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Communication Problems
Communication is a very complex process and it is not until things go wrong that we realise just how dependent we are on it; to make our feelings known, take part in day to day activities and enjoy a sense of humour.
Unfortunately about 1 in 3 people who have a stroke will lose their ability to speak and/or to understand what is being said to them in some way.
What kind of communication problems occur after a stroke and their severity depends on the part of the brain affected and the severity of the damage.
Damage to the left side of the brain can lead to problems with speaking, understanding, reading and writing, described as aphasia or dysphasia.
Damage to the right half of the brain can affect control of the muscles involved in forming speech described as dysarthria. It can also affect memory and the organisation of language.
Most people now use the term aphasia as an 'umbrella' term to refer generally to communication problems due to stroke.
Aphasia Is Not Confusion
It is also important to realise that this difficulty in communicating is not the same as being confused or losing intelligence in some way. Although it is common to have a bit of confusion in the initial stages of having a stroke this usually passes quickly.
The Effect Of Communication Problems
Communication problems after a stroke can include any combination of different aspects of language such as ability to
- put thoughts into spoken or written language
- spell
- put words together into sentences
- understand spoken words and sentences
- understand or use other forms of communication such as gesture/symbols
Effect On Independence
- understanding conversation
- dealing with correspondence
- explaining own thoughts and ideas to others
- accessing information
- expressing emotions
Social Impact
- role changes within the family
- relationship difficulties
- social isolation
- employment
- leisure
- accessing information and services
Psychological Impact
- depression
- loneliness
- poor self image
- loss of identity
- strong emotional reactions—anger, anxiety, frustration
Speech And Language Therapy
Careful assessment by a speech and language therapist is essential in identifying where exactly the problems with speech and language lie. No two strokes are the same and what is helpful for one person will not necessarily help another.
Once a proper assessment is made the speech and language therapist can develop ways to work on improving communication difficulties and explain how to use other ways of communicating.
Contact a speech and language therapist
Recovery—Keep Going
Recovery depends on the position and severity of the stroke. Some people regain or overcome their loss of speech quite quickly. For others it may take months even years. Recovery keeps on going even if it is slowly. Keep going. There are many accounts of individuals' battles with stroke that other people find inspiring.
How Can Family And Friends Help?
It is very important to realise just how frightening and frustrating it must be for someone who has suddenly lost their ability to communicate.
Family and friends can help a lot by showing that they understand what is wrong, establishing 'yes' and 'no' if possible and providing reassurance. (Some people appear to be able to indicate with gesture but actually mean the opposite so you have to check you have this right.)
Sometimes unexpected forms of expression such as swearing or singing come out. This is involuntary and out of the person’s control. Words may come out but they cannot be understood by other people, although they seem right to the person speaking them. Remember it is the brain that is damaged not the mind.
For more information see Helping Communication After A Stroke F5 [679K PDF]
Things That Can Help
- speech and language therapy
- picture cards and boards
- supported conversation—use of writing, pictures, gestures, facial expressions
- Chest, Heart & Stroke Scotland (CHSS) Volunteer Stroke Service
- computers and electronic communication aids—please see Alternative Communication Aids [45.7K PDF]
Useful Contacts
Connect—the communication disability network
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