Submissions from Readers

Aphasia but Intelligent

by JB

Question:My mom, 73, had a both kinds of stroke almost 2 years ago resulting in right side paralysis, some apraxia and aphasia. She went from working full time as a secretary to a hospital bed. After suffering gall bladder attacks and surgery for 3 months after stroke and then needing a PEG tube for eating for months after, then CDiff and a broken hip after a fall, she has finally come around to being fairly healthy but living in a nursing home close to me. Throughout all of this her communication has not improved. She has about 10 words she repeats for everything. We've told her she doesn't make sense and she now has a communication tablet to use but she never uses it. Yet, she continually tries to talk to us and expects us to understand her. There are times through the long minutes of charades, we can get what she's talking about to a point but many times, after LONG periods of trying, we just give up. I feel we have failed her by humoring her at times pretending to understand or going through the charades or not insisting that she try to use the device. She can write and sometimes get the letter or part of word but it is taxing and a chore. Aside from all of that, she still has a very intelligent mind but because of right side paralysis and the communication issue, she has no way of expressing her thoughts or of doing anything really productive. So she sits in a nursing home in a wheelchair. Her aides and nurses have mostly learned her needs and gestures but this is not communicating and does not help when she wants to have these lengthy, abstract conversations with me or her roommates or others in the home. She also calls and rattles on for an hour and I have almost no idea of what she's talking about. How can I help her realize she doesn't make sense? How can I help her use her device or be more clear? Do I continue to humor her? We are all tired of living in frustration but I do not know what else to do. Any advice would be helpful.

JB in Texas

Answer: Rehabilitation for speech often requires a long term strategy, and I highly recommend that you get more speech therapy for your mom. If they do not offer speech therapy at the nursing home or you are not impressed with their speech therapy services, you can hire an outside therapist to come in on a private pay basis. I would check to see what services the nursing home has regarding speech therapy and support groups. If there is limited help, and you cannot afford to pay for ongoing private services, you pay to have a speech therapist come out for just a few visits and then meet with your family and the hospital staff to discuss strategies to help your mom.

I'm not sure if your mom is able to leave and be transported to outside services, but you could also search for outside services that could benefit her. I don't know what area of Texas you live in, but for example, in the Dallas area, there are several free programs for patients with aphasia. A speech therapist in your area would most likely be able to tell you what services are available.

If none of the above is an option, you could read online about treatment for Wernicke's aphasia and speech apraxia for suggestions. I highly recommend using the services of a speech therapist though over trying to figure it out yourself.

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