1 in 3 clients with stroke will be discharged with effects of aphasia.
Approx 900 strokes in Waterloo-Wellington annually.
Estimated that 300 new clients living with aphasia annually.
Estimated that approx 3% of the population is living with aphasia.
Waterloo-Wellington as a population of 700,00 therefore estimated that there are 2,100 people living with the effects of aphasia.
Almost right away my wife sent an e-mail to everyone that we knew that I had a stroke. She did say to everyone that we thank God that I am physically stronger and going to be better. However, her note to everyone was Frank has problems speaking, writing and with reading and comprehension. All the things we take for granted. So, in her note, she asked them to please call while he's at home resting, or better yet, visit. With that said, my phone number and address were given to everyone.
There were many e-mails sent, and almost all of them replied with an e-mail, wondering how I was doing and my family. You talk about being stressed, when I'm at home alone during the day with only the cat to talk to and seeing that people sent e-mails to me and yet I couldn't even reply, that is frustrating. And if the cat started talking back, then I should go back into the hospital.
It has been almost 2 years since the stroke, and the visits were very few. Oh yes, the obligated visits from a minister and family members showed up but after a week or two the honeymoon was over.
Only recently and slowly can I read out loud to my four-year-old boy. It makes me cry because those years of being a daddy are difficult.
I even remember one friend calling me and said,” Frank, call Becca”. Only one problem, my brain won't allow me to understand numbers and some soft tones let alone on the phone. But I tried. I started with trying to understand the phone number. Okay the first number is.... and they started telling me the numbers one by one. One, two, three, four, five.. Stop. He'd yell. Okay, the first number is five in the phone number. Now there are eight more numbers to finish. I was really exhausted by the time I tried to dial. And you know what, I still got it wrong. I don't know how someone that I know with so many degrees in counselling and education, they could't take a moment to say we will have them call you instead.
This story is real. And I'm sure there are many others like it, and others who deal with it. Actually,I am sure others have the same issues. How do I know, I've heard the same story from others who have had a stroke.
About 50,000 people in Ontario deal with aphasia...
People with aphasia are COMPETENT.
This means that: - They are intelligent - They can make their own decisions - They know what they want Other people, however, can make assumptions and underestimate the person’s abilities because he/she has language difficulties. What they need, then, is to be given the right tools to help reveal what they know, the thoughts underneath the aphasia. This results in difficulty: Getting the message IN , And sending the message OUT Problems getting the message IN results in difficulty: Understanding conversation, e.g., our hearing is fine but our sentences don’t make sense to the other individual.
- They are intelligent
- They can make their own decisions
- They know what they want
Other people, however, can make assumptions and underestimate the person’s abilities because he/she has language difficulties.
What they need, then, is to be given the right tools to help reveal what they know, the thoughts underneath the aphasia.
This results in difficulty:
Getting the message IN , And sending the message OUT
Problems getting the message IN results in difficulty:
Understanding conversation, e.g., our hearing is fine but our sentences don’t make sense to the other individual.Problems getting the message OUT results in difficulty:
Using words when talking. The person may speak slow and haltingly, with tremendous difficulty finding words, or conversely, the person may be very fluent but say wrong words and have grammar mistakes such that other people cannot understand them. -Getting the message OUT in writing can also be affected.
Some people with aphasia have problems primarily with expressive language (what is said) while others have their major problems with receptive language (what is understood). In still other cases, both expressive language and receptive language are obviously impaired. Language is affected not only in its oral form of talking and understanding but also in its written form of reading and writing . Typically, reading and writing are more impaired than oral communication. The nature of the problems can vary from person to person depending on many factors but most importantly on the amount and location of the damage to the brain.
Amount and location of the damage, along with other factors, e.g., age, educational level, and health status, also affect the severity of the problems. People with severe aphasia may understand almost nothing of what is said to them and say little or nothing. At best, their oral communication may be only approximations of "yes" and "no" and maybe common social phrases like "hi" and "thanks." People with mild aphasia may be able to carry on normal conversations in many communication settings. They may have trouble understanding language only when it is long or complex, or they may have some trouble finding the words they need to express an idea or to explain themselves, orally or in written form. Word finding problems are common in people with aphasia and is like the common experience of having a word "on the tip of our tongues" but not being able to remember it. The person may forget the word comb even though he or she can show you how to use it.
There are also degrees of aphasia between mild and severe . A person may speak only in single words (e.g., names of objects) or in short, fragmented phrases. Smaller words of speech (e.g., the , of , and ), may be omitted, making the message sound like a telegram. Words may be put in the wrong order. Incorrect grammar may be used. Sounds and/or words may be switched. A bed may be called a table or a dishwasher a wish dasher . Or, the person with aphasia may make up a word. In some cases, nonsense (or real) words are strung together quite fluently, but make no sense to the listener.
It usually requires extra effort for the person with aphasia to understand spoken messages, as if he or she is trying to comprehend a foreign language. The person may need extra time to process and understand what is being said. It may be especially hard to follow very fast speech like that heard on radio or television news. He or she may misinterpret subtitles of language, e.g., taking the literal meaning for a figure of speech like "He kicked the bucket." Difficulty with one or more of these skills may lead to communication breakdowns and frustrating communication for both the person with aphasia and his or her listeners. Other conditions may result from stroke, either by themselves or in addition to aphasia.
Thinking problems can also include problems organizing one’s thoughts to speak As a result: -Their talking is vague, rambling and may wander off topic without getting to the point -There may not be a logical sequence or order to what the person says.
People may OVERESTIMATE the survivor’s abilities to communicate because they seem to speak fluently enough. -But if they listen carefully, people would start to realize that what the survivor is saying is a little “OFF”, or that it’s hard to follow.
A large portion of information we experience and interpret is processed via non-verbal sensory modalities.
Adapting for Sensory Needs:
Reduce or eliminate background noise. Establish face-to-face orientation with. Adapt appropriate distance and body position in relation to the person. Assume the same eye-level as the person.
Adjust lighting to a level that will allow the person to make their vision more comfortable without straining. Position the person to prevent glare or light in the face. Assume an appropriate position and distance. Touch the person appropriately only after verbal identification. Verbalize any change of position in relation to the person.