Suggestions for Family and Friends

Here are some ideas that may help you to communicate better with someone with aphasia. Remember that everyone’s aphasia is different, so not all of these suggestions will work for everyone. If your family member is seeing a speech-language pathologist, you may want to print this out and take it to him/her for feedback on which of these suggestions (or others) are likely to be useful for your family member.

  • First, be aware that aphasia affects language skills, not intellect. The majority of people with aphasia will not have any decline in their intellectual abilities or memory (exceptions include people who had such problems prior to the onset of their aphasia, and those who had damage to more than just the language areas of the brain in the same incident that caused the aphasia).   Although this is not a perfect analogy, it may be helpful to think of a person with aphasia much as how you think about someone who doesn’t speak English; they simply cannot communicate with you efficiently but otherwise are fine intellectually. People with aphasia continue to have ideas, feelings, opinions and preferences that may be masked by their aphasia.
  • communication strategies provide aphasia helpHave a pen and paper handy.  A pen or pencil and blank, unlined paper can be very useful in a number of ways. The person with aphasia can use it to communicate their ideas by writing the word(s) or by sketching a picture or symbol. Family members and friends can use pen and paper to write down a key word to help the  person with aphasia understand the topic under discussion, or to draw a picture or map of what they are talking about.
  • Use gestures freely. Encourage the person with aphasia to use gestures, hand signals, facial expressions and pointing to help get their message across. Use these same tools yourself to assist the person with aphasia to understand your message.
  • Talk naturally, but perhaps a bit on the slower side.  Use your natural tone of voice when speaking with a person with aphasia. It is not necessary to speak louder or to use a babyish tone of voice;  in fact, doing either of these things may offend or irritate a person with aphasia. Over the years many of our clients have complained that people treat them as though they are hearing impaired or intellectually challenged. This just adds to their frustration. It may be helpful, however, to use a slightly slower rate of speech and to pause between main ideas, to give them a chance to process what you have said and to give them a chance to let you know if they need clarification.
  • Use direct, straight-forward language, rather than quickly delivered, complicated language.
  • Do not assume that someone with aphasia has understood everything you said. Depending on the type and severity of their aphasia, they may or may not have difficulties with comprehension. Even those who understand most of what you say may have some gaps in their understanding. If they are able to verbalize, get them to paraphrase what you said back to you to confirm that they understood.  Otherwise, summarize the most important parts of the conversation for them, part by part.
  • Have props handy. For people with severe aphasia, it is often helpful to have items like calendars, family photos, newspapers, menus and appointment books available. These can be used to assist the person with severe aphasia to get their message across.
  • Facilitate, rather than correct.If someone with aphasia uses the wrong word, or uses a gesture instead of a word, avoid the temptation to correct them. If, however, they are visibly struggling to get a word out and appear frustrated, it may be helpful to give them some kind of hint. For instance, if you think they are trying to say “purse”, you could face them and say “puh”. This kind of cue often helps get the word out. Or perhaps you could try writing down what they are trying to say, as reading may (or may not) help them say the word.  If you don’t know what they are trying to say, give them a pen and paper, or a calendar, newspaper or appointment book, to help them get their message out in a different way – for example by pointing, printing or drawing a sketch.  Encourage them to gesture; not only might this help you know what they are trying to say, sometimes making the hand movement for something ( such as bringing the hand to the mouth to ifamily support is important for aphasia helpndicate “eat”) helps them to get the word out.  In some situations, asking a series of “yes/no” questions may help the person with aphasia to get to the message they want to say.
  • Communication, rather than perfection, is the key.  People with aphasia are at risk for social isolation due to their communication impairment.  It is important that the people in their lives, such as friends and families, keep interacting with them, even if communication may be less than perfect. By understanding that their communication impairment masks but does not diminish their feelings, ideas and opinions,  and by being open to any and all ways for your family member to get their ideas and opinions out, you can help your family member with aphasia to remain connected to others.