My dad just had a stroke. What do we do now?

Your first job: the next 48 hours

Right now you are the person who holds the information, so start there. With a stroke, one fact from you can change the treatment he is eligible for.

• Report the exact time he was last seen normal. This "last known well" time decides whether clot-clearing treatments are still safe. If he woke up with it, say so precisely.
• Bring his medication list, or the pill bottles in a bag. Blood thinners especially change what the team can do.
• Tell the team who he was last week (walking, talking, living alone), and pick one family point person so updates don't scatter.
• Ask two questions: "Was this an ischemic or a hemorrhagic stroke?" and "Given the timing, is he a candidate for clot-busting medicine or a clot-removal procedure?"

Why imaging comes first, and why the type matters. A brain scan comes before any treatment because the two kinds of stroke are opposites. About 87% are ischemic (a clot blocking blood flow); the rest are hemorrhagic (a bleed). Clot-busting drugs help the first and are dangerous in the second, so the scan has to come first. For a clot, teams may give a clot-dissolving medicine (usually within about 4.5 hours of onset) or, for a large blockage, remove it with a catheter (in selected patients, sometimes up to 24 hours). "Time is brain," so speed is everything, which is exactly why your timing detail matters so much.

In the hospital: things to consider

Most stroke patients are cared for on a dedicated stroke unit, which is one of the best-proven parts of stroke care: it measurably improves the odds of surviving and going home. The sickest go to intensive care. Stays vary a lot, but often run a week or two.

Two things families often notice first. Swallowing: the team will do a swallow screen before he eats, drinks, or takes pills by mouth, and may keep him "nothing by mouth" at first, because a stroke can make swallowing unsafe and send food into the lungs. Delirium: a sudden, fluctuating confusion that affects roughly one in five older stroke patients. It's usually temporary. Familiar things help (glasses on, hearing aids in, a familiar face), and you can flag it to the nurse, since you know his baseline and they don't.

Before he leaves, get these

• A written med list you've personally compared against his old one. Errors at discharge are extremely common (studies find most patients have at least one), and they drive readmission.
• A clear picture of what the stroke affected: movement, speech, swallowing, vision, thinking. This shapes the rehab decision next.
• A prevention plan in writing: the blood-pressure and, if needed, blood-thinner plan that lowers the chance of another stroke. Ask who owns it.

Which rehab setting?

This is the decision families are least ready for, and it comes fast. A hospital discharge planner proposes options and you decide. They must give you a list of facilities with quality data (you can compare them on Medicare's Care Compare) and can't steer your choice. Rehab should start in the hospital and continue in one of these settings:

Higher-intensity inpatient rehab tends to show bigger gains, though that partly reflects who's well enough to go there. The therapy comes in three flavors: physical (moving, walking, balance), occupational (dressing, bathing, daily tasks), and speech (talking, thinking, and swallowing). Whichever setting, your job is continuity: the medication list, the deficits, and the prevention plan have to travel across every handoff, because the system won't carry them for you. This is exactly what Greenlue holds together, so you're not the filing cabinet.

Coming home, and the months ahead

The hospital part is short. Recovery is the long game, and this is where your role really is. Here's the job, as a checklist.

Set up the home first

• Falls are common after a stroke (a large share of survivors fall in the first months), so clear throw rugs and cords, add grab bars and a shower chair, and light the paths.
• Ask the occupational therapist or social worker for a home check before discharge; they'll flag what to change and what equipment helps.
• If speech was affected, set up simple communication aids: a picture board, a whiteboard, or a phone app.

Sort the paperwork (while he still has capacity)

• A healthcare proxy, a financial power of attorney, and a HIPAA authorization naming you (free forms: AARP, CaringInfo). A stroke can affect the ability to decide or sign, so this is more urgent than after most events.
• Keep those, the discharge papers, and his records in one place the family can reach. That's what Greenlue holds, so there's no binder to carry around.

Know what to watch for

Here's how the American Stroke Association says to spot another stroke, using the word F.A.S.T.:

Some versions add Balance loss and Eye or vision changes (B.E. F.A.S.T.). These are general signs from a national source. His care team may give you a different list for him, so go by what they tell you, and call 911 for any emergency.

His recovery, day to day

• The fastest gains usually come in the first three months, with more out to six months or a year, then a slower phase. Progress can still continue after that; a plateau means slowing, not stopping.
• Recovery happens between sessions, not just in them. The therapists set the plan; the biggest help is that he keeps doing the "homework," within what they okay.
• Common leftovers include weakness on one side, trouble with words (aphasia), swallowing changes, and deep fatigue. Keep every therapy and follow-up appointment.
• Watch mood closely. About one in three stroke survivors get depressed, and it quietly slows recovery, so mention low mood early.

What he'll need from you, and protecting yourself

• Rides to therapy, keeping meds straight (especially the stroke-prevention ones), meals, and patient encouragement.
• If speech is affected: give extra time, use short sentences, don't talk louder, and talk with him, not for him. Don't finish his sentences.
• Split roles with siblings: one on the medical side, one on paperwork, a shared calendar. Stroke caregiving is heavy, and most caregivers report real strain, so share it.
• Use FMLA if you work (up to 12 weeks, job-protected, a few hours at a time), and treat your own sleep and mood as part of his care plan.

Nearly all of it is coordination

Which is exactly what Greenlue carries with you:

Common questions