How NUH helps stroke survivors return to work

Published on 20 February 2026

The Early Supported Discharge Programme and Return To Work Clinic are among NUH’s efforts to empower stroke survivors in regaining independence, both at home and in the workplace.

At a glance

• NUH’s Early Supported Discharge Programme brings intensive rehabilitation into patients’ homes, helping stroke survivors regain independence sooner.
• More than 65 per cent of stroke survivors who were employed before their stroke returned to the same or a modified job after completing the programme.
• The Return To Work Clinic supports survivors beyond physical recovery, addressing cognitive, emotional and workplace challenges.

When 54-year-old senior assistant engineer Mr Chen Chye Song suffered a stroke in December 2024, he was left with weakness and poor coordination on his left side. Everyday tasks such as walking, household chores and typing became difficult.

The father of two also worried about whether he would be able to return to work – a common concern among working adults who have had a stroke. As his children have yet to complete higher education, the thought of not being able to provide for his family felt “scary”, he said. 

In Mr Chen’s case, those fears proved unfounded. He was among those who have benefited from National University Hospital’s (NUH) Early Supported Discharge (ESD) Programme since its launch in 2007. Through the programme, he was able to return to work in less than a year.

A key feature of the structured programme is that it brings intensive rehabilitation into patients’ homes. Selected patients like Mr Chen, who are medically fit and have adequate home support, are discharged from hospital earlier to continue their rehab at home, within the comfort of a familiar environment and community.

The multidisciplinary ESD Programme is led by Dr Bernard Chan, Senior Consultant, Division of Neurology, Department of Medicine, NUH, and includes a neurologist, a physiotherapist and an occupational therapist.

 
Helping survivors become ready for work

An international study led by researchers from the National University Health System (NUHS) found that while more than 80 per cent of young stroke survivors regain good functional recovery – meaning they are able to manage daily activities independently – only about 60 per cent successfully return to work.

The research included nearly 2,000 stroke patients from NUH and Ng Teng Fong General Hospital. 

Lead researcher Dr Benjamin Tan, Consultant, Division of Neurology, Department of Medicine, NUH, said: “Every stroke survivor deserves to have the right support in place to (enable) a full recovery. For younger stroke survivors, in particular, NUH’s vision is to make return to work a possibility for more patients.”

Ms Chen Zhenzhen, Senior Principal Occupational Therapist, Department of Rehabilitation, NUH, said that post-stroke rehabilitation at home and in the community helps patients regain functional skills and reintegrate into daily life more effectively.

“Patients tend to recover better in familiar surroundings because it allows them to practise functional skills and real-life daily tasks,” she said. “Caregivers can also learn how to support the patient as they move around in their home or in the community.”

In Mr Chen’s case, he was discharged just a week after his stroke. He then underwent one month of intensive rehabilitation at home under the ESD Programme. A physiotherapist and an occupational therapist visited his home 10 times, helping him rebuild strength, coordination and confidence through targeted exercises, daily activities and work-related tasks.

With his wife supporting him throughout his recovery, Mr Chen’s consistent efforts eventually paid off, and within three months, he saw his condition improve significantly.

When work is still a struggle

NUH also supports stroke survivors through a dedicated Return To Work (RTW) Clinic for those who find it challenging to resume employment after a stroke.

Introduced in 2021, the clinic is run by a multidisciplinary team that looks at the full range of challenges survivors may face, including physical, cognitive, psychological and social issues that can affect work.

Occupational therapists tailor rehabilitation to job roles and daily routines, while stroke case managers focus on mood, confidence and other social challenges and needs, said Ms Magdalene Chia, Stroke Case Manager, RTW Clinic, NUH. Since it started, the clinic has supported more than 180 patients, including 33-year-old paramedic Nur Azhar Hanafiah.

After his stroke in June 2025, Mr Azhar initially returned to administrative duties, uncertain if he would be able to resume paramedic work. Through the RTW Clinic, however, he received enough support to be able to gradually transition back to frontline work.

“I’m back on the ground now, but with an extra member (of my team) to accompany me in case I become fatigued,” he said. 

Why recovery is not just physical

The RTW clinic also uses tools such as the Patient Health Questionnaire-9 (PHQ-9) to screen for depression, as well as the Montreal Cognitive Assessment (MoCA) to identify patients who may have cognitive deficits and be at risk of workplace difficulties.

A study led by NUHS researchers found that those who performed better on the MoCA were more likely to return to work within three months. Data showed that cognitive and psychological challenges, such as difficulties with memory, concentration and mood, were strongly linked to whether stroke survivors resumed employment, said Dr Tan.

“Physical recovery alone is probably not enough when we talk about returning to work,” he said. “Cognitive and psychological barriers are often less visible and not easily assessed, and they should be systematically assessed in post-stroke patients.” 

As such, identifying risks early and matching patients to the right support or intervention can create a more coordinated path from acute care to the workplace.

Cherishing ordinary routines

Today, Mr Chen’s life has largely returned to normal. He cherishes the ordinary routines that many take for granted, such as climbing stairs, taking daily walks on his own and continuing the work he loves.

“The battle to recovery has been tough but behind it, there are many heroes like my wife and the NUH therapists who taught me many techniques to regain function,” he said. 

Mr Chen also expressed his gratitude to his employer and colleagues who supported him when he returned to work. “I’m not as fast as before, but their patience has helped tremendously,” he added. 

He also encouraged other stroke survivors looking to return to work to overcome their fears and persevere for their loved ones. 

“Stroke is scary, but I did not give up because of my two children – my daughter is still studying, and my son is serving National Service,” he said. “They gave me the strength and willpower to win this battle.”