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Aphasia – the Invisible Impairment

The following blog is written by Peninsula Health speech pathologist Hannah Sanderson (pictured). 

At Frankston Hospital, our Speech Pathology Department helps our patients in many different ways. We provide assessment and management of patients with swallowing impairments, laryngectomies, tracheostomies and communication impairments.

Communication impairments can occur for a number of reasons. Frequently, we see a number of different communication impairments with our patients who present to Frankston Hospital with a stroke.

At Frankston Hospital, we have a fantastic team of dedicated clinicians working together to help our stroke patients. A stroke is commonly recognised in the community as something that causes people to have trouble walking or using their arms. However, a stroke can also cause what’s referred to as an ‘invisible impairment’ by Speech Pathologists, this being Aphasia.

Aphasia is a condition that is not widely known in the community. It is one of the complex communication disorders that can affect a person’s ability to use the hardwire in their brain where the language centre of the brain is stored. This might result in:

  • having trouble finding the right word when speaking
  • jumbling up the sounds when they speak, resulting in words being said incorrectly
  • having completely absent speech
  • having trouble understanding what others say
  • not being able to read or write letters, words or sentences

Because of these difficulties, in hospital it can lead to our patients having trouble: telling our doctors what’s happened to them; letting our nurses know when they’re in pain; or expressing to their loved ones how they feel. As Speech Pathologists, we work with our patients to, not only identify and assess Aphasia, but help our patients communicate with others and feel involved with their care. This can be done by providing therapy to reprogram the brain’s mapping to access their language centre or create new ways for our patients to communicate. Importantly, we also teach our medical, nursing, allied health teams and patients’ families how to better communicate with people who have aphasia, to help their understanding in conversation.

Someone who is familiar with the impact of Aphasia is Helen, who recently had a stroke.

It was a strange feeling that came on all of a sudden,” says Helen.

“[There were] three strange sensations in my head, I was aware I’d had a stroke and could comprehend it, but all of a sudden I lost the ability to speak”.

“The next morning I still had difficulty talking, but I could say a few words. It was quite strange, there was no pain. I would lose words and I would forget words”. “[It’s the] strangest feeling [when] you’ve lost the ability to talk or make sense of words and you just feel so bewildered. I can walk and I don’t need any support in that. I am surprised that I can do that and not talk the same,” explains Helen.

When we first met, Helen, who was an inpatient at Frankston Hospital, felt relieved.

“I think I felt that someone could come and help me. And you gave me a lot of helpful information. I felt reassurance that someone [was] acknowledging it was a problem,” says Helen.

Things which Helen identified that we did to help her were being “very patient, very kind and giving [me] confidence to attempt speaking and reading in a gentle way. They give you hints on how to practice your reading, because I couldn’t text, I tried to text it was just a jumble of words that wouldn’t make sense. I just could not make head or tail of the alphabet.”

Helen explained when she has trouble finding her words she needs to look for another option.

“Look for a similar word. Don’t use what you can’t find. Go and look for a similar word and use that. You can get quite anxious trying to find a word and it won’t come so [you] to need to take time.”

Since returning home Helen can still lose words, but it most cases can communicate well enough.

“I can go to the shops now and I’ve got confidence that I won’t stumble over when talking to someone. It took a while. I did have to tell a chap once ‘I’m sorry I’ve recently had a stroke’ and that wasn’t hard. I was advised by the Speech Pathologist that if you are stumbling, then say so. So now I say ‘I recently had a stroke and I can’t get the words out as easy’”

When asked how Helen thinks about her future recovery she is optimistic.

“The speech is coming back, I was definitely lucky,” says Helen.

 “But it’s still hard. I think acceptance is another thing. It’s only a month since the stroke really and I do find it hard to accept that it has happened but I have to. You can wish this didn’t happen but I can only fight to get back what I did have. Where I go now, you know how much better I can get, I don’t know. But I’ve come a long way I think.”