A Peek Into the World of a Client with Aphasia
Our language is one of the biggest reasons why humans are special. Without language, the world would be chaotic and confusing.
Because of language, we are understood and are able to understand others as well. Most of what we do, other than eat, drink, and breathe, relies on the use of language. Without words, we cannot read, write, listen, speak, or perform more complex functions such as learning, keeping a job, or socializing.
Now imagine if this ability to use language is partially, or even totally, taken away. This condition is called aphasia. Aphasia happens when the brain is injured, such as in stroke, head trauma, brain tumors, or brain infections.
A caregiver may see themselves caring for clients with aphasia during their career, so it is necessary to understand the challenges caregivers face as well as have a good understanding of how to care for these clients.
There are many types of aphasia, but the most common are these three:
1. Receptive aphasia, or the inability to understand language
People with receptive aphasia can feel like they have woken up in a different country whose language they do not recognize. Those with receptive aphasia usually know that someone is trying to talk to them, but they cannot understand what the person is saying. They are able to talk, but their sentences usually do not make sense because they use the wrong words or invent new ones. They may point to an object, such as a bag, and insist that it is called a “prangly.” A spoken sentence could be made up of words like this. Because of their inability to understand language, they are usually also unable to read and write. To both the caregiver and the client, the other’s speech sounds foreign and difficult to understand.
2. Expressive aphasia, or the inability to make speech
People with expressive aphasia can understand language, but they cannot make words to form speech. This is why clients can read but are unable to speak or write. They have trouble forming and pronouncing words, and it can take a very long time to pronounce each word. It’s like knowing what to say, but the mouth refuses to obey the brain. There is a disconnect between the brain and the mouth so that, after much difficulty and many pauses, clients can only utter a word or two.
3. Global aphasia, or having both receptive and expressive aphasia
People with global aphasia will have great difficulty understanding language or speaking clearly. They are also unable to read or write. Global aphasia happens when the brain suffers extensive injury.
Caregivers must understand that frustration is the biggest challenge for clients with aphasia. Clients know that they could communicate before their brain injury, and can feel very frustrated that they are suddenly unable to understand language or form words that are understood by others. They may plan out how to get their message across but fail to do so successfully. The result is that clients cannot tell their caregiver how they feel and what they need, which can get in the way of proper care.
Caregivers must exercise empathy and a great deal of patience when caring for a client with aphasia. It is helpful to tell the client the topic of your conversation beforehand, and then ask only simple questions that are answerable by “yes” or “no.” Caregivers must also remember to use simple words and to reword phrases as needed during the conversation. It can also be helpful to use gestures when making an important point.
The biggest challenge for caregivers is providing a means to communicate for clients with aphasia, even when it is very difficult. This opportunity for communication means a lot to the client, because their caregiver is letting them know that they truly care.
