Colleagues

Brain injury is more common than many people think, with around 350,000 people being admitted to hospital with a diagnosis of brain injury every year. It can affect many aspects of the brain injury survivor’s life, including their ability to work. However, with appropriate support from employers and colleagues, a return to work can be made easier for the survivor, which in turn can make the work environment more positive for everyone.

Below we offer guidance for the colleagues, both existing and new, of an employee with brain injury. It offers information about how brain injury might affect the survivor within the workplace, and what you as a colleague can do to support them.

Information and guidance specifically for employers is available on Employers.

While your colleague is absent

You may be aware that your colleague has had a brain injury even before they return to work, for instance if they have been in hospital and someone has shared this information with you.

At this stage, you may not know whether or not your colleague will be returning to work after they are treated and discharged from hospital, and it is likely that neither your employer nor your colleague themselves will know at this stage either. However, there are still some things you can do in the meantime to help your colleague in the event that they do return.

• If your jobs overlap, keep notes of projects and tasks as they progress. You could perhaps consider creating a separate file for your colleague with updated information about projects or meetings that have taken place.

• Learn about brain injury and its effects. This will give you a better understanding of how your colleague’s behaviour and work performance might be different if and when they do return.

• Respect the amount of information your employer shares with you about your colleague’s situation, even if they do not share any information at all.

• Consider sending your colleague a well-wishing card or a gift from the workplace to show that you are thinking of them.

• If visiting your colleague in hospital or at home, try to avoid engaging them in lengthy discussions, as they might experience fatigue, emotional issues, memory problems or difficulties with processing information at this early stage.

• Your colleague might be a friend as well as someone you work with. If this is the case, refer to our information on Friendships after brain injury.

When your colleague returns to work

If your colleague returns to work, you might think this means that they have recovered from their brain injury and will now be ‘back to normal’. However, it is common for brain injury survivors to experience long-term physical, emotional, cognitive or behavioural effects after their injury, and you may find that they are different upon their return to work.

Even if your colleague appears to be their usual self, this does not mean that they are not experiencing changes from their injury. Many of the effects of brain injury are not visible. It can also sometimes take days, weeks or even months for some of the effects of the injury to develop. For many, however, common effects of brain injury such as fatigue or memory problems can cause challenges from the onset, especially in demanding settings such as the workplace.

If your colleague is new to the workplace, you may not know how much of their behaviour is due to the injury. In this case, take time out to get to know one another and don’t be afraid to ask questions about their injury if they seem open to discussion. Do, however, consider that this will be a very personal part of their life, and they may not wish for it to be discussed at all. Consider as well that starting a new job can be a daunting and stressful experience for anyone, and they might only choose to share such personal information with you once they are more settled.

The effects of brain injury within the workplace

Brain injury can cause a range of physical, cognitive, emotional and behavioural effects on both a short and long-term basis. Many of these effects can have an impact on the survivor’s work performance or affect their interaction with other colleagues.

This section describes some of the most common effects of brain injury and how they can affect your colleague’s performance or behaviour while at work.

Physical effects

• Fatigue - this refers to regular, pathological tiredness commonly experienced by brain injury survivors and is very different to the tiredness you might feel at the end of a working day. It can make your colleague struggle with working long or even regular hours, and it might be necessary for them to take frequent rest breaks.

• Mobility issues - crutches, wheelchairs or mobility aids may be needed by your colleague. It might even be necessary for adaptations to be made to the environment, such as ramps or handrails being installed. Floor space may need to be clear at all times to ensure your colleague is safe while moving around.

• Communication problems - this can either be problems with word finding, speaking, or understanding what is being said.

• Epilepsy - your colleague might develop epilepsy after their injury, and might be at risk of having a seizure at work. More information on epilepsy and what to do if someone is having a seizure is available on our page Epilepsy.

• Headaches - headaches might cause your colleague to be in regular or constant pain through their working day. Medication can sometimes help, but not always.

Cognitive effects

• Memory problems - your colleague’s short or long-term memory might be affected. They might need to frequently rely on memory aids such as notebooks, alarms or calendars to remember tasks, deadlines and meetings.

• Impaired problem-solving - your colleague might struggle with managing projects, resolving problems or improvising if issues arise.

• Impaired decision-making - it might be more difficult for your colleague to ‘weigh up’ information and make decisions accordingly. This can cause particular challenges or risks if they are in a role that requires making important decisions on a regular basis.

• Reduced concentration - it might be difficult for your colleague to concentrate on tasks or meetings for sustained periods of time. This can be particularly difficult if there is a lot of noise or activity going on in the background. It can be helpful for your colleague to have their own quiet space in which to work.

• Problems with motivation - your colleague might struggle with getting into, focusing on, or staying interested in a task or project.

• Repetition or ‘perseveration’ - in contrast to problems with motivation, your colleague may continue to carry out a task despite no longer needing to do it. They might also continuously repeat certain conversations or phrases.

• Impaired empathy - your colleague might struggle with interpreting other people’s emotions. This might make them appear to be insensitive or indifferent, which can affect their interpersonal relations with other colleagues.

Emotional and behavioural effects

• Personality change - if your colleague has returned to a job they had before their injury, you might find that their personality is different after their injury. This might affect your relationship with them, especially if you are friends as well as colleagues.

• Loss of confidence - your colleague might feel less confident about their ability to perform well, and may need regular reassurance.

• Mood swings - unpredictable mood swings, such as sudden anger outbursts, might make it difficult to have a steady working relationship with your colleague.

• Depression and sense of loss - your colleague might develop depression or a sense of loss for their old self; for instance if they are no longer able to do tasks that they did before their injury. Depression can affect their work performance, and might also cause them to interact less with colleagues.

• Frustration and anger - your colleague might have difficulties with managing their anger, or they might get angry about seemingly minor things that did not bother them before their injury

• Disinhibition - your colleague might swear, shout, do inappropriate things or fail to recognise workplace boundaries.

• Issues with insight - this refers to an issue whereby the brain injury survivor is unaware of how they are affected by their brain injury. This can make it difficult to have conversations with them about how their injury affects their work performance. It can also mean that they might be unable to realistically assess how safe they are with carrying out certain tasks.

Tips for supporting your colleague

The effects of your colleague’s injury and the impact it has on their work performance may become more noticeable over time. In the long-run, your colleague may learn ways of managing their effects within the workplace. They might also find that they have to adapt their role, or take on a new role that is more suitable for them. In any case, ongoing support and understanding from colleagues and employers has been found to help brain injury survivors with a successful return to work.

Even so, workplaces are often busy, stressful environments for many people, and the effects of brain injury can make coping with this an even greater challenge. The following tips can help you to support your colleague with brain injury within the workplace.

• Encourage other colleagues to learn about brain injury - It is important for other colleagues, and not just you, to have an understanding of brain injury. This can ensure that there is a full supportive network around the brain injury survivor in the workplace.

• Do not rush to do things for your colleague - Your colleague might struggle with some tasks, but do not instantly assume that they cannot do them. Instead, give them time to try things by themselves, if it is safe for them to do so, and offer support if you notice that they are consistently struggling.

• Offer practical help where needed - If possible, offer to help your colleague in practical ways that will not take up too much of your time. For instance, if your colleague has memory problems, offer to take notes of meetings for them to refer to afterwards. Or if you live near them and they are unable to drive or use public transport, offer to pick them up on your way to work or drop them off home afterwards.

• Try to adapt the environment to make it more suitable - Brain injury can cause some people to have sensitivity to bright lights, loud noises, or generally busy environments. Unfortunately, many work environments often fit this description, and can therefore be overwhelming for some survivors. You can help by trying to keep noise levels to a minimum and removing unnecessary distractions from the environment.

• Praise your colleague’s achievements - Everyone appreciates having their work recognised and praised. For your colleague, seemingly small tasks might be significant achievements, so provide positive feedback where appropriate.

• Make allowances for behaviour - Remember that problems with managing anger or inappropriate behaviour are common effects of brain injury. Do therefore try to make allowances for this kind of behaviour where possible. If the behaviour is consistent, gently remind your colleague that they are not behaving appropriately and encourage other colleagues to do the same. If the behaviour continues, consider informing your colleague’s manager.

• Get advice - If you are concerned about something and wish to seek impartial advice, consider contacting your HR department or ACAS. The Headway helpline is also available to offer information and guidance.

Above all, don’t be afraid to ask. Ask your colleague how you can best support them, as the type of support your colleague may need will be unique to their personal circumstances and role.

This information was last reviewed in 2023.