By Avi Golden
Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write.
Aphasia is always due to injury to the brain, most commonly from a stroke, particularly in older individuals. But brain injuries resulting in aphasia may also arise from head trauma, brain tumors or infections.
Aphasia can be so severe as to make communication with the patient almost impossible, or it can be very mild. It may affect mainly a single aspect of language use, such as the ability to retrieve the names of objects, the ability to put words together into sentences or the ability to read.
More commonly, however, multiple aspects of communication are impaired, while some communication channels remain accessible for a limited exchange of information.
Patient assessment tips
The impact of aphasia on relationships may be profound, or only slight. No two people with aphasia are alike with respect to severity, former speech and language skills, or personality.
But in all cases, it is essential for the person with aphasia to communicate as successfully as possible from the very beginning of the recovery process.
Here are some suggestions to help EMS providers communicate with a person with aphasia:
- Make sure you have the person’s attention before you start talking.
- Minimize or eliminate background noise from a television, radio or other people.
- Keep your own voice at a normal volume level, unless the person has indicated otherwise.
- Keep communication simple, but age appropriate.
- Simplify your own sentence structure and reduce your rate of speech.
- Emphasize key words, but don’t talk down to the person with aphasia.
- Give them time to speak. Resist the urge to finish sentences or offer words.
- Communicate with drawings, gestures, writing and facial expressions in addition to speech.
- Confirm that you are communicating successfully with yes/no questions.
- Praise all attempts to speak and downplay any errors.
- Avoid insisting that each word be produced perfectly.
Finally, it is import for people with aphasia to engage in normal activities whenever possible. Do not shield them from family or ignore them in a group conversation. Rather, try to involve them in family decision-making as much as possible. Keep them informed of events but avoid burdening them with day-to-day details. Encourage independence and avoid being overprotective.
Learn more how to better understand and communicate with stroke survivors with aphasia in this video, “Patience, listening and communicating with aphasia patients” from the RVA Aphasia Group.
About the author
Avi Golden is a practicing EMT and former critical care and flight paramedic with North Shore LIJ (Northwell) EMS and NY Presbyterian EMS. Avi holds a bachelor’s of science in biology and has extensive experience as a practicing paramedic both in the United States and with Magen Adom David in Israel. After experiencing a stroke in 2007 and experiencing resulting aphasia, Avi now educates the medical and lay community and advocates for aphasia awareness. Connect with Avi on LinkedIn.