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How you can communicate with your loved one if he or she has aphasia

  • Aphasia means your loved one has problems understanding language and speaking. He or she may be unable to find the right words or put sentences together.

    General considerations

    These are general guidelines on how to communicate with your loved one:

    • Don't assume your loved one can't understand what is being said. Never say anything you wouldn't want your loved one to hear.
    • Include your loved one in communication even if he or she seems unable to speak or understand.
    • Respect your loved one's privacy.
    • Tell your loved one what is happening.
    • Know when your loved one is tired.
    • Encourage your loved one to be as independent as he or she can be. Give him or her an interesting and stimulating setting.
    • Be sensitive to your loved one first, the aphasia second.

    How you can create a good communication setting

    These are general guidelines that may help your loved one understand and use speech.

    • Communicate in a quiet room. Your loved one will follow the conversation more easily when talking with one person. Noise (such as TV, radio, other people or machines) may confuse him or her.
    • Limit the number of people in the conversation. Try to avoid large groups. Your loved one may become confused if trying to follow conversation shifts between many people.
    • Stand in your loved one's line of sight opposite the side of the body affected. For example, if his or her right side is affected, stand so your loved one's left eye can see you. Be sure he or she can see your face and hands clearly. People with aphasia often watch facial expressions and gestures to understand what is being said.
    • Let your loved one know when he or she understands you.
    • Do not ask your loved one to talk and do another task at the same time.

    What to remember when you are the speaker

    Effects of stroke

    Left-sided stroke: Aphasia and language apraxia: The left side of the brain controls the ability to speak and understand language in most people.

    These are general guidelines that may help your loved one understand words:

    • Speak more slowly and pause often. Your loved one will understand best if you say something simple and give him or her time to grasp the idea before moving to another idea.
    • Do not shout or talk more loudly. Your loved one hears you but does not always understand the meaning of the words.
    • Speak in short, simple sentences about things he or she can see. Avoid long, conversational speech. For example, "I am pouring you some water. Here is a glass of water" (as you hand the person the glass).
    • Avoid using pronouns when you talk. Your loved one needs to hear the names of things repeated over and over. For example, "Here is a plant someone sent. Aren't the tulips pretty? Red tulips." "Open the card. Who is the card from? Joe and Mary." This will help your loved one link words with ideas again. Try to do as much of this kind of talking as you can. You may use photos of family activities to start a conversation.
    • Mention the place and date as often as you can. During conversations, tell the month and / or place. For example, "It certainly is a hot August day."
    • Speak in an adult manner. Do not talk down to your loved one who has aphasia.
    • Do not bombard your loved one with too many questions.
    • Stress the important words in sentences.
    • Use visual aids when you speak. These include pictures, objects or charts.
    • Watch for signs your loved one understands what you are saying.
    • Write down any request you have of your loved one. This way he or she can read what you are asking.

    What to remember when you are the listener

    These are general guidelines that may help your loved one use words:

    • Be patient
    • Do not interrupt. Give your loved one at least 30 seconds to respond. Try to look relaxed while you wait.
    • Do not fill in the word your loved one is trying to find.
    • Do not correct errors. Restate what you think was said. This will help to see if you understand what your loved one said. It also gives your loved one the chance to hear a correct version.
    • Let your loved one know when you do not understand. For example try saying, "I'm not understanding you." Try pointing or using another word. If your loved one tries two or three times and gets frustrated, ask him or her to take a short break. Have him or her try again in a few minutes.
    • You may offer an initial sound or syllable if your loved one gets frustrated and you know what the word is.
    • Help your loved one find the right words by using questions such as:
      • What would you do with it?
      • How is it used?
      • What does it look like?
      • Where would I find it?
      • Can you describe it?
      • What color is it?
      • What goes with it?
      • If there one in this house/room/building?
      • Can you take me to it?
      • What sound does the word start with?
    • Encourage your loved one to use other ways to communicate, such as:
      • write it first and read it out loud
      • gesture the meaning or what someone would do with it
      • draw a picture
      • point to the picture, object or word on a chart
      • describe it in other words
      • describe the category or other words like it.
    • Give your loved one a sentence to complete. For example, "You said you want a drink of __________."
    • If nothing works, ask your loved one if he or she would like to skip it and come back to it later.

    What you can do at home

    These are general guidelines that may help your loved one's return home:

    • Work closely with the speech-language pathologist. By following his or her home program, you can help improve and maintain your loved one's communication skills.
    • Set up a routine your loved one can follow every day.
    • Remember that your loved one's abilities may change from day to day. They may even change from morning to night. Aphasia usually doesn't get worse unless the person has another stroke.
    • Let your loved one have rest times each day.
    • Learn when is the best time of day to work on communication skills. Try to use that time whenever you can.
    • Encourage your loved one to be independent and enjoy his or her favorite activities. If reading doesn't work, he or she could listen to books on tape.
    • Treat your loved one as a mature, responsible adult. He or she is not mentally incompetent. Don't let other people ignore your loved one. Let him or her share in life-affecting decisions.
    • Remember that communication problems may continue after the stroke. This doesn't mean that your loved one is lazy if recovery isn't complete.
    • Respect your loved one's wishes not to see friends or family for a while after returning home. He or she may want to adjust to the disability or wait until communication skills get better. Slowly get your loved one back into social situations.
  • Source: Allina Health Patient Education, Understanding Stroke: Information about Stroke and Recovery, fourth edition, ISBN 1-931876-13-4
    Reviewed by: Allina Health Patient Education experts
    First published: 02/01/2006
    Last reviewed: 12/09/2011