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How to talk with stroke patients who can't express themselves

Speech therapist offers four tips for communicating with people with aphasia

When you communicate with a person with aphasia, make eye contact and ensure that you have her attention before speaking.
When you communicate with a person with aphasia, make eye contact and ensure that you have her attention before speaking. PHOTO: ISTOCKPHOTO

Speaking, listening and reading are, for most people, as easy as ABC.

But some stroke sufferers face a mountainous task in carrying out these basic daily skills.

This can happen when the parts of the brain that control a person's language abilities are injured from a stroke.

This results in a communication disorder called aphasia, which affects how a person understands and uses language.

All four modalities of language can be affected - speaking, listening, reading and writing.

Brain injury caused by a stroke is the most common cause of aphasia. Other causes include brain damage due to severe head injury, brain tumour or infection.

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    Do this when speaking to a person with aphasia so that he knows you are speaking to him.

    He may have difficulty making sense of the words that you use, but might still be able to understand what you are saying through your non-verbal cues.

    These include your facial expression, body language and tone of voice.

    Making eye contact when you are talking is a good way to direct his attention to these cues.

    This also allows you to read his facial expressions and help you understand what he wants to say when he gets stuck.


    Use simple language when asking questions.

    Difficult questions can be hard for someone with aphasia to understand and are, therefore, easily misinterpreted.

    For example, instead of saying: "Would you like to have a cup of coffee or tea today?", simplify the question by asking: "Coffee or tea?"

    This gives the person more time to process what you have said and to find the right words to express himself.

    Aphasia does not take away a person's emotions or intelligence. He should still be treated like an adult. When a person with aphasia loses the ability to understand language or speak, it is natural for caregivers to think that their loved one has an intellectual disability. They may start speaking to him as if he were a child, which would come across as patronising to him.

With the rising number of stroke cases in Singapore over the past decade, the number of people suffering from aphasia here has also gone up.

One of the most obvious symptoms is when a person unintentionally substitutes a syllable, word or phrase with something else. These errors in language are called paraphasias.

For instance, he might substitute a word with a related meaning, such as "table", instead of "chair".

Or he might use words that sound similar, such as "tape", instead of "take".

Sometimes, words might be substituted with made-up words that do not make sense at all.

This can make it difficult for family and friends to communicate with a person with aphasia.

Ms Rachel Chia, a senior speech therapist at Singapore General Hospital, said some people who have the disorder may withdraw from social conversations or activities as they find it difficult to express themselves.

She offers four tips on how to communicate better with people with aphasia.

Joyce Teo

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A version of this article appeared in the print edition of The Straits Times on January 24, 2017, with the headline How to talk with stroke patients who can't express themselves. Subscribe