Influence of low income on return to participation following stroke

Purpose:Low income is known to influence participation post stroke, but the process by which this occurs is poorly understood. Methods:A qualitative multiple case study approach, focusing on the experience of returning to participation in personal projects among eight low-income francophone stroke survivors living in eastern Ontario (Canada). Data included semi-structured interviews with the stroke survivors and with their care partners, participant observations, assessment measures, and chart reviews. Results:Healthcare professionals inconsistently gave the stroke survivors needed information and assistance to access entitlements during discharge planning. Income support programs were difficult to access and once obtained, were not completely adequate to support essential necessities (food, medication) in addition to other goods and services related to valued activities. Housing was an important monthly expense that limited available monies for personal projects. Only in instances where participants were assisted with housing by informal networks were there adequate funds to pursue personal projects. Conclusion:This case study demonstrated that even in a universal healthcare system, post-stroke participation for those with low incomes was severely restricted. Changes at the clinical level and at the public policy level could facilitate participation.