I've been hearing the term "garbled" to describe speech which is difficult to understand. I'm looking for a better term for this, as "garbled" just sounds strange to me.
I've used "disorganized", "difficult to understand" ... I just don't feel that gets the point across, as the point is the speech is both disorganized and difficult to understand.
Garbled speech comes from an otherwise a/o patient, who is unable to say the correct word. This patient will often be angry and frustrated because they know the word, but it's not coming out correctly. Speech can be clear.
Ex, (Patient trying to get help for the bathroom): "I shoe the box."
Dysarthria is an inability to speak clearly. It's not mumbling, it's being able to say the right words, but the words just don't come out sounding right. I usually see this in a severe stroke patient with facial paralysis and drooping of one side of the mouth. Again, you can see that it's a matter of being unable to form the syllables due to some physical limitation, rather than a cognitive problem.
Disorganized speech is usually the province of the psych (or dementia) patient. They'll ramble on about unrelated topics when you ask them a question.
We also use "inappropriate," "incomprehensible" or "confused" on our assessment sheets.
Last edit by UM Review RN on Jul 19, '07
The speech therapist at my last assignment had a sheet posted listing not only descriptions of speech itself, but that of abnormal speech patterns. (this was a neuro unit) It was soooo helpful. Maybe your ST can give you something similar to use as a resource.
If in doubt, I just describe the speech as best I can and quote examples. One that had me stumped was a patient who was admitted because
of a sudden change in speech and talked just like Elmer Fudd. Or Lili Von Shtupp from Blazing Saddles ["A wed wose, how womantic. "]
I kid you not... I couldn't think of any other way to describe it (no, I didn't chart elmer fudd lol... but it was tempting). I ended up googling 'elmer fudd speech impediment' (or something like that) and found out there IS a designation for that type of speech and pattern. (rhotacism)
Last edit by EmmaG on Jul 19, '07