day and work occurs during the day, and they couldn’t do both.  And so, it’s finding that balance—I think returning to work is really important. Employment provides us with an identity, it provides a social outlet, it provides reinforcement and hopefully things we do well and things we’re passionate about. But we also have to feel comfortable with our body and able to communicate unhesitantly with the other people who are going to ask questions, we have to ask for accommodations. You have to instruct other people about, “This is what I need,” and so it’s going to be a balance and a learning process. Sometimes I think the idea of transitioning back on a part-time basis and then going full-in can work better.