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Communication Problems
About 1 in 3 people who have a stroke will lose their ability to speak and / or to understand what is being said in some way.
The general term for communication problems is 'aphasia'.
- Aphasia is not confusion
- Effects of communication problems
- Assessment and recovery
- How can family and friends help?
- Helpful resources
- Useful contacts
Aphasia is not confusion
It is 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 some confusion in the initial stages after a stroke this usually passes quickly.
- Damage to the left side of the brain can lead to problems with speaking, understanding, reading and writing.
Please note: damage to the right half of the brain can affect control of the muscles involved in forming speech: known as dysarthria. It can also affect memory and the organisation of language.
Effects of communication problems
Communication problems after a stroke
include:
- Difficulty understanding what is being said
- Difficulty making yourself understood
- Difficulty with reading and writing
- Difficulty with numbers
If you have communication problems you may have other difficulties in making your wishes and feelings known and having your fears and worries addressed.
You may feel frustrated, angry and cross or very emotional.
You might even find other unplanned ways of expression come out such as swearing or singing. This is common and people will help and support you with this.
Communications problems can also affect:
- Your sense of independence, e.g. understanding conversation, accessing information and dealing with letters and emails.
- Your role within your family / close relationships.
- Your confidence in social situations.
- How you feel about yourself: you may feel a sense of loneliness, isolation and depression.
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Assessment and recovery
You will need a careful assessment by a speech and language therapist to identify where exactly the problems with your speech and language lie.
Your speech and language therapist can develop ways to work on improving your communication difficulties.
It is important to develop a basic form of communication, e.g. establishing a 'yes' and a 'no'. Thumbs up or down can easily be developed into a simple conversation.
Picture cards and boards can be helpful resources: see our range of Aphasia Friendly Resources.
Recovery depends on the position and severity of your stroke. Some people regain / 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!
- For more information about speech and language therapy, including how to access private therapy, contact the Royal College of Speech & Language Therapists.
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How can family and friends help?
It is important to realise just how frightening and frustrating it can be for someone who has suddenly lost their ability to communicate.
- Difficulty in communicating does not mean the person has impaired intellect.
Having a conversation with someone who has communication problems is just as much a 2-way experience as for anyone else. You both share responsibility for making the conversation successful.
Your communication skills can make a difference! You can help by showing that you understand what is wrong, establishing 'yes' and 'no' if possible and providing reassurance.
- Do be prepared to give the person you want to converse with your full attention.
- Minimise distractions and background noise.
- Position yourself where your face is clearly visible.
- Reassure the person you will give them the time they need.
- Remember that someone may have more difficulty on some days than others, particularly if they are over tired, upset or under pressure. If so, offer support and be prepared to wait.
- Remember the other person has opinions and thoughts which are important and valid. Check that you are understanding correctly.
- Remember that communication is much more than just words: watch and listen to how something is being communicated.
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.
Things to avoid doing:
- Don't pretend to understand if you do not. Say you have not been able to understand and go back to a point in the conversation where you were both clear.
- Don't ask other people for information that the person could provide.
- Don't speak for the person, presuming that they can't respond / understand.
- Don't turn a conversation into therapy or a test by making someone say a word over and over.
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Helpful resources
- Speech and language therapy
- Picture cards and boards
- Supported conversation: use of writing, pictures, gestures, facial expressions
- Chest Heart & Stroke Scotland Volunteer Stroke Service
- Computers and electronic communication aids: phone the Advice Line Nurses for more information.
Useful contacts
- Connect: the communication disability network.
- Speakability: the national charity that supports and empowers people with aphasia to overcome barriers.
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