Your spouse or parent has aphasia: where to start

What aphasia is, in brief

Aphasia is a language problem caused by damage to the parts of the brain that handle language, most often from a stroke. It can affect speaking, understanding, reading and writing, in any combination. Many people know exactly what they want to say but cannot get the word out, or say a different word than the one they meant.

Aphasia does not usually affect intelligence. Your family member is still the same person, with the same memories and opinions. Treat them as the adult they are, and include them in decisions.

Work with the speech-language pathologist

A speech-language pathologist (SLP), also called a speech therapist, is the most important person on the team for aphasia. They assess which language skills are affected and plan therapy. If no one has mentioned speech therapy yet, ask the doctor for a referral.

• Ask what to practice at home. Sessions are short, and practice between them matters.
• Ask how best to talk with your family member. The SLP can tell you whether to use writing, pictures, gestures or yes/no questions.
• Sit in on a session if you can. Watching how the therapist gives hints is the fastest way to learn.
• Ask what happens when therapy ends. Insurance often covers a limited number of sessions, and it helps to plan for continued practice afterward.

Make everyday conversation easier

• Turn off the TV and talk in a quiet room, one person at a time.
• Use short, simple sentences, but a normal adult tone.
• Ask yes/no questions, or offer two choices: “Coffee or tea?”
• Write key words down, point, gesture or draw.
• Wait. Give extra time to answer before stepping in.
• Check that you understood: “You want to call Susan. Is that right?”

Our guide to communicating with someone who has aphasia covers these techniques in more detail.

Practice a little every day

Practice helps most when it is short, frequent and at the right level: ten to twenty minutes once or twice a day, with most answers right but not all of them. Stop before frustration or fatigue sets in. Early on, your family member may tire very quickly, and that is normal.

Our page of free aphasia exercises has seven activities you can do together at the kitchen table, such as naming things around the house and finishing familiar sentences. For something your family member can do on their own, try our free online lesson. It needs no account and takes about five minutes.

Look after yourself too

Caring for someone after a stroke is hard, and aphasia adds its own strain: conversations that used to be easy now take effort, and you may feel you have lost a partner to talk with. Those feelings are common and understandable.

• Find a support group. Many hospitals, stroke associations and community aphasia centers run groups for people with aphasia and their families, in person or online.
• Accept help. Let friends and relatives take on specific tasks, including spending time talking with your family member.
• Take breaks. You do not have to be the therapist every hour of the day. Ordinary time together matters too.
• Talk to a doctor about yourself if you are not sleeping, feel low most days, or feel overwhelmed.

When to worry

Call 911 right away for sudden new trouble speaking or understanding, sudden weakness or numbness on one side, a drooping face, loss of vision or balance, or a sudden severe headache. These can be signs of another stroke, and fast treatment matters.

Contact the doctor or speech therapist if speech or understanding gets steadily worse over days or weeks instead of better, or if your family member seems withdrawn and depressed. Depression is common after a stroke and can be treated.

When you are ready for more practice

Parrot Software has 94 programs for speaking, understanding, reading, writing, memory and attention, designed for practice at home. It also includes live conversation practice with a talking person on screen. The first week is free, with no credit card. There is no rush: settling in, getting therapy started and finding a routine come first.