Practical resources to help family caregivers in the midst of caring for someone

Communicating with someone who has aphasia: how to be a good communication partner

Communication is something we can take for granted from day to day.  Discussing the weather, the neighbours, recent events, or a movie watched together are all examples of communication. But what if you suddenly could no longer speak or understand others?

Loss of the ability to communicate brings about a major change in how we relate to others.  Furthermore, it can cause feelings of isolation for the person with the communication difficulty as well as family members and friends including you as the caregiver.

The loss of the ability to communicate due to aphasia can be particularly challenging because the person retains his/ her intelligence and is competent to make life decisions despite the difficulty with understanding or speaking. Imagine if you wanted to inform someone about how to manage your finances, investments, or express your wishes on where you would like to live or not like to live but you could not do so.

We know that the frustration felt by both people with aphasia and those around them is significant. Depression can be a common result and this should not be overlooked.

So what can I do?   

Answer: A lot!

Once you understand what aphasia is, you can then figure out how to work with it.  Aphasia is a language disorder resulting from some kind of brain injury (for example, a stroke). Roughly one in three people who have a stroke will have aphasia. It is not an uncommon condition despite the fact that many people are not familiar with the term aphasia. Understanding aphasia is the first step to managing it better. This can be compared to understanding any other condition (for example, diabetes). Once you understand what you are dealing with, then you can learn the strategies to manage it and live well with it.

Understanding aphasia

Imagine that you are walking the streets of Montreal. You only know a few words in French and everyone around you is speaking fluently in the language. You may pick up a word here or there. You may only understand just enough to know very generally what people are saying around you. You may be able to use some French words you recall from school to help you out:  Merci– thank you!  Bonjour – Good Morning!   However, trying to navigate the city and find specific areas of interest such as where to buy a good winter jacket may prove to be a challenge.  This can be compared to the experience of a person with a milder form of aphasia where they can get by but with some difficulty. This can be annoying if not frustrating!

Now, let us travel even further away to a foreign country.

Imagine that you are surrounded by people whose language you cannot understand at all. There is a complete language barrier. How challenging would this experience be? And yet, despite not being able to speak, understand, read, or write in the language that is being used, you know what you want to do, where you want to go, how you are feeling, and why, but you are unable to express it to anyone. This is the experience of the person with more severe aphasia.

How can I communicate more effectively with someone with aphasia ?

Supported Conversation Techniques (SCATM) can help to improve communication.  These different techniques can assist you as the conversation partner. Using these techniques will help to connect you better with the person you are caring for and will show them that you understand their communication difficulty and are willing to work towards overcoming the barriers of aphasia.

Supported Conversation Techniques (SCATM) :

  • Speak directly to the person with aphasia. Acknowledge the person’s frustration, fears, or concerns.

To help the person understand you:

  • Make sure your messages are clear by simplifying your language and confirming that you have been understood.
  • Keep the content adult –like. Do not use childish terms or references to simplify your language.
  • Use hand gestures, pictures, or drawings to help the person understand.
  • Write down key words to help the person follow and better understand the conversation

To help the person express themselves:

  • Ask “Yes” or “No” questions
  • Ask only one question at a time
  • Make sure the person has a way to respond (by verbally saying “Yes” or “No,” by nodding or shaking their head, by pointing to written “Yes” or “No”, or by gesturing thumbs up or thumbs down)
  • Provide a way for the person to answer or ask a question. You can write down several answers to a question and have the person point to the answer (for example, “what would you like to do today?” Write down some options for the person to point to: shopping, visit friends, etc.)
  • Confirm that you have understood what the person is trying to tell you.
  • Always have a pencil and paper available!

If you need any further assistance or guidance, please consult with a Speech-Language Pathologist.

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