Tips to help you and your loved one communicate

The basics

  • Do not assume your loved one cannot understand what is being said. Never say anything you would not want your loved one to hear.
  • Work closely with the speech-language pathologist. You can help improve and maintain your loved one's communication skills by following the home program.
  • Learn when is the best time of day to work on communication skills. Try to use that time whenever you can.
  • Set up a routine.
  • Let your loved one rest several times each day.
  • Respect your loved one's wishes about when he or she would like to see members of their care circle. Your loved one may want to wait until he or she has adjusted to the injury or improved his or her communication skills. Slowly get your loved one back into social situations.
  • Include your loved one in communication even if he or she seems unable to speak or understand.
  • Let your loved one share in life-affecting decisions.
  • Encourage your loved one to be as independent as he or she can.

Helping your loved one listen

  • Reduce distractions. Close the door. Turn off the TV or radio. Pull the curtains.
  • Limit the number of people in the conversation. Try to avoid large groups.
  • Sit down so your loved one can see you. This will help him or her be more relaxed.
  • If your loved one wears hearing aids, make sure he or she wears them, has them turned on, and the batteries are working.

Helping you speak

  • Speak slowly.
  • Use short, simple sentences.
  • Pause between sentences to give your loved one time to "digest" what you have said.
  • Give your loved one directions, questions or pieces of information one at a time.
  • Talk about things your loved one can see. Use photos, hand movements or facial expressions.
  • Write down any request you have for your loved one. This way he or she can read what you are asking.
  • Watch for signs your loved one understands you. Repeat or rephrase what you are saying if needed.
  • Do not ask your loved one to talk and do another task at the same time.
  • Try not to switch topics too quickly or often.
  • Keep conversations short and to the point.

Helping your loved one speak

  • Allow at least 30 seconds for your loved one to respond, follow a direction or to tell you something.
  • Remind your loved one to:
    • speak slowly
    • speak clearly
  • Encourage your loved one to use other ways of communication 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
  • 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.

Helping you listen

  • Be patient.
  • Do not interrupt. Give your loved one at least 30 seconds to respond. Try to look relaxed while you wait.
  • Let your loved one know when you do not understand. For example try saying, "I am not understanding you." 


After a brain injury, some people are more likely to cough or choke on liquids or solids. This is called aspiration. It is common for people who have dysphagia to also have aspiration.

Watch your loved one for signs of aspiration:

  • a wet-sounding voice
  • breathing you can hear
  • struggling when breathing or swallowing
  • shortness of breath
  • a rattling sound in his or her lungs
  • fever 

If you think your loved one has aspiration:

  • do not try to stop the coughing. Coughing is the body's natural protection against choking.
  • have your loved one stop eating and drinking until he or she stops coughing and the airway is clear
  • make sure you or your loved one talks about aspiration with a speech-language pathologist or doctor. He or she can check for aspiration and may give tips to reduce the risk of choking.

When to call 911

Call 911 if your loved one:

  • has a blue or purple tinge to his or her skin color
  • is not breathing for more than 30 seconds
  • is unable to speak

Source: Allina Health Patient EducationUnderstanding Stroke, fifth edition, neuro-ahc-90662
Reviewed By: Allina Health Patient Education experts
First Published: 02/01/2006
Last Reviewed: 05/01/2018