‘Occupational therapy in older people with stroke’ examines how occupational therapists (OTs) increase people’s independence, quality of life, and satisfaction in all aspects of daily life. A fundamental philosophy of OT is to treat everyone as an individual, taking into account their personal roles, beliefs, attitudes, function, and environment. Consequently, the approaches to rehabilitation described in this chapter may be applied to both older and younger adults. A case study has been used for illustration. Key aspects of functioning affected by stroke are explored, focusing in particular on cognition and perception. The OT will work with the patient and their family to identify areas of function which are particularly important to them, and will aim to enable people to complete these activities as independently as possible. This chapter gives an insight into key fundamental therapeutic interventions with the older person following a stroke.