Objective To explore the care needs of stroke patients at different phases, so as to provide better basis for continuing care for patients. Methods Based on the Timing It Right (TIR) framework, semi-structured interviews were conducted to explore the care needs of 52 stroke patients at different phases of disease course（ 10 cases at acute phase, 13 at stabilization phase, 10 at preparation phase, 10 at adjustment phase, and 9 at adaptation phase） and the phenomenological methods were used to analyze the interview data. Results Different care needs in five phases were extracted: emotional and family support needs, and needs for disease diagnosis information at acute phase; needs for targeted rehabilitation training guidance, etc., at stabilization phase; needs for ca-regiver role readiness at preparation phase; needs for continuous nursing care at adjustment phase; needs for returning to social life in adaptation phase. Conclusion Stroke patients at each phase have different needs across the care continuum.Understanding of these needs helps to establish a discharge readiness service model which dovetails with the Timing it right framework, and to rea-lize the continuity of information, management and relationship among hospitals, communities and families.