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Stroke and Speech: What you can do when aphasia strikes and a loved one can't speak

Stroke and SpeechQ: My mother had a stroke and now she can’t speak or write, but she can respond to questions by nodding “yes” or “no.” What is causing this? Will she be able to speak again? What can I do to help her?

ANSWER: You’ll want to confirm this with a doctor, but it sounds like your mother might have aphasia, a condition stroke survivors often experience that impairs their ability to communicate. Her likelihood of recovery depends in part on how much time has passed and whether she’s in treatment. And yes, there are things you can do to help her.

LANGUAGE-SYSTEM CRASH
A stroke can damage the part of the brain that controls language. This causes problems communicating, of course, but it doesn’t affect intelligence.

Having trouble speaking is normal, as is being able to respond to yes and no questions. There also may be times when your mother has trouble understanding you and others. Difficulty reading and writing is common too.

THE REBOOT
Your mother’s ability to speak again depends on the type and severity of aphasia she has. Approximately half of people who have aphasia recover quickly, within the first few days. This is known as transient aphasia. Most people who have symptoms for a couple of months won't completely recover but may improve over the years through intensive speech-language therapy, the National Aphasia Association notes.

WHAT YOU CAN DO
Have your mother evaluated by a speech-language therapist, who can recommend the best therapy for her. Participate in the therapy sessions when possible and ask for exercises you can practice with your mother.

Keep her engaged and as active as her condition will allow. People with aphasia often feel isolated, helpless and lonely, which can lead to depression. Invite family and friends to visit often. Encourage your mother to communicate to the best of her ability. Encourage people to come in pairs or small groups. Your mother will enjoy the camaraderie and her friends will have an easier time sustaining a conversation.

Be patient and understating and try a few commonsense strategies the National Aphasia Association recommends.

  1. Have your mother’s attention before you speak.
  2. Minimize or eliminate background noise (TV, radio, other people).
  3. Keep your voice at a normal level.
  4. Keep communication simple but adult.
  5. Give your mother time to speak; resist the urge to finish sentences or offer words.
  6. Communicate with drawings, gestures, writing and facial expressions.
  7. Confirm that you’re communicating successfully with yes and no questions.
  8. Praise all attempts to speak and downplay any errors.
  9. Engage in normal activities whenever possible.
  10. Encourage independence; avoid being overprotective.

You also might consider a finding a support group for people with aphasia and their caregivers. The National Aphasia Association offers a directory.

Howard S. Kirshner, M.D., is a board-certified neurologist at Vanderbilt Medical Center in Nashville, Tenn., and board member of the National Aphasia Association.

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