How you can communicate with a person who has aphasia
Aphasia means the stroke survivor has problems understanding language and speaking. He or she may be unable to find the right words or put sentences together.
General considerations
These are general guidelines on how to communicate with a person who has aphasia:
Don't assume the person can't understand what is being said. Never say anything you wouldn't want the person to hear.
Include the person in communication even if he or she seems unable to speak or understand.
Respect the person's privacy.
Tell the person what is happening.
Know when the person is tired.
Encourage the person to be as independent as he or she can be. Give him or her an interesting and stimulating setting.
Be sensitive to the person first, the aphasia second.
How you can create a good communication setting
These are general guidelines that may help the aphasic person understand and use speech.
Communicate in a quiet room. The aphasic person will follow the conversation more easily when talking with one person. Noise (such as TV, radio, other people or machines) may confuse him or her.
Limit the number of people in the conversation. Try to avoid large groups. The aphasic person may become confused if trying to follow conversation shifts between many people.
Stand in the person's line of sight opposite the side of the body affected. For example, if the person's right side is affected, stand so the person's left eye can see you. Be sure the person can see your face and hands clearly.
People with aphasia often watch facial expressions and gestures to understand what is being said.
Let the person know when he or she understands you.
Do not ask the person to talk and do another task at the same time.
These are general guidelines that may help the person who has aphasia understand words:
Speak more slowly and pause often. The person will understand best if you say something simple and give him or her time to grasp the idea before moving to another idea.
Do not shout or talk more loudly. The person hears you but does not always understand the meaning of the words.
Speak in short, simple sentences about things he or she can see. Avoid long, conversational speech. For example, "I am pouring you some water. Here is a glass of water" (as you hand the person the glass).
Avoid using pronouns when you talk. The person needs to hear the names of things repeated over and over. For example, "Here is a plant someone sent. Aren't the tulips pretty? Red tulips." "Open the card. Who is the card from? Joe and Mary." This will help the person link words with ideas again. Try to do as much of this kind of talking as you can. You may use photos of family activities to start a conversation.
Mention the place and date as often as you can. During conversations, tell the month and / or place. For example, "I certainly is a hot August day."
Speak in an adult manner. Do not talk down to the person who has aphasia.
Do not bombard the person with too many questions.
Stress the import words in sentences.
Use visual aids when you speak. These include pictures, objects or charts.
Watch for signs the person understands what you are saying.
Write down any request you have of the person. This way he or she can read what you are asking.
What to remember when you are the listener
These are general guidelines that may help the person who has aphasia use words:
Be patient
Do not interrupt. Give the person at least 30 seconds to respond. Try to look relaxed while you wait.
Do not fill in the word the aphasic person is trying to find.
Do not correct errors. Restate what you think was said. This will help to see if you understand what the aphasic person said. It also gives the person the chance to hear a correct version.
Let the person know when you do not understand. For example try saying, "I'm not understanding you." Try pointing or using another word. If the person tries two or three times and gets frustrated, ask him or her to take a short break. Have the person try again in a few minutes.
You may offer an initial sound or syllable if the person gets frustrated and you know what the word is.
Help the person find the right words by using questions such as:
What would you do with it?
How is it used?
What does it look like?
Where would I find it?
Can you describe it?
What color is it?
What goes with it?
If there one in this house/room/building?
Can you take me to it?
What sound does the word start with?
Encourage the person to use other ways of commuication, such as:
Write it first and read it out loud.
Gesture the meaning or what someone would do with it.
Draw a pictures.
Point to the picture, object or word on a chart.
Describe it in other words.
Describe the category or other words like it.
Give the person a sentence to complete. For example, "You said you want a drink of __________."
If nothing works, ask the person if he or she would like to skip it and come back to it later.
What you can do at home
These are general guidelines that may help the aphasic person's return home:
Work closely with the speech-language pathologist. By following the therapist's home program, you can help improve and maintain the aphasic person's communication skills.
Set up a routine the aphasic person can follow every day.
Remember that the aphasic person's abilities may change from day to day. They may even change from morning to night. Aphasia usually doesn't get worse unless the person has another
stroke.
Let the person have rest times each day.
Learn when is the best time of day to work on communication skills. Try to use that time whenever you can.
Encourage the person to be independent and enjoy his or her favorite activities. If reading won't work, he or she could listen to books on tape.
Treat the aphasic person as a mature, responsible adult. He or she is not mentally incompetent. Don't let other people ignore the aphasic person. Let him or her share in life-affecting decisions.
Remember that communication problems may continue after the stroke. This doesn't mean that the person is lazy if recovery isn't complete.
Respect the person's wishes not to see friends or family for a while after returning home. He or she may want to adjust to the disability or wait until communication skills get better. Slowly get the person back into social situation.
