Background: Communication in health care is sometimes problematic because of the participants' asymmetrical positions when negotiating the patients' future care. When decisions are made about stroke survivors' care treatment they should be involved despite communicative disabilities.

Method: In a total of five hours recorded talk, data from care-planning meetings with elderly persons surviving stroke, has been transcribed and analyzed. To identify how the actors agreed upon decisions about care efforts after discharge, an inductive analyzing approach was used through the procedure of coding and categorization. By looking for patterns the two approaches emerged.

Findings: Two distinctive approaches appeared in the communicative process, the open-minded and the aimdriven. The open-minded was characterized by questioning, merging information discussing alternative solutions leading to a goal step by step. The other communicative approach appeared to be aim-driven and was characterized by alliances between some of the participants. When the participants were involved in communicative alliances, they seemed to share a predetermined common goal for the patient's further care after discharge. The most significant alliance involved the patient together with relatives. The most noteworthy finding is that of the patient's need for communicative alliances with other participants when negotiating their needs and desires of further care. It was shown the stroke survivors are able to express their life world perspective when they are in alliances with relatives or healthcare professionals.