A stroke can damage the brain’s language centers, resulting in an inability to speak that is frustrating for both the survivor and their loved ones. This difficulty is commonly due to aphasia, a disorder that impairs the ability to process and use language, affecting speaking, understanding, reading, and writing. Other conditions include dysarthria, which involves weakness or paralysis of the speech muscles, and apraxia of speech, which is a difficulty in planning the complex movements needed to say words clearly. It is important to remember that this loss of verbal communication does not reflect a loss of intelligence or understanding. Effective communication remains possible and is fundamental to recovery and maintaining the stroke survivor’s quality of life.
Adjusting Your Approach: Strategies for the Listener
Improving communication starts with the listener, who must adapt their style to support the stroke survivor. Speaking at a slower pace and using short, simple sentences that convey only one idea at a time is helpful. Avoid using complex jargon or figurative language, as these can significantly hinder comprehension of the message.
Reinforce your verbal message using natural facial expressions and gestures, which provide visual cues. Frame questions in a way that allows for a clear, simple response, such as asking closed-ended questions that require only a “yes” or “no” answer, rather than open-ended questions like “What do you want to do today?”. Giving the survivor ample time to formulate a response is essential; resist the urge to interrupt or finish their sentences.
Allowing silence demonstrates patience and respect for the effort required to communicate following a stroke. If you are struggling to understand a word, you can ask the person to try and “talk around it” by describing the concept or using a related word. This partnership approach, where the listener actively adjusts their behavior, facilitates the survivor’s ability to express themselves.
Utilizing Non-Verbal Methods and Communication Aids
Stroke survivors can use a variety of methods and tools—a multi-modal approach—to bridge the gap left by impaired speech. Encourage natural gestures, such as pointing, nodding, or miming actions, to convey immediate needs or ideas. Even if their writing or drawing is impaired, attempting to write a key word or sketch a basic image can often be enough to communicate the main idea.
Low-technology aids offer simple ways to communicate, such as picture boards or communication notebooks. These boards often feature symbols or images of common needs, feelings, or activities, allowing the person to point to what they are trying to say. Whiteboards or “Boogie Boards,” which are lightweight LCD writing tablets, are also effective for those who retain the ability to write words or short phrases.
For more complex communication, high-technology aids like Augmentative and Alternative Communication (AAC) devices or specialized tablet apps can be used. These applications can convert typed text into synthesized speech, or they can use picture-based systems that speak a message when a symbol is selected. These devices provide a powerful voice and can be customized to their personal interests and vocabulary, ensuring they can communicate about relevant topics.
Creating a Supportive Communication Environment
The emotional and physical setting significantly influences the success of communication attempts. Minimize background noise and distractions, such as turning off the television or radio, to help the stroke survivor focus their limited cognitive resources. Communicating face-to-face is also helpful, as it ensures the person can see all of your non-verbal cues and facial expressions.
Approaching the conversation with patience and normalizing the frustration for both parties is essential for a sustainable communication relationship. You can validate their effort by saying something like, “I know you know more than you can say right now,” to show understanding for their difficult situation. When a breakdown occurs, simply repeating what you thought you heard, or checking to confirm the message, helps to keep the conversation moving forward without causing embarrassment.
Always include the stroke survivor in conversations, even if participation takes longer, to ensure they do not feel isolated or invisible. Maintaining a respectful, adult conversational manner is important; avoid talking down to the person or speaking over them. Regularly asking for and valuing their opinion, particularly on family matters, reinforces their role and independence within the household.
The Role of Speech-Language Pathology
A Speech-Language Pathologist (SLP) formally assesses and manages post-stroke communication impairments, including aphasia, dysarthria, and apraxia of speech. The SLP diagnoses the specific nature of the difficulty and develops a personalized rehabilitation program based on the individual’s needs and goals. They utilize techniques that leverage the brain’s capacity to reorganize, a process known as neuroplasticity, to help the person relearn language skills.
The SLP’s role extends beyond direct therapy, training family members and caregivers on effective communication strategies. This professional guidance ensures the family environment supports the survivor’s recovery by establishing the best ways to interact with them. An SLP helps implement the use of various aids, such as communication boards or AAC devices, and integrates them into daily life to optimize participation.