What is Aphasia?
Aphasia is a disorder that results from damage to the parts of the brain that contain language. Aphasia can cause problems with any or all of the following: speaking, listening, reading, and writing.
Damage to the left side of the brain causes aphasia for most right-handers and about half of left-handers. Individuals who experience damage to the right side of the brain may have additional difficulties beyond speech and language.
Individuals with aphasia may also have other problems, such as dysarthria (slurred speech), apraxia or swallowing problems.
Signs and Symptoms of Aphasia
Aphasia can cause problems with spoken language (talking and understanding) and written language (reading and writing).
Aphasia can be mild or severe depending on the amount and the location of the damage to the brain.
- Difficulty using words and sentences
- Short or incomplete sentences (omits smaller words)
- Use words that don't make sense (jargon)
- May have difficulty finding words
- May put words in the wrong order
- May switch sounds
- May struggle with both using words and understanding
- Difficulty understanding others
Communicating with the Aphasic Patient
- Make the patient's daily schedule of activities as routine as possible. A structured day improves the patients' orientation and memory allowing them to take on greater responsibility in their rehabilitation.
- Try to provide communication stimulation during routine patient care activities. For example, as you feed them, talk about the foods they are eating for dinner, the classification, the way the foods they are eating are prepared.
- Never discuss anything in the presence of the aphasic patient that you would not want them to hear. Even the patient whose comprehension is poor may attend to body language such as facial expression, which may result in the patient becoming confused or frightened.
- Encourage the patient to participate in group activities to promote socialization and language stimulation.
- Don't discuss the patient's business or personal matters with them when they are fatigued or become upset. Postpone it for another time.
- Be sure you have the patient's attention before beginning any communication. Touch them on the shoulder, wait until they are looking at you and then begin.
- For best results, the environment in which you are communicating should be quiet and calm, and as relaxed as possible for optimal communication.
- The patient is an adult and should be continued to be treated as one. Although there may be comprehension difficulties, they are aware that they are adults, and treating them any other way is demoralizing.
- Speak slowly, using natural pauses. Use your natural voice. Don't shout, the patient is not deaf or hard of hearing, they are aphasic.
- Keep instructions or questions short, simple, direct, and answerable with a "yes" or "no". Use gestures or visual cues whenever possible.
- If the patient does not understand or respond appropriately, tell them that they did not understand you, pause, and repeat, possibly rewording it.
- If the patient is trying to tell you something and you are unable to understand, ask simple questions and use simple gestures until they indicate that you have found the subject area.
- If all techniques fail, and you do not know what the patient is trying to tell you, admit it, saying "I'm sorry, I don't understand. Maybe we can try again later."
- Give the aphasic time to respond, don't interrupt, or try to fill in for them.
- Often an aphasic patient is able to say a word one moment, but not the next, or repeat it again at a later time, Don't say, "You said it yesterday, you can say it again" By giving the patient just the beginning sound of the word they are trying to say, may be helpful. Or describing similar words or what it's used for.
- When the aphasic patient makes a mistake, try to minimize the frustration by saying, "That's hard to get out".
- Don't correct errors. Try re-stating what you think they were trying to get out.
- In group situations, don't talk for the aphasic patient, or don't talk as if they were not in the room.
- Be realistic, Telling them that "Your speech will come back" will not make them feel better in the long run. Instead, be honest, "We can't tell how much speech will return. You just have to try your best."
- Try not to show your frustration or take your frustration out on the patient.
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