My dad was hard of hearing and docs would turn to me instead. Frustrating to him so much. I spent half my time telling the doc to talk directly to him, not me.
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Just curious. Can the aphasia patient write and be understood that way? Can they read and understand the written word?
Sometimes.
We have a good friend who has early onset dementia (not aphasia). Her ability to communicate speaking has become very challenging. But she is a great writer, and this does help her. In addition, she can use writing for things that don’t require an immediate response.
Spoken communication requires split second comprehension and split second formulation of spoken responses. For someone with aphasia, this quick processing can be very challenging.
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My 61-year-old friend with early onset Alzheimer’s can’t write at all and can read only a little at this point. 
Absolutely understand his frustration. I was in a patient’s room showing his daughter what I was doing with an augmentative signboard, and how well the patient was responding, with his language, to the pictures. The doctor walked in during my session. and spoke to the daughter.
I had to “interject” by leaning over the doctor, and I met my eyes with the patient and said, something like:
“Is there any other question you had for Dr. Smith today, Mr Taylor?”
“There was something you had asked earlier, and I want to make sure you get your information.”
I had to step out with the doctor, and whispered to him, “this patient wants questions directed to him first. We owe that respect to all of our patients.”
(People on this website know that I can be very direct-my apologies- but I learned that I had to be very assertive working in the hospital environment, and I can’t seem to let it go-and it had nothing to do with our scared, and vulnerable patients.)
I know that a number of physicians didn’t think that I should interject during their time, but some of these “bedside manners” were atrociously embarrassing and unprofessional.
@thumper1, I know you’ve had similar experiences.
FYI, our professors helped us to understand the two aphasia models that seemed to confuse patients’ families.
Broca’s aphasia: where the “accident” is in the frontal cortex, is an area on the L side of the brain which helps to conduct movement, so the way we remembered when we were learning, B is in the “front” of the alphabet and the front involves making motor movements. In speech/language trauma you can’t seem to put together or coordinate your speech movements.
Wernicke’s aphasia: the involved area is just behind the ear. The W is in the back of the alphabet, behind the ear, so hearing or interpreting incoming (receptive language) can be convoluted and mistaken. Given that we lose hair follicles inside the inner ear, as we age, hearing isn’t our best strength, so the frustration level intensifies with hearing damage.
These types of aphasias often don’t occur in isolation, depending on the damage by injury, stroke or disease, so you can’t predict what type of skills the patient will have. The most important factor is to get therapy services immediately after the injury, as soon as the patient can tolerate sitting up for a little while. We need to use all parts of the brain immediately and consistently.
Hope that helps.
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Thank you for explaining this.
It’s so upsetting to see my friend being marginalized and talked to as if she doesn’t understand. When she gets it just fine, thank you very much.
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It sounds like he was having problems for quite awhile, according to this article from today’s LA Times:
Wow, that’s very sad.
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Incredibly sad! He’s one of my favorite actors….starting way back in the dark ages with Moonlighting.
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I loved Moonlighting!
Also, when it first came on, our entire family said, “Oh my gosh, that’s J (H’s brother)!” Not only do they look alike, but the mannerisms and speech patterns are identical. Over all this time, they have aged the same, too, including shaved heads. it continues to be uncanny.Truly separated at birth.
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He’s such a likable guy. Watching with my 86 year old Dad all I could think about was you can have all the $$ in the world but health is more important.
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I still have a few laminated large cards. They show pictures of common items, like water. I use to leave them with patients with aphasia so they could communicate with staff or family.
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“Other patients have receptive aphasia ; they may experience intense confusion when people talk to them, and they may fail to follow conversations.”
Any kind of aphasia would be very frustrating and disheartening, but this would be particularly frightening.
I had a patient once who had just gotten back from the Cath Lab with a new heart stent. I asked him “how are you feeling?” He looked at me very puzzled, as if I had spoken a foreign language. I looked at his ID bracelet, and as always, asked him to tell me his name. Again, the puzzled expression, and then he just shook his head.
I called the Doc immediately, who came in and spoke to him and said to me “Oh God, this is not his baseline.”
By the time they got him to CT scan, he was back to normal. The event was diagnosed as a TIA. He told me later that everything people were saying was gibberish. Very scary.
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I hope that Willis had been getting therapy after the “event” because it doesn’t sound like he was getting it. It’s so, so sad for our patients, as well as for us.
Working the hospitals, with these patients, was tough on me emotionally, because I met the families who would regale me with what the patient did prior to the “event”. They were the ones who needed the grief counseling because they wanted their family member back.
I spent a lot of time with families telling them that we wanted their parents/siblings back too, and emphasized quality of life for the patients who wanted to be “back” as well. Upon discharge, I had to reinforce and reiterate that the patients didn’t want family events to “change”. Most patients realized that they were not well, but wanted to be included in the same family events and visits. Rough memories.
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