Your loved one may have aphasia, a disorder affecting communication. While the person's intellect is spared, their ability to read, write, understand spoken and written language, and speak or find words when communicating is impaired. There are several different types of aphasia, and this depends on where in the brain the injury has occurred. There are also different severities of aphasia. There are many different approaches to communication with your family member. I recommend using many types of strategies because sending and receiving messages in a variety of ways can help reinforce your family member's understanding and speaking.
For understanding:
- Write out key words and phrases while you talk. For example, "What would you like for lunch? Soup or a sandwich?" while writing "soup" and "sandwich". Point to each word while you say it. This will help with comprehension, while also activating reading and speaking centers in the brain.
- You may feel that your family member's understanding is good, when it may be more impaired than you realize. You may become upset with your spouse because they don't seem to respond to what you are saying, or that they are "forgetting" what was just discussed. People with aphasia may react appropriately during social situations, which gives the impression that they understand the conversation. This may be a successful communication situation on the surface, but they may not understand some of the message. It can be a problem when the conversation is fast and there are many people talking.
- Use gestures a lot when you are talking, like an informal sign language. Your gesture represents the idea or object. Examples of this would be using your hand in a cutting motion for "cut", your finger to your temple when saying "think", or pointing to the cake when you talk about it "Do you want some cake?"
For speaking:
- If the person is having problems finding the right words, resist the urge to do it for them. Instead, ask them to show you, gesture it, describe it, write it, or even wait a few moments for them to collect their thoughts. You can tell them, "Let's try again in a few minutes". Ask them if they want your help.
- Depending upon how writing has been affected, you can ask them to write down one or two words to help you understand. For example, if you want to know what they want for breakfast, and they have difficulty telling you, you could ask them to point to the item or to write it down its name. Always have a small pad of paper and pen nearby so that you can use this in any setting. Even if your family member can only write the "e" for eggs, you can narrow down the choices with just this information.
- When dining out, allow the person with aphasia to do as much of their own ordering as possible. One strategy can be to get the restaurant menu before your outing so that you can go over it together and take your time. This strategy gives you and your loved one time to explore the different arrangements—"The entrée comes with two side dishes, which ones would you like?" Restaurants are often busy and the person with aphasia may feel pressure to communicate with an unfamiliar person in a hurry.
People with aphasia can become just as frustrated as you are when they cannot effectively get their message across. Remember that they may not be able to think of the most efficient way to communicate. They are struggling to express themselves in the only way that they can. You may play "20 questions" to get to the right response, but they may need you to guide them through the process to find the right concept. However, the communication burden is not yours alone.
