WHAT IS APHASIA: WORD JUMBLES IN ALZHEIMER'S DISEASE

Aphasia (ah-FA-ze-ah) is a language disorder that affects a person’s ability to communicate. "Aphasia" is a general term used to refer to deficits in language functions, such as speaking, understanding what others are saying, and naming common objects. It is caused by damage to the portions of the brain that are responsible for language.

Aphasia is not a disease, but a symptom of brain damage. The type and severity of language dysfunction in Alzheimer's disease is somewhat random, as it depends on the precise location and extent of the damaged brain tissue.

Alzheimer's Disease (AD) & Aphasia

Alzheimer's disease symptoms fall into two categories:

ü   Cognitive (Intellectual) Symptoms

ü   Psychiatric Symptoms

The Cognitive Symptoms include "The 4 Cognitive 'A's of Alzheimer's Disease". These are:

·                Aphasia

·                Apraxia

·                Agnosia

·                Amnesia

4 Types of Aphasia:

Generally, aphasia can be divided into four broad categories:

1.   Expressive Aphasia involves difficulty in conveying thoughts through speech or writing. The persons know what they want to say, but cannot find the words they need. Expressive aphasia may be non-fluent, in which case a person has trouble:

Ø   Finding the right words

Ø   Saying more than one word or phrase at a time

Ø   Speaking overall 

Another kind of expressive aphasia is fluent aphasia. Persons who have fluent aphasia may be able to put many words together. But what they say may not make sense. They are often unaware that they are not making sense.

2.   Receptive Aphasia involves difficulty understanding spoken or written language. The person hears the voice or sees the print but cannot make sense of the words.

3.   Anomic or Amnesia Aphasia is the least severe form of aphasia. In this type of aphasia, the person has difficulty in using the correct names for particular objects, people, places, or events.

4.   Global Aphasia results from severe and extensive damage to the language areas of the brain.  The person loses almost all language function, both comprehension and expression. They cannot speak or understand speech, nor can read or write.

Therapy:

Language Therapy can help and should be tailored to the individual needs of the person. Rehabilitation with a speech pathologist involves extensive exercises in which the persons read, write, follow directions, and repeat what they hear. Computer-aided therapy may supplement standard language therapy.

Care Tips:

There are simple ways to keep distractions and noise down, such as:

ü   Turn off background music, news or TV.

ü   Move to a quieter room.

Always assume that the person with aphasia is listening and understanding. Talk in adult language, never make them feel like children. 

If they cannot understand you, do not shout. Unless the person also has a hearing problem, shouting will not help. Make eye contact when talking to them.

When asking questions:

·                Ask yes/no questions.

·                Give clear choices for possible answers. Do not offer too many choices.

·                Visual cues help.

When giving instructions:

Ø   Break them down into small, simple steps.

Ø   Allow time for the person to understand. Sometimes this can be a lot longer than you expect.

Ø   If frustrated, consider switching activities.

Encourage a person with aphasia to communicate in other ways, such as:

v   Pictures

v   Pointing

v    Hand gestures

It may help everyone to have a book of pictures or words about common topics or people. This can make communication a lot easier.

Generally, it is a good idea to keep them involved in conversations. Check to make sure they understand, without pushing too hard or causing more frustration.

Do not correct when they remember a thing incorrectly.

When leaving anyone with speech problems by themselves, make sure they have ID with:

ü   Contact information of family members or caregivers.

ü   An explanation of their speech problem and basics on communicating.

Questions for your Doctor or Nurse:

Take a few minutes to write your own questions for the next time you see your healthcare provider:

ü   How long will I need therapy?

ü   Will my aphasia go away?

ü   How can I find a stroke or aphasia support group?

Care Tips:

How can family, friends and caregivers help?

A person with aphasia and family members will need the help and support of a doctor, counsellor and speech pathologist. It's a good idea for family and friends to:

Ø   Be open about the problem so people can understand.

Ø   Set up a daily routine for the person with aphasia that includes rest and time to practice skills.

Ø   Use sentences that are short and to the point.

Ø   Stand where the person with aphasia can see you.

Ø   Treat the person as an adult, keeping him or her involved in all possible routines. No one likes to be ignored. Include the person in your conversation.

Ø   Help the person with aphasia cope with feelings of frustration and depression.

Ø   Be patient with the person with aphasia. Give them the time they need to try to speak and get their point across to you. This respects their dignity.

Ø   Talk to your doctor, nurse or other healthcare professionals.

(Source:  Alzheimer’s and Dementia Weekly, 8 December 2015)