Occupational transaction after stroke constructed as threat and balance

Older adults who have had a stroke may experience anxiety, depression and difficulties participating in meaningful occupations while also experiencing excitement, discovery and satisfaction in creating a new occupational balance. The aim of this qualitative study was to explore how older adults experienced the changes in their everyday occupations after a stroke. Five women and three men who had experienced a mild to moderate stroke participated in focus group discussions. Systematic text condensation was applied. The participants’ experiences revealed how the stroke was perceived as an ‘occupational threat’ that produced feelings of social exclusion which were experienced as occupational exclusion, deprivation, marginalisation and imbalance. However, at the same time, the participants reconstructed occupational balance by performing occupations in new ways. The participants’ experiences provided insight into how they perceived their occupations as threatened after their stroke, while at the same time endeavoring to reconstruct occupational balance. These findings indicate that everyday life after stroke is a time of transaction where people are actively involved in creating control, occupational balance and being socially include