When Communication Becomes a Struggle: Living With Aphasia

Living with AphasiaThere are few things as frustrating in life as not being able to make yourself understand. That’s unfortunately the situation with aphasia, a disorder in speech and language. Aphasia is more common in older adults because of its occurrence in conjunction with illnesses and medical conditions that happen later in life.

What is Aphasia?

The National Aphasia Association describes aphasia as a communication disorder affecting approximately 2 million Americans. It most commonly occurs with a stroke, but other causes include head trauma, brain tumors, or infections. Another form of the disorder is Primary Progressive Aphasia (PPA), caused by neurodegenerative diseases such as Alzheimer’s or Frontotemporal Lobar Degeneration.

For those who have PPA, the main issue is related to language and communication. Individuals with PPA may be perfectly able to live their own without assistance—at least for a time. However, since this is a progressive disease, the worsening of their ability to communicate will cause disruption in various elements of their daily life—i.e., talking on the phone, the ability to read and process language, the ability to speak or communicate in writing. Of course, this will make it inadvisable to drive, and the individual’s ability to go out alone without getting lost or confused will also be compromised.

Since PPA is caused by a degeneration in the areas of the brain that control speech and language, the initial stages will not impact such functioning as memory, reasoning, and visual perception. These mental abilities typically show decline in the later phases of the disorder.

Aphasia caused by stroke is related to an injury to one or more language areas of the brain. The severity of the aphasia is related to where and how severely the stroke caused damage. For instance, Broca’s aphasia (non-fluent aphasia) manifests itself with less fluency in speaking and misuse of words. Wernicke’s aphasia (fluent aphasia) may result in confusing and rambling speech in which the speaker adds unnecessary words and even invents new words. Global aphasia (the most severe form) leads to several communication problems that affect the individual’s ability to speak and comprehend language.

For those with Alzheimer’s or other forms of dementia, aphasia is often an associated condition of memory loss. An individual may forget words and also be unable to understand the spoken or written word. As is the case with other symptoms of Alzheimer’s, this is a condition that worsens over time. You may notice this condition by the individual’s increasing use of vague terms such as “that thing” or “that guy” rather than the use of the actual noun or name.

Ways to Communicate

Whatever the cause of aphasia, there are several treatments and strategies that have proven effective in improving communication. The American Speech-Language-Hearing Association (ASHA) reports that speech-language pathologists work with those suffering from aphasia to improve the specific language skills impaired by damage to the brain. There are also various strategies that ASHA recommends when communicating with someone with aphasia, including:

  • Get the person’s attention before you start to speaking.
  • Maintain eye contact and watch the person’s body language and gestures.
  • Minimize or eliminate background noises (such as TV, radio, and other people).
  • Speak at a normal volume—don’t speak loudly unless the person asks you to do so.
  • Keep communication simple, but use adult language. Don’t “talk down” to the person.
  • Reduce your rate of speech.
  • Give the person time to speak. Don’t finish the person’s sentences or offer words.
  • Communicate with drawings, gestures, writing, and facial expressions in addition to speak.
  • Ask “yes” or “no” questions instead of open-ended ones.

Senior Living Options

If your parent’s aphasia is related to a stroke, Alzheimer’s, or another form of dementia, you should consider the overall care needs of your parent in making a decision about the best senior living option. Independent living may be just fine for those individuals who can still care for themselves and need no assistance with the activities of daily living. However, assisted living or memory care may be the better option if your parent’s aphasia is impairing daily functioning and if the condition has progressed to the point where memory and reasoning are now impaired.

In the event of a stroke, skilled nursing may be the option needed to deal with the totality of your parent’s condition that may extend beyond aphasia to physical impairments that restrict movement or the ability for your parent to eat, dress or bath without assistance.

Clearly, there is no one-size-fits-all solution. Have your parent’s doctor weigh in on your parent’s health needs, and consider your parent’s preferences to make the most appropriate decision.

CHIME IN: Does your parent have difficulty with language? What are some of the ways you communicate?

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