This review focuses on the experiences and rehabilitation needs of working age, higher functioning stroke survivors in relation to their 'return to work'. It grew out of the poststroke experience of one of the authors and her realization of the inadequacy of services to facilitate return to work and optimal recovery from stroke. The authors' aim is to present a practice-oriented review that can provide information for future practice and research. Returning to work and sustaining employment are considered key aspects of rehabilitation and recovery by younger stroke survivors. From a psychosocial perspective, successful return to work can enhance recovery and life satisfaction by consolidating self-esteem, confidence and social identity. However, even higher functioning stroke survivors with minimal or no obvious physical disability may experience workplace challenges relating to their neurological condition. Appropriate rehabilitation would include specific preparation for return to work, education within the workplace to facilitate return to work, participation by the stroke survivor in all aspects of the management of their return to work, and an ongoing role for a stroke educator/workplace advocate. In conclusion, further research is required in this area to support stroke survivors in returning to and maintaining employment to achieve their poststroke potential. Thirteen recommendations arising from the existing literature and the lived experience of one of the authors are presented at the end of the review.
Survivors who experience stroke of mild to moderate severity are typically discharged home quickly, with only minimal referral for rehabilitation follow-up or support to meet specific needs in recovery. Particular vulnerabilities of younger, higher functioning stroke survivors have received some recognition in international literature in recent years. This article reports on findings of a small Australian qualitative study focusing on recovery and return to work experiences of young higher functioning female stroke survivors, in particular exploring experiences of post-stroke vulnerability from participants’ own perspectives. Our research adds depth and nuance to this developing area of interest and research. Our findings include survivors’ reflections on the consequences of delayed diagnosis, the impacts of empowering and disempowering interactions with health care professionals, a general lack of access to psychosocial rehabilitation, and frustrations of financial hardship. Implications for health professionals, service systems, and income support provision are discussed, along with directions for future research.
In Australia, 20% of stroke survivors are aged less than 55 years. These younger survivors value age-appropriate, identity-affirming goals, such as resuming employment. This article reports on a small qualitative research project that explored the experiences of young, higher functioning stroke survivors in re-establishing identity and returning to work. The participants understood identity as both an inner sense of self and as socially and discursively constructed. The research found that the participants actively pursued identity continuity while managing biographical disruption. Resumption of life roles and responsibilities were important for identity re-establishment, but fraught, particularly the return to work. The findings suggest that psychosocial rehabilitation could play a greater role in supporting survivors' resumption of valued life roles, including return to work.
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