1. EXTENDED OCCUPATIONAL REHABILITATION Ksenija Šterman, MD, Specialist for Occupational, Traffic and Sports Medicine Ljubljana, 09.06.2016

2. Disclosure I have no potential conflict of interest to report.

3. Occupational rehabilitation Succeeds the medical rehabilitation Persons with serious injuries or diseases They mostly suffer from a brain injury (through haemorrhage, trauma, stroke, tumours) Patients are referred by their general practitioner or other specialists The services are paid by the Health Insurance Institute of Slovenia

4. Course of work We use a team approach to treatment. The team consists of a physician, specialist of occupational medicine, a social worker, psychologist, occupational therapist and rehabilitation instructor. The activities are being carried out throughout the processes of evaluation, extended rehabilitation, and workplace training. They consist of programmes of managing and reducing difficulties in the cognitive, behavioural, emotional, social areas and in physical activities.

5. Process of evaluation Duration up to three weeks, usually 8-10 days. Persons are normally present 6 hours daily The evaluation is interdisciplinary Focused on discovering the impairments showing on the levels of either personality, behaviour, physical or sensory activity An individual rehabilitation plan is created

6. Extended rehabilitation Duration of few months to one year, in exceptional cases up to two years Increasing self-awareness and creating insight in the consequences of health impairment Cognitive trainings, exercises Learning the strategies to overcome deficits and critical behaviours Individual and group psychological treatment Development of working skills, working endurance and productivity Acquiring new functional skills

7. Extended rehabilitation Educational help Programmes of working therapy and improvement of functional performance Developing the independence and the ability to control important life situations Planning the activities in home setting Developing new areas of interest Working with the family

8. Workplace training Cooperation with the employer Analysis of options for a suitable employment Informing the employer of the individual‘s capabilities, restrictions and specific needs Adapting the workplace, work procedures and accessories Specifying the work tasks The person is further supported by our expert and a mentor in the real workplace.

9. Workplace training Gradual inclusion in the working process The time spent at work daily is gradually extended The work scale and difficulty are also expanded The rehabilitation is finished either when we assess a sufficiently stable work functioning or when we can clearly establish that the person will not be capable of work.

10. Extended rehabilitation analysis From January 2012 to September 2015, 58 persons included

11. Educational and age structure

13. Suggestions at the end of the extended rehabilitation

14. Conclusion Final assessments to acquire the disability status according to the Pension and Invalidity Insurance Act or Vocational Rehabilitation and Employment of Disabled Persons Act Inclusion in employment, training or schooling with adequate supporting measures, advice and adjustments. The progress is being followed The unemployed may continue with vocational rehabilitation based on a referral by the Employment Service of Slovenia If a person is found to be incapable of work, it is attempted to include them in the day-centre programmes or other social inclusion programmes.