How To Communicate With Someone With Aphasia

Before his stroke, Thomas Broussard Jr. had a successful career. He was an associate dean at Brandeis University, near Boston, for five years. Before that, he ran a career counseling company for 15 years. But his life changed on September 26, 2011. That’s when he had an ischemic stroke on the left side of his brain. He wasn’t able to see out of his right eye, and the right side of his body was limp.

What he didn’t know at the time was that he acquired aphasia, a language disorder that often occurs as a result of a stroke. Broussard knows that he had conversations with medical providers shortly after his stroke but has no memory of the types of questions he was asked or the answers he gave. Luckily, Broussard’s wife was there to help communicate with medical providers in the hospital and at follow-up visits.

“For many people who’ve had a stroke, the brain is somewhat scrambled for a while,” says Broussard. “Some doctors say it takes about a month for your brain to settle down.”

Broussard began seeing a speech-language pathologistabout a month after his stroke and slowly began his road to recovery. Family members attended the first few sessions but eventually had to go back to work. Broussard notes that writing in a diary also helped him recover, although what he wrote in the early days of his diary did not make sense.

Today, Broussard is the president of Stroke Educatorand volunteers at a local hospital. He also gives talks around the country about brain plasticity and aphasia. His goal is to give patients hope. And to help family members understand what aphasia is and how they can support their loved one. “You have to love the person you’re with,” says Broussard. “Everything has to be made more simple at the beginning and less fast.”

Role of Speech-Language Pathologists (SLP)
The National Aphasia Association estimates that two million Americans are affected by aphasia and that 25 to 40 percent of stroke survivors have the condition. Aphasia results from damage to the parts of the brain that are responsible for language. It weakens a person’s ability to process language and express themselves. Aphasia also affects a person’s ability to read and write.

“Ongoing recovery in chronic aphasia looks different for everybody, and the gains may be more modest than you see in the immediate aftermath,” says Michelle Gutmann, PhD, a speech-language pathologist and clinical professor at Purdue University in Lafayette, Indiana. “But there is research to support the idea that recovery can extend beyond five years after a stroke. I think this information can give people hope.”

Speech-language pathologists use a person-centered approach to treating a person with aphasia (PWA), says Erin Mattingly, a speech-language pathologist and manager at Enterprise Resource Performance in Fairfax, Virginia. “We focus on restorative strategies that aim to restore or improve a PWA’s existing language skills and compensatory strategies to help improve communication when language is not restored to a functional level.”

Another role of a speech-language pathologist is to educate family members on the best ways to communicate with their loved one, notes Mattingly.

For example, a speech-language pathologist may teach a spouse how to prompt her husband to find specific words using verbal and visual cues. The speech-language pathologist may also teach a daughter how to help her mother get dressed in the morning by using pictures of clothing items for the mother to choose from. Or the speech-language pathologist may teach a family member or friend how to use an assistive device like a smartphone or iPad to better engage the PWA in conversation.

Tips for Maintaining Communication With Someone With Aphasia
“When a person has aphasia, it’s often difficult for them to come up with a whole sentence,” says Gutmann. “One strategy that can help is to ask questions in a yes or no framework.”

For example, ask the person if they are thirsty or hungry, which can be answered with a simple yes or no. Other strategies include keeping verbal messages simple, reducing environmental distractions like a loud TV, and using hand gestures in addition to verbal language.

Other tips to consider include:

* Simplify language by using short, uncomplicated sentences.
* Repeat or write down key words to clarify meaning as needed.
* Maintain a natural conversational manner appropriate for an adult.
* Encourage any type of communication — whether it’s speech, gestures, pointing, or drawing.
* Avoid correcting the person’s speech.
* Allow the person plenty of time to talk.

To learn more about communication dos and don’ts for loved ones with aphasia, visit the National Aphasia Association.

Mattingly reminds us that persons with aphasia should have a voice, too. “Whether that’s verbally, through gestures, writing, or devices, they deserve respect, attention, patience, and the chance to be heard.”