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Imagine not being able to able to convey your thoughts to your family or friends. Imagine not being able to understand what they are saying to you. Aphasia can be incredibly isolating for these reasons. It's important to know that while aphasia affects the language parts of the brain, one's intellect is often intact. This can be incredibly frustrating. Your loved-one may think the same way and know exactly what they want to say, but struggle to get their message out. People with aphasia report that everyone talks around them as if they aren't in the room. It's important to help your loved one with aphasia feel included. Here are some simple things you can do to help avoid isolation, maintain their connections, and feel heard and understood.
A: ask simple & direct questions
P: provide many ways to help them understand
H: help communicate, if asked
A: acknowledge their frustration. "I know you know..."
S: speak clearly, slowly, and pause
I: if you don't understand, say so
A: allow extra time
*Adapted from National Aphasia Association: "The Aphasia Caregiver Guide."
1. Ask simple and direct questions
Instead of saying, "Before we go to the bank and your appointment, do you want to stop at Chick-Fil-A?"simply ask, "Do you want Chick-Fil-A?"
Keeping it simple doesn't disrespect the person. It means thinking through what you need to say and removing the unnecessary parts of the story or question. Try to get to the heart of the matter.
2. Provide many ways to help them understand
Support your communication with pictures, writing, drawings, or pointing. For example, to help your loved one understand the plans for the day, you may write down your stops in order. "First we're going to the bank, then the dry cleaners, then to your doctor's appointment." You could write down the bolded words, show them on Google maps, or provide a picture.
Other communication aids may include gestures, facial expressions, pointing to keywords, or communication apps. Don't forget that your phone can be a great tool for communication- you can pull up family photos, show memories on Facebook, type words, or google pictures to make your spoken message more clear.
3. Help communicate, if asked
Adults with aphasia are adults. They have thoughts they want to convey and opinions they want to express. There will be times when they are having difficulty finding a word or responding, and your first instinct may be to jump in and help or guess their intended word. It's more helpful to wait and see if they can do it on their own. You can ask if they want help if you sense their frustration.
There are many strategies you can use to help set them up for success when asking a question. For example, you can ask more yes or no questions. Instead of asking "What are you doing for dinner tonight?" ask "Do you want to cook pasta tonight?" It can also help to provide options, "Should I cook pasta or fish?"
4. Acknowledge their frustration
Show your family member that you understand that he/she may know more than they can say. Say things like, "I know you know." Sometimes you can ask, "Should we take a break? Can we try again later?" Frustration or stress will further impede their word-finding abilities. In those moments, it's best to acknowledge their frustration and their competence, while gently encouraging them to take a break and come back later.
5. Speak clearly, slowly, and pause
Bring awareness to how quickly you may speak. It's incredibly important to slow your rate, enunciate, and pause. In addition, try limiting the amount of distractions and background noise around you. Whenever possible, go somewhere quiet to speak where you can see each other face to face.
6. If you don't understand, say so
Although it may feel helpful, avoid pretending that you understand if you don't. It's often obvious to those with aphasia when you missed their point. Let them know you are a little confused, but you want to make sure you understand them correctly. Give them time to work on the message and encourage multiple methods of communication.
7. Allow extra time
It's typical for us to try and fill in the silence. Practice pausing and work to become comfortable with more silence or breaks in the conversation. People with aphasia need more time to process what is being said to them and what they would like to say back.
Aphasia is a loss of language, not intellect. Your loved-one still desires the need and want to communicate their thoughts and connect with others. I hope these strategies help reduce frustration during communication breakdowns and allow for more successful conversations.
Atlanta Speech & Wellness is the only speech therapy private practice in Atlanta that specializes solely in adult neurological rehabilitation. Our expertise is in brain injury, including stroke, TBI, concussions, and neurodegenerative disorders such as Parkinson’s disease and dementia. We are dedicated to providing individualized evidence-based therapy to help you improve cognitive or communication changes while empowering you to reach your full potential. If you're ready to work hard and return to doing what you love, give us a call!