Current guidelines on end of life palliative care for patients with severe stroke remain underdeveloped, especially when approximately a third of patients will die after a severe stroke. Gillian Mead, MA, MB BChir, MD, MRCP, FRCP (Edin), FESO, The University of Edinburgh, Edinburgh, UK, talks on future research directions on the topic. Incorporating frailty in prognostic scales and implementing shared decisions will ensure patients outcomes will improve. Detailed studies investigating the symptoms patients experience after a stroke as well improved approaches to dealing with grief in families will additionally benefit patients and their relatives. This interview was conducted during the 2022 World Congress on Controversies in Neurology (CONy) meeting.