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Patient Instructions

People with have aphasia have speech problems. They may have trouble:

• Finding the right word
• Saying more than 1 word or phrase at a time
• Speaking at all

This type of aphasia is called non-fluent aphasia. People who have it may understand what another person is saying to them, or they may NOT understand or be able to speak.

Another kind of aphasia is fluent aphasia. People 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.

People who have either kind of aphasia may become frustrated when they realize others cannot understand them, when they cannot understand others, or when they cannot find the right words.

A speech and language therapist can work with the person who has aphasia and their family or caregivers.

There are many ways to help a person with aphasia.

Keep distractions and noise down:

• Turn off the radio and TV.
• Move to a quieter room.

Talk to people who have aphasia in adult language. Do not make them feel as if they are a child. Do not pretend to understand them if you do not.

If they can not understand you, do not shout. Unless they also have a hearing problem, shouting will not help. Make eye contact when talking to the person with aphasia.

When you ask questions:

• Ask questions in a way they can answer you with a simple "yes" or "no."
• When possible, give clear choices for possible answers, but do not give them too many choices.
• Visual prompts are also helpful, when you can give them.

When you give instructions:

• Break down instructions into small and simple steps.
• Allow time for the person with aphasia to understand. Sometimes this can be a lot longer than you expect.
• If the patient becomes frustrated, consider changing to another activity.

You can encourage the person with aphasia to use other ways to communicate. Some are:

• Pointing
• Hand gestures
• Drawings

It may help the person with aphasia and their caregivers to make a book with pictures or words about common topics or people so that they can communicate better.

Always try to keep the person with aphasia involved in conversations. Check with them to make sure they understand. But do not push too hard for them to understand, since this may cause more frustration.

Do not try to correct the person with aphasia if they remember something incorrectly.

Begin to take the person with aphasia out more, as they become more confident. This will allow them to practice communicating and understanding in real-life situations.

When leaving someone with speech problems alone, make sure they have an ID card that:

• Has information on how to contact family members or caregivers
• Explains their speech problem and how best to communicate with them

Consider joining support groups for people with aphasia and their families.

Aphasia. Rockville, MD. National Institute on Deafness and Other Communications Disorders; 2008. NIH publications 97-4257.

Updated by: Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.