Advocate at the hospital on behalf of the stroke survivor

If the patient was transported to the hospital by ambulance, the ER staff should already know the nature of his emergency. Still, he needs you to serve as his advocate, which you can do in a number of ways:

• Speak up! Don't be shy or embarrassed to advocate for your good friend or relative. In his book Stroke for Dummies, John Marler says that something is wrong if someone who's had a stroke has been in the ER for more than five minutes without attention. You're not being pushy if you insist on his being seen immediately; stroke treatment is a race against time. Your job is to make sure the doctors and nurses understand that he's had a stroke.

• Report events accurately. Tell the ER staff exactly what happened and when it happened. For many strokes, treatment with intravenous clot-busting drugs can greatly reduce brain damage and increase the chances of recovery. But these drugs need to be administered within three hours of the onset of stroke symptoms -- and the sooner treatment starts, the better the outcome. So if his stroke began less than three hours before his arrival at the ER, it's even more critical that he be evaluated right away.

• Provide medical background. The ER staff will need to know important medical information about him, in addition to the details about this particular event. Has he had a stroke before? If so, when and what kind was it? What medications is he taking -- and does he actually take them as prescribed?

• Ask questions. Does the hospital have a stroke team? If so, is that who's treating the person you're caring for? If not, why not? Can his stroke be treated with drugs that dissolve blood clots? If so, has the treatment been started yet? If not, why not?

• Consider yourself part of the treatment team. Although you are his advocate, try not to be adversarial about it. James Frank, ICU director at the San Francisco Medical Center, spends much of his time talking to families of critically ill patients. "The best way you can advocate for someone is by working with the doctors and nurses," says Frank. He also recommends appointing a single spokesperson for the entire family so the ER staff isn't bombarded with questions and demands from different people. It's best if this spokesperson has durable power of attorney or has been appointed as the stroke survivor's agent in an advanced health care directive.
  

But your role doesn't end once you're comfortable with how your loved one is being cared for in the ER. Next he'll be moved into a hospital bed, where you can continue to be his staunch supporter and learn how to deal with the aftereffects of the stroke.