Stroke, while more prevalent in older adults, has become increasingly common in people younger than 65 years and is frequently observed in individuals in their twenties, thirties, and forties [1, 3]. The prevention, diagnosis, and treatment of stroke however, including ongoing management, have primarily evolved to meet the health care needs of older adults and are thus often unsuited to young people [4, 5]. According to research on idiosyncratic matching bias, people tend to dislike settings or objects that comprise features they perceive as extraneous, especially if other people like these features [29]. Young stroke survivors receiving care in settings aimed at the needs of older people may feel a sense of incongruity with their surroundings. Unconscious biases are likely also at play here. When people, such as healthcare workers, are exposed to older people, they adjust their attitudes and behaviours [30, 31]. They tend to express more conservative ideologies, walk more gingerly, and demonstrate other tendencies that enhance their capacity to accommodate elderly individuals. Even subtle reminders of older age groups, such as the word grey, can elicit similar tendencies [30]. Therefore, in stroke units in which many people are older, healthcare workers may inadvertently initiate behaviours that suit older, but not young stroke survivors.
The young stroke survivors interviewed in this study expressed concern that health practices do not accommodate the distinct needs and perspectives of young stroke survivors. Diagnosis was often delayed, because these individuals did not exhibit the signs of strokes that may be observed in older adults, and this ultimately compromised treatment efficacy and increased the risk of poor health outcomes reflecting similar findings to the literature [1, 3]. Young people were often unaware of the signs and risk factors of stroke, such as medication, autoimmune conditions, and singular vascular risks, because these individuals’ associated strokes with older adults. Participants also described feeling as though there was a lack of awareness about risk factors in young people in the health care professionals they encountered. Some specialists did not exhibit the same concern to young stroke survivors, assuming they would recover because of their physical fitness. These experiences coalesced in a feeling of alienation rather than belonging. Particularly as the focus on improved physical function fails to address the psychological, occupational and neurological impacts of stroke [8, 12].
The findings in this study are consistent with recent literature highlighting the importance of a person-centred approach to safe and effective care that address the connection between stroke severity, fear of stroke reoccurrence and overall impact on the person’s perceived quality of life [11, 32]. According to participants in this study, the fragmented nature of the health sector may have exacerbated these concerns. Because health services are circumscribed, participants felt that transitions—such as the transition from hospital to home—were not adequately supported. In addition, because of fragmentation, health care was seldom holistic and thus many of the emotional or social needs of survivors were overlooked. Feelings of alienation and frustration therefore, often remained untreated.
In approximately 40% of young stroke survivors, the cause of stoke is deemed as cryptogenic, indicating that no cause can be identified, despite extensive investigation [7, 12]. The young stroke survivors in this study who were not able to identify the cause of their stroke did not feel buoyed by the belief they could address their needs into the future and prevent further risk of stroke. Problems with memory and communication amplified this sense of helplessness as well as a reliance on family. The sense participants had that their impairments might last indefinitely, the inability to earn an income and to assist their family, greatly magnified this distress. Despite these circumstances, participants in this study reported many positive feelings and thoughts. They developed a resilient mindset, in which they conceptualised their experience as a challenge they must embrace to facilitate their recovery. They became more inclined to appreciate various facets of their life and learned to accept some of their limitations. As many studies show, both gratitude and acceptance are strongly associated with wellbeing and happiness [33, 34].
Despite the significance of these findings, researchers will need to conduct further research to validate the findings of this study. Limitation of this study are that the sample might have been skewed, because stroke survivors who were the most emotionally fragile may have refused to participate. Findings, such as the resilience and gratitude that many individuals exhibited, might not be representative. Furthermore, individuals often exhibit biased recollections of the past. For instance, people tend to overestimate how unpleasant they felt during adverse events in the past [35]. To address these concerns, future studies could utilise momentary sampling to assess the ongoing experiences of young stroke survivors during the experience.