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Replies: 3 - Pages: [1] - Last reply: 2021-11-30 13:42:58 - By: Bill Connors
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Todd
(Member)

Posts: 1
Registered:
2021-04-26 23:55:27

My father had a severe stroke in 1998. He has partial paralysis and aphasia. He went through several tries at speech therapy with no significant improvement, I attempted to work with him the last time and so I can attest to this directly. He lives on his own and takes care of himself and most home chores, however he needs us to do all of the bill paying, shopping, etc. We communicate through pointing and experienced guessing. My question is simply, is there something we should be doing for him that we are not? He gave up trying to talk long ago, because the same words come out all the time, usually “shit” or “no”. Have there been any advances in therapy that I should check on? Therapy really did not help at all and eventually he became quite discouraged even though I tried to stay upbeat.

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carole pomilio
(Member)

Posts: 47
Registered:
2021-04-26 00:03:56

Dear Todd,
I am sorry for your frustration. I do understand how difficult it is to have someone in your family who is unable to communicate. However it does seem that you have made it possible for your father to live somewhat independently and that is wonderful. The answer to your question is not a simple one. However I will give you some ideas. First of all, I worked with people who had aphasia and they continued to progress many years after their stroke. Although the progress does tend to slow down over time, gains are still possible. An important piece of information to think about is this: if you don’t use it you will lose it. To answer your question, research continues everyday into new advances in the area of stroke rehabilitation. There are advances in pharmacological treatments, massed practice techniques (constraint induced therapy), use of the computer for intervention as well as compensation and alternative strategies such as writing, drawing or using a picture/symbol system of communication. The first idea that you should try is to check into a local stroke/aphasia support group. It is unbelievable how a true group of peers can stimulate communication. Next, ask your physician to recommend a new evaluation with a speech pathologist to see if any of the new advances would benefit your father’s communication. A speech pathologist might also be able to recommend computer systems or compensation strategies which could enhance your father’s abilities. And finally, although I know you have tried assisting your father before maybe you should try again. Some times, people with aphasia are not ready to make gains when the treatment is initially attempted. Maybe now is a better time. You could also ask a close family member (grandchild or close friend) to work with your father instead of taking this on yourself. I hope this helps. If you need any other information please write back.
Carole Pomilio

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Bill Connors
(Member)

Posts: 4
Registered:
2021-04-26 00:03:56

I am so sorry to hear about your dad’s long bout with aphasia. While 9 years is a long time and recovery is easier said than done as I mentioned in another response. Actually my advice is quite similar to that response. I definitely have seen patients improve after long periods of time but this requires an excellent treatment program that uses a clear picture of his communication impairment to build a program exclusively for him. The fact is that aphasia is different for everyone. An important key to re-motivating him is to find ways for his to communicate even with small gains that he sees as significant. While this seems obvious and perhaps impossible to attain, it has been done. Often, the beginnings involve pragmatics [ PACE therapy ] which is very different from traditional didactic aphasia therapy. It focuses on taking turns, exchanging new information, using various modalities [ gestures, writing, drawing, etc ] . A key is to find in effective perhaps creative ways a modality of communication that allows for his attention as well as clarification, expansion and/or verification. Always, we persist also on attempts to establish speech output. Often in cases such as you describe, apraxia of speech and/or oral movements needs to be addressed. I have found that way too often apraxia has not been addressed effectively. I would be pleased to discuss this further with you if you would like. In any case, I wish you the best of luck.

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