Trainer: Kelly Sturgeon 10/24/25
This training will improve caregiver knowledge about aphasia and provide ways to help residents with difficulty communicating their needs.
What is Aphasia?
According to the National Aphasia Association, more than 2 million people have aphasia. Aphasia is more common than Parkinson’s disease, cerebral palsy, or muscular dystrophy. Aphasia is a communication impairment that results from an injury to the brain. The most common causes of aphasia are stroke and traumatic brain injury. Frontotemporal dementia can also cause aphasia. People living with Alzheimer’s Disease experience aphasia as the neurological damage affects language areas in the brain, making it difficult to understand words when listening or reading, or not being able to find the right word when speaking.
Notably, Bruce Willis was diagnosed with aphasia due to dementia in the Spring of 2022. While the announcement of his condition has helped bring a better understanding of what aphasia is and how it can impact a person’s daily life, one of the biggest challenges for clinicians and caregivers is that no two patients with aphasia will be the same. For example, some may be able to read words but not able to find the right words when speaking. Or some may be able to sing an entire song correctly but not able to speak a full sentence.
How Are Residents with Aphasia Affected by it?
Patients with aphasia have a communication disorder that affects their ability to interact with others, including their caregivers. Many living with aphasia are misunderstood to be ignoring someone who is talking with them when in fact they are having difficulty finding and saying words. Aphasia can often cause frustration for both the person and their caregivers. By being knowledgeable caregivers, we can better understand and reduce the stress that residents experience when they have difficulty communicating.
There are two types of aphasia:
Expressive aphasia affects a patient’s ability to use the correct words in either writing or speaking to explain their thoughts. A person with expressive aphasia knows the correct word they want to use, but cannot produce that word. Receptive aphasia affects a person’s understanding of what is being said or what they are reading.
Aphasia affects every aspect of a patient’s ability to communicate, including but not limited to tasks like speaking, writing, or reading. Imagine going to your doctor appointments and not being able to answer questions like “what is your name?” Simple tasks like reading or asking for a drink of water are now nearly impossible.
People with aphasia struggle in all daily tasks, from ordering a cup of coffee, telling someone how they feel, and engaging in conversations with friends and loved ones. Aphasia is also an isolating disability where many people find friends and family become distant as they do not know how to communicate with someone with aphasia.
How Does Aphasia Affect Caregivers?
When someone suddenly loses the ability to communicate, the effects are devastating not only for them but also for their caregivers and loved ones.
Here is a story from a physical therapist whose husband developed aphasia:
My husband had a stroke in February of 2020. He told my daughter every night before bed to brush her teeth. On that random Wednesday night, he could not produce those words. The first time we thought he was joking. By the third time when no words came out, we realized we had a problem. And just as suddenly, I became not only a wife and a mom but now was thrust into the role of caregiver, advocate, and mind reader. But I was not the only one in our house whose life changed.
Our children who were ages 7 and 20 at the time now had to learn how to communicate with their dad and to understand that he was still the same silly, funny person they always knew. I remember driving my husband home from the hospital while he tried his hardest to tell me where to go and what he wanted. I had no clue until he pulled on the steering wheel and pointed me in the direction of the nearest Dunkin. All he wanted was a simple cup of coffee! People with aphasia want to have normal conversations like they did before aphasia took over their lives. About a year after his stroke, my husband and I went out to dinner. He had regained the ability to say some words and short sentences. A couple sat at a table next to us laughing and talking. My husband told me “I just want to talk like them again.”
By Debra Reilly, PT, DPT
Physical Therapist, New York
Ways We Can Make a Difference
Since aphasia affects each person differently, there is no single way to help someone with aphasia. There are some helpful strategies to help communicate and patience is key.
Here are some ways we can help: 1. Avoid being rushed during care and when talking. Talk with a slower pace and make sure your voice is at a normal volume. Avoid raising your voice when the resident does not respond. That will create more stress. Have your supplies and plan for care organized so that you can be relaxed. 2. Allow for extra time when communicating. Conversations will take more time and more concentration for both the resident and caregiver. 3. Ask questions that are easy to answer like yes/no questions. You can also ask the resident if they want help to get their point across. For example: “I can see you are trying to find the right word. May I help you? Are you trying to tell me what you want to drink? Would you like juice or water?” However, don’t assume they want help. 4. Try to be in a quiet room without distraction when communicating. You may need to mute the TV or turn off the radio/cell phone so you can be totally aware of verbal and nonverbal cues being provided. 5. Offer choices, but limit the choices to two. For example: “Do you want your eggs fried or scrambled?” 6. Use non-verbal forms of communication. We can use many ways to communicate that do not require words such as visual aides that a resident can point to. Many of these aides are easily accessible online and can be printed and reused. We can ask our residents to show us what they are trying to explain like pointing to an object. 7. Know what our residents like and dislikes. Learning how our residents like their care routine to be done, what activities they like, and what their favorite foods and beverages are can reduce stress and ease their experience. 7. Notice their facial expressions and body language to help you understand what they are trying to express and how they are feeling about it.
We Are Our Resident’s Voice
Finally, the most important thing a caregiver can do is advocate for their residents by becoming knowledgeable about aphasia. We can also encourage our residents with aphasia to be less isolated by helping them to participate in social activities and social dining. As caregivers we can help facilitate social interaction by including them and helping them to feel part of the group.
Sources and Related Content
https://pmc.ncbi.nlm.nih.gov/articles/PMC3314936
https://foxrehab.org/aphasia-caregiver-tips-advice/#:~:text=Online%20Resources%20for%20Caregivers,situation%20to%20be%20very%20helpful.
ARTICLE 2.25.19
Speech-Language Pathology: Cognitive Therapy For Dementia And Beyond
PODCAST 6.14.23
ARTICLE 5.21.18
5 Activities To Increase Engagement Post-Stroke
ARTICLE 10.21.20
Care of Patients Post-stroke: The What, How, Why and What Now