Guest post by Ted Baxter

If your loved one has aphasia, your means of communication with them has been drastically altered.  It can be very frustrating (indeed, heartbreaking in some cases) to watch as a family member or friend tries valiantly to communicate even the simplest of messages.

As a stroke survivor (which occurred when I was 41 years old), I have been around all types of aphasia for about 12 years or so, and I’ve been a participant of many aphasia schools around the country. Recently, I’ve been teaching people with aphasia, clinicians, and students that want to be speech therapists what they should do in contrast with what they should stay away from in approaching people with aphasia.

Here’s a quick primer on what you need to know so that you can best help your loved one as he or she navigates this impairment in their speech.

Types of Aphasia

People who have aphasia have language challenges. Each type of aphasia can cause impairment that varies from mild to severe. Common types of aphasia include the following:

• Expressive aphasia (non-fluent): With expressive aphasia, a person may have trouble saying and/or writing words correctly. The person knows what he or she wants to say, yet has difficulty communicating it to others. It doesn’t matter whether the person is trying to say or write what he or she is trying to communicate.
• Receptive aphasia (fluent): With receptive aphasia, a person may be able to put many words together, but what they say may not make sense. They are often unaware that they are not making sense. In other words, the person can hear a voice or read the print but may not understand the meaning of the message.
• Anomic aphasia. With anomic aphasia, the person has word-finding difficulties. This is called anomia. Because of the difficulties, the person struggles to find the right words for speaking and writing.
• Global aphasia. This is the most severe type of aphasia. It is often seen right after someone has a stroke. With global aphasia, the person has difficulty speaking and understanding words. In addition, the person is unable to read or write.
• Primary progressive aphasia. Primary progressive aphasia is a rare disorder where people slowly lose their ability to talk, read, write, and comprehend what they hear in conversation over a period of time. With a stroke, aphasia may improve with proper therapy. There is no treatment to reverse primary progressive aphasia. People with primary progressive aphasia are able to communicate in ways other than speech.

Aphasia may be mild or severe. With mild aphasia, the person may be able to converse, yet have trouble finding the right word or understanding complex conversations. Severe aphasia limits the person’s ability to communicate. The person may say little and may not participate in or understand any conversation.

Specific Tips to Try While Interacting With a Person Who Has Aphasia

To improve daily communication with a person who has aphasia:

• Paraphrase periodically during conversation.
• Modify the length and complexity of conversations.
• Use gestures to emphasize important points.
• Establish a topic before beginning conversations.
• Keep distractions and noise down.
• Turn off the radio and TV.
• Move to a quieter room.
• Talk to people who have aphasia in adult language. Do not make them feel as if they are children.
• If a person with aphasia cannot understand you, do not shout. Unless the person also has a hearing problem, shouting will not help.
• Make eye contact when talking to the person.
• If the person becomes frustrated, consider changing to another topic or activity.
• It may help a person with aphasia, as well as their caregivers, to have a book with pictures or words about common topics or people so that communication is easier.

When You Ask Questions

• Ask questions so they can answer you with “yes” or “no.”
• When possible, give clear choices for possible answers. But do not give them too many choices.

When You Give Instructions

• Break down instructions into small and simple steps
• Allow time for the person to understand. Sometimes this can be a lot longer than you expect

Always try to keep people with aphasia involved in conversations. Check with them to make sure they understand, but do not push too hard for them to understand, since this may cause more frustration.

And remember:  Do not try to correct people with aphasia if they remember something incorrectly. It only causes embarrassment or further frustration.

As someone who has made a nearly full recovery from a massive stroke, I can now say that those first weeks after my stroke were among the most difficult of my life. I still experience occasional challenges with my speech, but it is minimal. I know that the help my family and friends offered me during my recovery sped along my return to full speech function. And for that, I’ll always be grateful.

About the author: After spending 22 years in the financial industry, Ted W. Baxter retired as a global finance executive with a large hedge investment firm based in Chicago.

Ted now resides in Newport Beach, CA where he volunteers at several health-related institutions and hospitals in Orange County, leading groups in a stroke-related communication recovery program, and is a stroke and aphasia advocacy ambassador. He is the author of Relentless: How A Massive Stroke Changed My Life for the Better. For additional information, visit www.tedwbaxter.com.