Aphasia Can Make Communication Difficult But Not Impossible

Anthropologists say that human’s ability to speak and express our thoughts verbally makes us particularly special as a species, especially when compared to other animals.

That’s why it’s especially difficult when certain medical conditions can take away someone’s ability to vocalize or speak clearly, a condition generally called aphasia. Some residents of Manchester and elsewhere may experience aphasia for different reasons and at different points in their life, including while receiving palliative care.

The team at Above and Beyond Home Health Care and Hospice has worked with several clients experiencing aphasia over the years. This condition can be challenging for the clients, who have difficulties communicating without their voices, and it can be challenging for caregivers and people around them who are trying to communicate right back and understanding what they have to say.

In many cases, aphasia can make what used to be a simple verbal request into a tricky, frustrating drawn-out non-verbal situation similar to charades. Too many of these situations can make people afraid to speak up or ask for things, or dread trying to “translate” gestures that sometimes can be tricky and confusing.

Because aphasia can occur with several types of medical conditions, we’re familiar with how it works and we’re happy to offer suggestions for clients and their family members to help understand each other, including finding ways to be more patient with each other.

Defining aphasia

The National Aphasia Association said aphasia is more than just not being able to speak. It could involve being unable to put together groups of words correctly, not being able to remember the right word for the right concept, or saying words or phrases incorrectly.

Certainly, people of all ages may have these problems occasionally – we call it ‘being tongue-tied.’ But not being able to do these tasks all the time could be considered aphasia. It all stems from the same brain function that controls speech and language, along with writing, listening, and reading.

Internal or external trauma that disrupts this part of the brain can lead to aphasia. This could include a stroke that paralyzes part of the body on a temporary or permanent basis.

Aphasia is also a recognized sign of advanced Alzheimer’s disease and can take place as the brain declines and stops some critical functions. It is often accompanied by memory loss, another recognizable sign of Alzheimer’s disease.

Other conditions like ALS may cause aphasia, such as if the muscles of the throat no longer function. It may make it difficult, even painful to talk.

In some cases, family members will recognize what’s happening right away as someone’s health declines, such as when someone experiences a stroke. But some signs are harder to detect unless you’re specifically looking for them, such as subtle changes in how someone understands what they’re reading, seeing, or hearing.

The National Aphasia Association has defined more than six variations of aphasia, including Global, which is defined as someone not being able to state many recognizable words and also not being able to understand what’s being said to him or her.

Other versions include Broca’s aphasia, where someone can understand speech well and be able to read but has difficulties forming words; and mixed non-fluent aphasia, where someone can speak clearly but has difficulties reading or understanding other people’s speech. They also are unable to write.

Another variation is Primary Progressive Aphasia, which is specifically connected to neurogenerative diseases like Alzheimer’s disease.

Options for relief

Because there are so many types of aphasia, it’s difficult to offer a universal way that people can communicate with each other.  In some situations, once they reach the aphasia stage of a particular condition, it’s difficult to go backward and find ways to improve the situation.

Instead, families need to find ways to communicate, which can vary due to whatever type of aphasia someone is dealing with.

For instance, inviting someone to write down their thoughts on a stylus or computer tablet may work well for people who can still think clearly, follow instructions or express themselves. If someone is alert but can’t come up with the coordination to input the right words, then these methods won’t be as effective.

Some options can include:

• A text-to-speech program or keyboard. Famous physicist Stephen Hawking dealt with aphasia for more than a decade because he created a simple computer that let him touch certain words or common phrases. An assistive technology center in your community may offer similar options. There also can be software and phone apps that can speak what you type in.
• Learn sign language together. As a family, everyone can study American Sign Language. This can allow people to speak and “listen” without having to use their mouths. Newcomers to ASL may still use their mouths to sound out the words as a habit, which could help people trying to learn lip-reading.
• Create a book. A picture-style book of common phrases, letters, and numbers can be a useful tool to communicate. A stack of paper and pencils nearby can also be useful.

Besides displaying patience, family members can also work to not pressure each other to speak or understand each other. Because this situation can be new and frustrating, people may be slow to get out the right words and don’t want to be further rushed.