“Simone* (not her real name) posted this query on a social networking website. Then she went onto explain that her dad had high blood pressure and didn’t know it, one day he was well and working hard in his busy job in the city, next day he was in hospital after having a stroke on the way to work. He was due to do a big presentation to a large group of people and then felt faint in the taxi and managed to ask to be taken to hospital before he lost consciousness.

After that, it was as though he was completely silenced. He had a little bit of right-sided weakness but otherwise he was able to walk around and do most other things as normal. We had no idea of what it was until the doctor mentioned that he had had a stroke and had something called “Aphasia.” Some people say that these symptoms can resolve in about 24 to 48 hours but although Dad recovered a little bit of his speech after a few days, he was not back to normal!

The next few weeks were a blur with a short stay in hospital, investigations, lots of doctors, a pile of new medications and loads of information leaflets. Dad was discharged home pretty quickly before Christmas and he’s still on the waiting list for community speech therapy in his local NHS service. Although he looks well and is able to walk around as normal, he is struggling to say what he thinks and is starting to get really down about his talking. It’s not just his talking as well, his writing is affected – he just holds the pen but can’t seem to find the words to write down.

My mother, brother and I are at our wit’s end with not knowing what to do for him. There is no way that he can go back to his work right now because he used to be meeting with people, talking and presenting every single day. It’s been devastating to everyone in the family. Every single aspect of our life has been touched by this… Aphasia. What can we do to help him?”

 

Aphasia, or a language impairment that can occur after a stroke or brain injury and can be devastating because in today’s society, for the digital age and the work-place, communication is a critical skill. At any time, there are around 250,000 people in the UK who have aphasia and many of these people will be under retirement age1.

Hidden disabilities

Communication difficulties are often considered hidden disabilities because, they are not as visable as physical or sensory disabilities. Aphasia can affect all aspects of language function such as speaking, listening, reading, writing and even calculation skills. It can be devastating to relationships and self-image as so much of a person’s self-esteem, identity and personality is intimately intertwined with language skills.

The importance of a good social network and family support for someone with Aphasia cannot be underestimated. Emotional support is vital in helping the person with this devastating “silent” disability cope with the impact of the loss of aspects of, or all of their language skills in their life. This loss can impact on everyone in the family, particularly if the person with aphasia was the primary wage earner for the family as described above. Awareness of the impact of this loss on the person with aphasia’s (and their carer’s) mental health is also very important.

Fortunately, there is quite a lot that can be done to support someone with aphasia to improve their ability to communicate and support their mental health.

Services to access

The most important first step for this family to take is to try and get the support of a HCPC registered Speech and Language Therapist. A range of services exist, from the NHS to the private sector. Families should also be aware that they it is permitted to them to access private services whilst on a waiting list for their local NHS services. Help for finding services is available from the Royal College of Speech and Language Therapists and the Association of Speech and Language Therapists in Private practice. A Speech and Language therapist with specialism in stroke and aphasia can help shape their treatment goals into steps that can assist to maximise recovery, guide realistic expectations and help create a social environment that can support the person’s ability to communicate using all means available to them. The Speech and Language therapist can also provide emotional support and counselling related to communication which is invaluable for the person with aphasia and their loved ones. Support can also be provided by the Speech and Language therapist through liaison with the GP to arrange treatment for mental health problems that can arise related to the communication disability such as depression or anxiety.

Goal setting

Many aphasia clinical guidelines indicate that highly frequent practice of language skills (such as 45 minutes per day) in targeted activities are useful in regaining language function for those who can tolerate it. Whilst for many people with aphasia most of the spontaneous natural recovery occurs in the first 12 months, many guidelines have indicated that continued gains can be made in the longer-term particularly when the person with aphasia is motivated and able to participate in increased intensity of treatment. Preliminary goal setting should happen first to assist the therapist in choosing the right assessment tools to help the person with aphasia to achieve their realistic and meaningful treatment goals.

Treatment options for aphasia are often longer-term depending on the nature of the person’s needs, the severity of their communication issues and the availablity of people to support them. Treatment can include face-to-face as well as technology based treatments. Often a combination of the two are very beneficial in supporting the person with aphasia to achieve a more intensive treatment approach. Adult children of people with aphasia, who may be more technically savvy than their parents, are ideally placed to help their parents. From the set-up of their computer with the Speech and Language therapist recommended software and apps or just to support them in general to increase their familiarity with the technology.

Family and friends can also help to create a supportive environment to enable the person with aphasia to communicate successfully through:

  • using short clear sentences – give one piece of information at a time
  • don’t rush – allow time for the person to take in what you are saying
  • be patient – give the person with aphasia space to respond at their own pace
  • encourage the person to communicate in any way he/she can
  • encourage the person to let you know when they have not understood
  • clarify – and rephrase when necessary

 

In the longer-term however, it may not be possible for the person with aphasia to return to all of their previous function and roles depending on the nature and extent of their communication disability. However, with a supportive environment, their ability to create communication (through the use of gesture, technology, photos, writing, drawing, reading and speaking) can be amazing!

If you’re interested in finding out more check out our free tailored 10 part inbox speech and language therapy courses. Designed by our Iris Speaks Experts to help your family on their speech and language journey. Sign up here!

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1 The Stroke Association, 2008.

Written by Kim Clarke, Speech and Language Therapist