On my neuro outpatient placement I came across a few people with expressive aphasia. Needless to say that a conversation doesn't take place in the usual way. Most of the patients I have seen are only able to say one or two words at a time and a lot of the times it seems like they are saying a word related to the one they want to say but just do not quite hit it. So it usually takes them about three trials before they can say the one word.
I find it very hard not to put words in their mouth by guessing what they want to say but just be patient and waiting for the right word to come out. Another challenging aspect of communication with those type of patients I find is not to give up (patient or physiotherapist) trying to talk and listen because it is important what they have to say.
I think it is imperative to find the right balance with helping them out with the word they are looking for without being patronising or impatient. Who knows, I might improve my ability to communicate with aphasic patients over the next three weeks. And I hope that the times where I have to say:"I am sorry, but I can not understand what you are saying" are becoming less frequent.
Edith
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Hi Edith,
I had a patient in my neuro outpatient who had expressive aphasia. When I read her notes initially, I was very worried that spending 90 minutes twice a week with this patient was going to be very difficult as she could only say one word. I guess what helped me was the fact that she was very animated and used the intonation of her voice a lot to get across what she was trying to say. I also tried using closed type questions to make it easier for her to answer. She also had a little book with common words written in it for her to refer to if she needed to (ie. days of the week, etc).
In the end she ended up being one of my favorite patients. I can’t even imagine how frustrating it would be for her to try and communicate with others on a daily basis and only be able to say one word. Spending that extra time with her to really understand what she was saying made our patient physiotherapist relationship that much more rewarding, especially since I know how much it was appreciated.
Good luck,
Meghan
Edith,
I was really worried at the beginning of my neuro placement about dealing with aphasic patients, because you just feel so rude, and they can get so frustrated...one lady burst into tears quite a few times trying to get out what she had to say.
I think you're right in not putting words in their mouth....be very patient, if they're getting upset providing some reassurance and maybe suggesting that you can come back to it later, perhaps they might be able to tell you then etc etc....I found helpful and it worked with a particular patient. These were acute pt's though and hadn't received any speech therapy as yet.
The good thing though, was by the end of the placement, my anxiety decreased so much when I had an expressive aphasic patient.....you definitely get used to it.
Madeleine
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