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Ten Tips for Communicating When Your Spouse Has Aphasia
A Caregiver's Perspective

By Stephanie Mensh, Stroke Caregiving Expert

My husband, Paul Berger, has aphasia, a speech-language disability that makes reading, writing, and speaking difficult. Paul's aphasia was caused by a stroke when he was 36. We had been married for four years. The first few weeks following Paul's stroke, he had lost all of his language abilities.

While he was still in the intensive care unit, Paul tried to communicate with me. He held up his left hand (his right side was paralyzed), and turned it one way, then the other. For what seemed like hours, I guessed and guessed at what he was trying to tell me. Did he want the nurses to stop something? Did he want to pray? Was there something wrong with his hand?

Finally, I guessed that he wanted his fingernails trimmed. I couldn't believe him. After going through brain surgery on his ruptured aneurysm and looking like he was hit by a truck, then suffering a terrible stroke, being too weak to sit up, having pneumonia (the list of his medical problems went on and on): he wanted a manicure! That's when I realized that I would need help to learn to communicate with Paul.

Here are the top 10 tips I learned to help me communicate with my husband after his stroke.

Top 10 Tips from the Professionals

Stephanie's Top 10 Tips

1. Be patient.

1. Okay. Nobody is perfect. I'm a Type A.

2. Speak in a normal tone of voice.

2. Yell. He's my husband. I yelled at him before his stroke.

3. Speak slowly. Use simple words and short sentences.

3. Four-letter words are easy to yell slowly.

4. Limit background noise or distractions. Turn off the TV or radio.

4. Why does he only want to talk during my show?

5. Develop non-verbal strategies, including gestures, pointing to things, using picture cards, or drawing in a pocket notebook.

5. I can read Paul's mind, and we always win at charades. The trick is first to understand what topic we're discussing.

6. Making the first sound of the word can help the person with aphasia to say the whole word or phrase.

6. We created cues for each letter of the alphabet. When I see Paul making the cue, like pointing to his nose for N, I'll help with the sound if he can't get it.

7. Aphasia can result in switching words that are close in meaning or sound, like restaurant-refrigerator, or opposites, like yes-no, hot-cold.

7. I've learned to write down numbers, since Paul often switches five-fifteen-fifty or hundred-thousand. We live in the Washington, DC suburbs, so we hear a lot of people switching million-billion-trillion.

8. Aphasia impairs language, not intelligence. Respect the survivor's intelligence by involving him in decision-making, and by including him in discussions of current events.

8. Okay. Like most couples, we have our disagreements. I can yell louder, but Paul can do the "silent treatment" better.

9. People with aphasia must make as much effort to concentrate when they listen as when they form words to speak.

9. Be careful what you say. Paul can be extraordinarily fluent repeating a secret to the wrong person.

10. Having a sense of humor and laughing is important. However, people with aphasia have an easier time understanding concrete words and actions, instead of jokes based on slang, puns, clever plays on words, and abstract words.

10. Paul can enjoy most comics - words and pictures. But he laughs loudest at slapstick. We both laugh at some of his aphasia-induced word switches and misunderstandings (when I explain them to him).


Copyright (c) Paul E. Berger & Stephanie Mensh
Permission is granted to reprint this article
in your newsletter or magazine only with the following byline:
"Stephanie Mensh is a speaker and author.
To find out more about her programs and services,
or call (703) 241-2375."

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