Monday, October 15, 2012

Communicating With People Who Have Aphasia

I am copying this here because it is how I have to communicate with my husband. I think it would be very useful for people to know and I am thinking of printing it out and handing it to folks at the

Communicating With People Who Have Aphasia
Some Do's & Don'ts

Aphasia is a communication impairment usually acquired as a result of a stroke or other brain injury. It affects both the ability to express oneself through speech, gesture, and writing, and to understand the speech, gesture, adn writing of others. Aphasia thus changes the way in which we communicate with those people most important to us: family, friends, and co-workers.

The impact of aphasia on relationships may be profound, or only slight. No two people with aphasia are alike with respect to severity, former speech and language skills, or personality. But in all cases it is essential for the person to communicate as successfully as possible from the very beginning of the recovery process. Here are some suggestions to help communicate with a person with aphasia:

  1. Make sure you have the person's attention before communication.
  2. During conversation, minimize or eliminate background noise (such as television, radio, other people) as much as possible.
  3. Keep communication simple but adult. Simplify your own sentence structure and reduce your own rate of speech. You don't need to speak louder than normal but do emphasize key words. Don't talk down to the person with aphasia.
  4. Encourage and use other modes of communication (writing, drawing, yes/no responses, choices, gestures, eye contact, facial expressions) in addition to speech.
  5. Give them time to talk and let them have a reasonable amount of time to respond. Avoid speaking for the person with aphasia except when necessary and ask permission before doing so.
  6. Praise all attempts to speak; make speaking a pleasant experience and provide stimulating conversation. Downplay errors and avoid frequent criticism/corrections. Avoid insisting that each word be produced perfectly.
  7. Augment speech with gesture and visual aids whenever possible. Repeat a statement when necessary.
  8. Encourage them to be as independent as possible. Avoid being overprotective.
  9. Whenever possible continue normal activities (such as dinner with family, company, going out). Do not shield people with aphasia from family or friends or ignore them in a group conversation. Rather, try to involve them in family decision-making as much as possible. Keep them informed of events but avoice burdening them with day to day details.
These guidelines are intended to enhance communcation with persons who have aphasia. However, they cannot guarantee that communication will be immediate or on a par with former skills.

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Needing a wheelchair

It seems so strange to me that 1 1/2 years of taking care of Dean could result in me still learning new things about his injuries, but it's happened.

We don't go many places and I always thought that with the diagnosis of PTSD it must be that all the people and bustle was just too much for him. I was almost right. There is actually another piece in there that never occurred to me until one day at the VA.

I took him to the VA for an appointment one Monday after he had been at drill all weekend (drill always wipes him out). He was beat this day and I talked him into letting me push him in a wheelchair around the VA and he complied. We were there for many hours and through much stress. Now normally after a day at the VA when he gets back into the truck afterwards, he is putting off an air of "get me the hell home and don't talk to me" and he is very shut down. But this particular day after having been pushed in the wheelchair at the VA he was jovial and happy in the truck on the way home. I asked him if he thought the wheelchair had anything to do with it and although he didn't like admitting to it, he said the wheelchair helped him.

We tried the wheelchair routine for the next couple of appointments and it worked the same way time after time.

It was a weekend camp retreat where we had to do lots of walking in this most beautiful forest setting (which is Dean's favorite place to be) where I was really wishing he had a wheelchair. I could see how much mental energy the walking was taking from him. He said that every step was like stepping off of a moving cart and that it really just wipes him out.

It was this weekend that I realized that the main reason we avoided leaving our house was not due to the PTSD, it was that walking took so much concentration and mental energy that he didn't have any brain function left to deal with the people, the bustle, the noise, etc. When I remove the need to walk from the equation, he can handle the other stuff 100 times better!