Aphasia

APHASIA

Can you imagine how it feels to be unable to communicate with your family and friends after suffering Stroke?

Around 250.000 people in the UK currently suffer from this condition, known as "Aphasia"

Each year 10,000 people become aphasic in the UK.

Aphasia is the inability to communicate through the spoken language, including the loss of reading and writing skills. Neurological disorders such as; trauma, tumours, and strokes cause this impairment.

As in many disorders, aphasia can range from mild to severe.
The symptoms can begin with speech delays and progress to the loss of communication skills in all areas. Although, the individual may display language impairments, this does not necessarily affect other areas of their life skills. Comprehension remains unaffected.

Quick Facts

	Aphasia can happen to anyone regardless of age, sex, race, education, and social status.
	Aphasia can be temporary. It may only last a few hours or few days depending on the extent of the injury and prompt medical intervention. More than half of those who initially display symptoms of aphasia will recover.
	Aphasia can not be prevented, because the location and extent of the neurological damage determine the disorder.

At this time, medicine and drugs are not available to cure aphasia, however there has been some success with speech therapy and surgery. Surgery has proven to be successful in cases where pressure from a tumour or other injury can reduce the swelling. Speech therapy is not a cure, but it will enable the patient to utilize skills that have not been impacted by the brain trauma.

Global aphasia -- Is the severest form of aphasia. This diagnosis is made when the individual is unable to produce recognizable words and has very little understanding of the spoken language. It further affects the ability to read and write. Global aphasia is typically seen after a stroke. Improvement with early intervention is possible. Individuals with extensive brain damage will suffer permanent impairment.

Broca's aphasia -- This form of aphasia limits the individuals ability to speak with the exception of utterances and a very restricted vocabulary. It is extremely difficult for the individual to form sounds. Despite the inability to speak, the individual will not lose their understanding of language.

Mixed non-fluent aphasia -- This terminology is used to define individuals who have who have inadequate and difficult speech. Although, this resembles severe Broca's aphasia, there are comprehension limitations, leaving them with the inability to read or write beyond an elementary age level.

Wernicke's aphasia -- Creates the inability to understand the meaning of spoken words, although the individual maintains the ability to speak. Speech patterns are not typical and they do possess difficulties in the area of finishing thoughts and adding words that do not fit into the conversation. Reading and writing are also impaired.

Anomic aphasia -- Individuals with this particular form of aphasia find it very difficult to use words that they attempt to recall in conversations. This is especially apparent in the area of nouns and verbs. Their speech may be fluent, however the inability to converse in a flowing pace leaves them frustrated. They do not have difficulties understanding speech and their reading and writing skills are intact.

Other combinations of speech/understanding disorders exist. Various symptoms may be present leaving the individual with symptomatic challenges that cannot be placed into a specific diagnostic category. For example, reading may be the primary deficit (alexia) or disorders that affect only reading and writing (alexia and agraphia).

I hope in reading this, you'll find help and encouragement. If liked me, before my stroke, you didn't know what Aphasia was. Now after the event, are trying to come to terms, with a love one who now suffers with it.

I suffered my haemorrhage/ stroke/ aphasia in 04/JUNE/2000, I was admitted to the North Manchester General Hospital at 8 o'clock on the Sunday morning, 8 hours later, given a scan and X-rays, and a long wait till the following morning at 11 a clock, where the consultant said I could have some paracetamol, it was the left hand side of the brain. In the resulting aftermath, I was left paralysed all down my right-hand side, unable to communicate, read and write. Talking, I couldn't remember how-to talk, I didn't even remember my name.

I was 50 years old, I didn't fit the parameters of a general stroke sufferer. My consultant said I was just unlucky. Then he turned round to address his junior doctors and said, the best thing for this patient would be repetition work. He was talking about physiotherapy, but I misunderstood his direction, and from the next week, when I eventually got someone to understand what I wanted, A4 ring binder filled with paper and some pens, and the alphabet printed on the top of the page.

I didn't know it was called the alphabet, I didn't know what the letters were called, and I didn't care. But it was familiar and reassuring, in a world of chaos and uncertainty you find yourself in. Because it wasn't a word, or a sentence to understand you didn't half to think. I found it very therapeutic and relaxing, just to copy over and over again

Then at two months, when I could manage it, to distinguish and remember what certain words looked like, ie nurse, Doctor, breakfast, dinner, tea about 20 words in total, someone typed up a 24 hour clock, ie 12-10 12-20 12-30 and so on. So with this simple method, I could keep a diary, ie Doctor mornng 11-00, dinner 12-30 and so on. Lorna my wife, expected me to do this, to keep her informed about my day on the ward. Thinking back I am sure what I did in the first few weeks and months, laid the foundation of my recovery.

And because I couldn't remember how-to speak, I thought maybe what about singing, I had a Walkman cassette brought in for me.

With ABBA the 1970s group greatest-hits, familiar and reassuring, and at night I would fall asleep listing to them, and the little voice that attempted to sing along was born.

Someone brought me in a cassette of names, the same name said very deliberate spoken, with a pause in between, for about 20 times, then the next name, just the immediate family, about 10 names in the total.

I'm not saying it's easy - far from it, but I believe in doing this, I was giving the devastated pathways, in my brain a fighting chance to begin firing again. Now 18 months has elapsed, now I used a voice recognition software, to counter the dyslexic qualities of the aphasia, to correspond all over the world.

Did you know, how tiring it is just to think and wonder, I was amazed. Where had all my stamina and strength gone, years and years of strength, just gone, a new born baby, had more strength than me. I'm telling you this, encase you underestimate the traumatic effect of getting a stroke

To the family's and carers, who having found themselves in a position with an aphasic relative, it's up to you, to bring a little peace and sanity back to them.

	Be strong. Stronger, than you're ever been before in your life.
	Talk to the person with aphasia as an adult and not as a child. Avoid talking down to the person.
	During conversation, minimize or eliminate background noise (i.e., television, radio, other people) whenever possible.
	Make sure you have the person's attention before communicating.
	Praise all attempts to speak; make speaking a pleasant experience and provide stimulating conversation.
	Encourage and use all modes of communication (speech, writing, drawing, yes/no responses, choices, gestures, eye contact, facial expressions).
	Give them time to talk and permit a reasonable amount of time to respond..
	Accept all communication attempts (speech, gesture, writing, drawing) rather than demanding speech.
	Downplay errors and avoid frequent criticisms/corrections.
	Avoid insisting that each word be produced perfectly.
	Keep your own communication simple, but adult. Simplify sentence structure and reduce your own rate of speech.
	Keep your voice at a normal volume level and emphasize key words.
	Augment speech with gesture and visual aids whenever possible.
	Repeat a statement when necessary.
	Encourage people with aphasia to be as independent as possible.
	Avoid being overprotective or speaking for the person except when absolutely necessary. Ask permission to do so.
	Whenever possible continue normal home activities (i.e., dinner with family, company, going out).
	Do not shield people with aphasia from family or friends or ignore them in a group conversation. Rather, try to involve them in family decision-making as much as possible keeping them informed of events but not burdening them with day to day details.

God bless you all. Noel.

Involve Aphasic family member in decision making.