With increasing life expectancy and the changing age structure of the population, the health sector is experiencing increased demands on services associated with age-related diseases including stroke and Alzheimer's disease. The communication needs of older Australians in these disease groups need to be understood to enable adequate provision of speech pathology services. In this project we set out to make a preliminary investigation of 12-month communication outcome and discharge destination of aphasic stroke survivors over age 65 at onset of first ever in a lifetime stroke (FELS). The recruitment timeframe was a 6-month period of stroke admissions to a large metropolitan health network. Nearly 70% of stroke admissions were aged 65 years and over and 34% were ascertained retrospectively from medical records as having aphasia. Within this group, there was a 20% mortality rate. Sixteen left-hemisphere stroke survivors with aphasia were followed up at 12 months. More than half were living in residential care. Excluding the impact of recurrent stroke, 12-month reassessment of language demonstrated substantial improvement could occur in the old-very old stroke survivor. These findings highlight the need to develop systematic review and follow-up speech pathology services that operate effectively in residential care environments.