What is the term for word confusion in the elderly

[newtress]

Hello everyone, I'd like to know what the term is when an older person who hasn't had a stroke or any neurological pathology speaks words and sentences but the words are not in the right order, or the word is similar but not right eg: I wish I could block (instead of walk) around the neighborhood. I'm sure she was thinking walk around the block. I've just heard the thought in sentences but the words are close but off by a letter or word. I'm refering to some who do not have a dx of Alzhiemers or dementia. Wondered if there is a clinical term for the word confusion for some seniors. Hypoxia involved?

[Emergency RN]

it's obvious here that given the amount of care giver uncertainty in terms of labeling, i would focus more on describing the actual deficit rather than giving it a diagnostic name, for risk of either my mislabeling it, or having it mistaken by someone that is used to calling it something else. hence, i would write that patient (or care giver) notes that the "patient suddenly has been having difficulty at finding his words while speaking."

the reader would then understand exactly what the problem is.

that said,

expressive aphasia involves difficulty in conveying thoughts through speech or writing. the patient knows what he wants to say, but cannot find the words he needs...

source: http://www.ninds.nih.gov/disorders/aphasia/aphasia.htm

imho, the above sounds the most appropriate given the the description of the op.

[newtress, LPN]

My goodness, look at all these possibilities. It doesn't seem to be black and white with so many reasons why it could be that an elder is having trouble making their sentences make sense. But alas, you all have given me plenty of terms to look further into and keep in mind underlying complications of the brain that haven't been diagnosed. It seems a tricky state for a geriatric patient to be in while it is occuring, and they haven't had an event or do not exhibit other behaviors of Alzhiemers or demntia, but I can infer that perhaps it can be a precursor to the above. I also think that some do not get screenings or testing for these things and stay undiagnosed. Thanks for the input and responses.

[Mrs. Sparkle Pants]

Get a speech path assessment. They are a good first step When dealing with these issues.

[tewdles, RN]

Apraxia mostly refers to motor skills.

Some form of aphasia is common in dementia patients.

I enjoy the good comments and information found on allnurses.

[GHGoonette, BSN, RN]

Op, this could be what you're looking for:

paraphasia

(par-ă-fa′zhă) A disturbance of speech marked by substitution of words and disorganized sentence formation; a mild form of aphasia.

literal p. Substitution of words that are similar in sound to the correct one.

verbal p. Substitution of words that are similar in meaning to the correct one.

[newtress, LPN]

Ok GHgoonette I think you hit it. The definition of paraphasia encompasses exactly what I was trying to describe in my question. Good job my friend and thanks for sharing!

[steelydanfan]

Yes, I think that the old term for paraphasia would be "word salad" at least that was the first thing that came to mind after your description.

[steelydanfan]

As you can see there are lots of possiblities. Which definition applies depends on the cause and expression. Does this happen every time she tries to communicate? I would say finding out the root cause is pretty important to the diagnosis and treatment.

Word salad is generally non sensical, just a random string of words with no apparent meaning. Expressive aphasia or apraxia are both about not being able to find or use the right words. Both are generally related to damage to the speech center of the brain.

I always find it hard to differentiate between word salad and expressive aphasia, because some pt.s seem to 'want to filll in the gaps" , if you will, although they certainly seemed to have intent in thier speech.

A very interesting clinical problem, and one that I love to try and solve by looking at visual clues, family input ets.

[SuesquatchRN, BSN, RN]

expressive DYSphasia

[newtress, LPN]

Thanks for the response. I received a good outline from everyone and have a good understanding of this perplexing condition.