Communicating with aphasic patients

[mhb23]

Hi everyone,

I'm doing some informal research on means for effective communication with patients with recently aquired aphasia (i.e., post stroke).

I was recently assigned to my first post-CVA aphasia patient and found myself feeling a lot of empathy for him. It must be terribly frustrating to loose your ability communicate (as well as your understanding of others in many cases).

I would love to hear any personal accounts that anyone would be willing to share.

Thanks, Matt in Philadelphia

[KellieNurse06]

Do you mean someone who had something happen not understanding those around them???? Alot of people seem to think that because a person can't talk that they have no clue what's going on........not all but alot do.........try eye blinking....like 1x for yes 2x for no...or vice versa...........eye contact for yes...etc.....there are tons of ways to communicate.......

I have a family member who is non verbal & totally dependant for care....I can tell lots just by demeanor, expressions, alertness etc.................that's what we use as a communication tool......

[pegbord]

Kellienurse06 makes a good point. Many people who find themselves in situations where they are unable to talk are in no way unable to know what is happing all around them. It is easy to forget that their inability to orate has nothing whatever to do with their ability to clearly perceive and accurately comprehend conversations and goings on around them. Eye contact is a very effective way to try and understand what the patient is trying to say. For example if they are able to engage you directly with eyecontact, then they specifically look away - take note what direction their eyes travel and ask them questions about what you observe when you look to the direction they indicate. . . . . combined with the "blink" system, this may be useful.

[mhb23]

thanks for the reply.

this patient with aphasia, as is often the case, is able to vocalize some simple responses .. he says yes and no frequently. but, unfortunately, often the response is inappropriate. one can see that he seems to be desperate to get the words out but he just cant. I was just hoping to hear some stories from people who found themselves able to form a therapeutic, perhaps nonverbal relationship with a severely aphasic patient.

[GatorRN]

Because pts loose their ability to speak doesn't necessarily mean they've lost thier ability to write. Try handing them some paper n a pen to write out what they can't say. Many facilities also have available a printout with pictures on it of various things that the pt can point to a particular thing to communicate what they are trying to say. Check with your OT or PT dept for availability of such an item. Hope this helps some.

[kelso1]

If you have an SLT (speech and language therapy) department I would check with them. Chances are if he has a diagnosis of aphasia he has already been seen by them. They will be best placed to indicate to you what he finds helpful/not helpful in terms of communication. Pictures to point to and the use of writing are very good ideas. Alphabet boards can also be helpful in triggering what he wants to say by pointing to the first letter of a word etc. You may find this tunes you in better to his topic of conversation.

[AgentBeast, MSN, RN]

Wouldn't the communication method be dependent upon the type and degree of aphasia? The difference between Broca's and Wernike's aphasia is huge.