Parenting After Stroke

Stroke is the fifth leading cause of death in the United States and the leading cause of disability. Historically, stroke has been considered a condition limited to older adults. However, stroke is affecting an increasing number of young and middle-aged adults. Effects of stroke may be more profound for younger adults due to the disruption in their life course at a time focused on employment, family routines, and childcare responsibilities. Beyond paid employment, there is a paucity of research on resuming meaningful life roles such as parenting. Any impairment from stroke can make it difficult to be a parent to the same extent and level of engagement as before the stroke. As parenting is a critical life role with numerous responsibilities and challenges, the intersection of parenting and stroke recovery must be explored.

The purpose of this dissertation research was to develop a better understanding of how parenting both affects and is affected by the experience of having a stroke among younger stroke survivors. The research purpose was accomplished through a systematic review examining the state of the science on parenting after stroke (chapter 2), a qualitative study assessing the parenting experiences of 10 younger survivors following stroke (chapter 3), and a longitudinal concurrent convergent mixed methods study exploring the change in health-related quality of life and acute recovery experiences among 30 younger stroke survivors with targeted analyses to explore the role of parenting (chapter 4).

Parenting tasks were severely limited following stroke, though the specific duties impacted were dependent upon the age of the child. Stroke impairments disrupted survivors’ identities, relationships, and roles as parents as well as those of their families. Parents’ heightened concern for their children and an inability to consistently meet their needs may have affected their recovery. Support from family, friends, and extended networks was vital to survivors during the recovery process. However, difficulty in accepting dependence and variation in survivors’ relationship dynamics likely influenced the role of social support. Insurance and finances, often related to employment and income changes, were determinants of access to care following hospital discharge. Accessing care allowed survivors to engage with healthcare providers who helped them to improve and manage their impairments. Coping strategies influenced survivors’ adaptation post-stroke while their level of determination contributed to their engagement in rehabilitation activities. Finally, being of younger age influenced survivors’ experiences with stroke recognition, diagnosis, and recovery. Findings from this dissertation will be used to inform future studies seeking to improve the lives, well-being, and health of younger stroke survivors living with minor children.