‘End-of-life care in stroke’ examines the specific challenges in stroke, the challenges and difficulties of decision-making, identifiers of poor outcome, defining what is ‘good stroke death’, effective communication, role of resuscitation, clinically assisted hydration and nutrition, prepalliative care plans, personalized end-of-life care for the dying patient, symptom control, and issues concerning grieving and caring for the staff members.
Over 80% of stroke deaths happen in those over 75. In most cases of life-threatening stroke, mental capacity is lost. Advanced care planning is rarely done and issues around decision-making are often challenging for those close to the patient. Families need an active communication process from day one with a realistic discussion of options. Where a poor outcome is feared, this needs communicating with reassurance and decisions made that would reflect the wishes and best interests of the person.