18 Tips for Communicating with a Loved One After a Stroke
Leanne Sherred, M.S., CCC-SLP
Finding yourself as a sudden caregiver to a stroke survivor can be a confusing and overwhelming experience. Unfortunately, over a third of survivors will also experience communication challenges following brain damage. While everyone is affected differently, it can impact a person’s speech patterns, ability to process and comprehend language, and their reading and writing skills.
Communication-related diagnoses that are common following a stroke include aphasia, apraxia, and dysarthria. Treatment from a certified speech-language pathologist is generally recommended. They are communication experts who can help individuals regain their normal speech function.
Here we'll discuss helpful tips and strategies you can use to better communicate with your loved one. While these take practice and patience, it’s important not to give up! Recovery can take time, but your involvement is essential to helping loved ones relearn communication and improve their speech language abilities.
1 Speak face-to-face
When expressing language, we use more than just our words. We point, gesture, use facial expressions, and more. Therefore, it's important to speak face-to-face with your loved one, making sure you have their full, undivided attention.
2 Minimize distractions
Speak in a quiet, relaxed environment. Try to minimize as many distractions as possible. This can include turning off the television, electronics, or noisy appliances.
3 Talk one person at a time
When speaking in groups or at the dinner table, there’s often a chorus of voices at any given time. Try to take turns talking, speaking one at a time and putting the spotlight on your loved one when it’s their turn to contribute to the conversation.
4 Speak clearly
Speak in a slow, measured way. Make sure to clearly enunciate your words. Use natural pauses and increase the inflection of your voice if there’s a point you want to emphasize.
5 Use simple instructions
It’s important that your loved one fully understands what you’re trying to communicate. One way to do this is to ask simple and direct yes-or-no questions to ensure their comprehension.
6 Treat them as an adult
Just because someone has communication challenges or comprehension difficulties, we should not treat them like a child. This can feel frustrating, demoralizing, and infantilizing. They are still adults, and we want to engage them in discussion and include them in decision making.
7 Give them enough time to respond
It can take longer for a stroke survivor to process information, think through their answers, and produce legible speech. Make sure to give them enough time to respond. Try not to interrupt them.
8 Provide hints
After a stroke, speech and language abilities may change day-to-day. Just because a person produced clear speech or understood your questions yesterday, doesn’t mean they will today. Progress often isn't a straight line. Therefore, try to avoid saying things like, “You said it yesterday, so you can say it again today.” Instead, if you notice your loved one struggling, give them a hint by offering the beginning of a sound or word.
9 Offer positive reinforcement
If your loved one is wrestling to produce a word, makes a mistake, or you're having trouble understanding them, try not to act frustrated. Keep a positive attitude. And when they do show progress, make sure to congratulate them.
10 Avoid corrections
Similarly, don’t overcorrect speech errors, or insist that every word be produced correctly. This can cause unneeded frustration.
11 Use different forms of communication
Words by themselves don’t always get across your intended message. Try gesturing or using visual cues when communicating. Augmentative and alternative communication (AAC) devices, including visual aids, electronic devices, and picture boards, may also help.
12 Try singing
Singing or humming your favorite songs can help stimulate parts of the brain damaged by a stroke. You can always start simple, such as singing “Happy Birthday.”
13 Play language-rich games
Playing board games or card games can also be an enjoyable way to stimulate language. Try to avoid some of the normal competitive pressures by removing the timer or just playing for fun, not for points. You can also watch trivia game shows like "Jeopardy" or "Family Feud."
14 Take a break
If you notice your loved one is confused, fatigued, or frustrated, take a momentary pause and revisit the subject later. It’s important to remember that these strategies don’t work every time, so don't feel discouraged.
15 Talk about enjoyable topics
Talk about things your loved one enjoys, such as family, friends, hobbies, or favorite TV shows. Or pull out a photo album to help rekindle some favorite memories.
16 Keep a schedule
Creating a schedule of expected tasks can give your loved one a greater sense of responsibility and improve their memory and cognitive abilities. Use visual cues to set reminders, or keep a calendar of daily activities.
17 Build a strong therapist relationship
Speech therapists don’t just “treat” patients, they also “coach” caregivers. Even if you’re seeing a speech therapist several times a week, they don’t have the same level of insight or familiarity with your loved one that you do. Therefore, it’s important that you build a strong working relationship with your speech therapist. In addition to providing speech therapy, they should be offering techniques, strategies, and exercises you can use at home with your loved one to incorporate new lessons. The more you keep your speech therapist in the loop about progress and setbacks, the better they can participate in your loved one’s care.
18 Consider online speech therapy
For stroke survivors with limited mobility, or who prefer the convenience of receiving speech therapy from the comfort of their home, consider online speech therapy. This is similar to traditional, in-person care, except you meet with your speech therapist using secure video chat technology (like Zoom). Online speech therapy can also be a much more affordable solution for individuals that have inadequate insurance coverage, or who can’t afford high out-of-pocket costs.
