12 Ways to Communicate with Someone with Aphasia

Pretend for a moment that you wake up on another planet. The inhabitants of this planet speak a different language. At some point, you become hungry and ask for food, but no one understands you. When they speak to you, you have no idea what they’re saying. They write out the words, but it looks like hieroglyphics. You try gesturing, but your movements make no sense to them.

It all sounds pretty frustrating, right? Well, this situation is somewhat similar to what it’s like having aphasia.

What is aphasia?

Aphasia is an impairment of language skills due to a stroke, traumatic brain injury, infection, or neurodegenerative disease. It can make speaking, understanding language, reading, and/or writing very difficult, depending on the severity and type of aphasia.

How can aphasia affect a person’s life?

When a person loses the ability to communicate, it can greatly impact their relationships. Aphasia can lead to social isolation, as well as depression and anxiety. Since a person with aphasia can have great difficulty expressing their thoughts, they may decline social events, not pick up the phone, and isolate themselves from others.  However, people with aphasia don’t have to withdraw from life. Speech therapy can help people with aphasia relearn the communication skills they’ve lost, as well as learn new skills in the process.

How to communicate with someone with aphasia

If you or someone you know has aphasia, there are many things you can do to make  communication easier for everyone involved. It’s important to realize that an aphasia diagnosis doesn’t just impact the person with aphasia. It affects their family, their caregivers, and others involved in their daily life.

Here are 12 tips that family, friends, and caregivers can use to improve communication with a loved one with aphasia:

1. Treat the person with aphasia as the adult they are. Remember, aphasia is a loss of language skills, not intelligence! Even though some types of aphasia do affect comprehension, your loved one is the same person as before, only now they desperately want to understand and communicate well again. Using strategies learned in speech therapy can combat feelings of frustration and depression for everyone.  2. Eliminate distractions. If the dog is barking, the radio is on, or someone is vacuuming in the room, it may be hard for someone with aphasia (or anyone!) to hear what’s being said and respond appropriately. When you’re communicating with someone with aphasia, try to avoid noisy environments. Try to reduce visual distractions such as the TV as well.

Remember, aphasia is a loss of language skills, not intelligence!

3. Get the person’s attention before speaking. That may mean saying their name or making sure they’re looking at you before you speak.  4. Keep your language short and sweet. Instead of saying, “I had to make your doctor’s appointment for next week because the only opening they had this week was at 7 a.m., which I know is too early for you. So I made the appointment for next Wednesday at 11 a.m., which is a better time,” say, “Your doctor’s appointment is next Wednesday at 11 a.m.” Being straightforward will help your loved one process the information and avoid confusion.  5. Speak at a normal voice level. It’s one thing to adjust your language so someone with aphasia can better understand you. It’s another thing to modify your voice. Aphasia is an impairment of language skills. Unless the person also has a hearing impairment, you don’t need to speak louder for them to understand you. Speaking more loudly may come across as patronizing.  6. Don’t pretend to know what was said. It may seem easier to simply nod your head, pretending you know what your loved one with aphasia said. But what they have to say is important! And if you can’t understand them, then others won’t be able to, either. Plus, doing this doesn’t help your loved one. They need to practice communicating clearly. When you don’t understand what’s said, ask the person to repeat or rephrase the message until you can grasp it. Ask them to use one of the communication strategies they’ve learned in speech therapy. These might include writing the word down, pointing, gesturing, drawing a picture, or using other words to describe what they’re saying.  Similarly, your loved one with aphasia may occasionally respond with head nods even though they don’t understand what you said. It’s important to not always assume comprehension. 

When you don’t understand what’s said, ask the person to repeat or rephrase the message until you can grasp it.

7. Give your loved one plenty of time to respond, and try not to answer for them. Many adults are uncomfortable with silence, and they try to fill it. However, people with aphasia often need extra time to process what they heard and think of a response.  8. Don’t talk about the person without including them when they are present. How would you feel if someone was speaking for you or acting like you weren’t there? Not good, right? Just as you shouldn’t assume comprehension, don’t assume lack of comprehension, either. 9. Use yes or no questions. This type of question is a good way to help ease communication. Yes/no questions are often easier for someone with aphasia since they don’t need to produce a new word to answer you. 

Give your loved one plenty of time to respond, and try not to answer for them. 

10. Provide specific choices during conversation. Giving your loved one with aphasia two choices can help them maintain their independence and join in conversation. For instance, instead of asking, “What would you like for lunch?,” ask, “Would you like a big salad for lunch or something else?”  11. Use visual supports. A visual support like a picture can be a helpful communicative tool. While most people with aphasia struggle with reading and writing, they can usually identify and use pictures.  12. Use apps as a communication tool. We now have more options than ever to help people communicate. You can easily bring your “voice” wherever you go via an app on your tablet or phone–no need to lug a heavy computer around. There are apps specifically for adults with aphasia, as well as more general apps to communicate one’s thoughts, wants, and needs. And insurance often covers this. A speech-language pathologist can help you customize the app so that pictures of loved ones, favorite foods and items, locations, emergency information, and more can be said with the touch of your finger.  It’s understandable that aphasia can cause frustration, social withdrawal, and even depression. A loss of communication skills is a life-changing experience. But there is hope and help through speech therapy. With the right strategies and support, people with aphasia and their loved ones can still communicate and connect.

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