Finding your words again: Regaining language after stroke

You’re having a conversation and the word you want to say right on the tip of your tongue. It’s a frustrating experience that everyone has now and then. But for someone who has suffered a stroke, communication issues can be much more severe and long-lasting.

When the stroke involves the language center, the stroke victim often knows exactly what they want to say, but are unable to communicate their thoughts with words or unable to comprehend the spoken language. It can affect relationships with family and friends, their job and their own sense of wellbeing and mental health.

“We look at the whole patient during the stroke-recovery process,” said Geisinger neurologist Ramin Zand, M.D. “Providing therapy that helps the patient reclaim their ability to communicate is an important part of making them feel like the person they were before the stroke.”

What happens during a stroke?
More than 800,000 people in the United States have a stroke each year. When someone has a stroke, there is a disruption in the blood supply to their brain – sometimes including areas responsible for speech. Either the blood is blocked or a blood vessel in the brain bursts. As a result, brain tissue dies because it doesn’t receive the blood, oxygen, and nutrients it needs.

“A stroke is a medical emergency,” said Dr. Zand. “The sooner the stroke victim receives treatment, the better their outcome will be.”

The common types of communication impairment
Someone who suffers a stroke may experience several types of communication challenges,” said Dr. Zand. “The most common are aphasia, dysarthria and dyspraxia.”

Aphasia happens when the “language control centers” of the brain are damaged during the stroke. They may have receptive aphasia, which makes it difficult for them to understand spoken and written language. They may also experience expressive aphasia, which makes it difficult or impossible to speak even though they understand everything being said to them.

Dysarthria is a communication impairment caused by muscle weakness. It may cause slurred speech. Dyspraxia is a problem with muscle coordination that may make it hard to use the muscles required for speech.

How a speech therapist will help
“Speech therapy is an essential part of stroke recovery,” said Dr. Zand. “It should start in the first month after the stroke, when the brain is most flexible and able to heal and repair.”

A speech-language pathologist will work with the patient to identify communication challenges and a plan of action for therapy. The therapy will include exercises to strengthen language processing in the brain. This may include repeating words with the therapist, using phrases to describe words the patient can’t think of, conversational coaching, prompts to help spark memory of specific words and strategies for working around language disabilities.

How family members and friends can help
Family and friends are an essential part of the language recovery process. A big part of the help they can give involves exercising patience with the stroke victim’s communication challenges.

“Keep in mind that the person you know and love is still the same person after a stroke,” said Dr. Zand. “They may communicate differently, but most of their thoughts and feelings are unchanged.”

A few tips to keep in mind:

• Speak slowly and clearly in short sentences, but don’t talk down to them.
• Maintain eye contact with the stroke victim to show you’re paying attention.
• Don’t finish their sentences, even if you know the word they are searching for.
• Reassure them that you understand their frustration.

“Part of your job as a family member is to help stroke victims maintain a positive outlook about their recovery,” said Dr. Zand. “By showing them patience and understanding, you can give them the confidence to persevere.”

Ramin Zand, M.D., is Geisinger’s neurology director of Clinical Stroke Operations and Northeastern Regional Stroke director. To schedule an appointment with Dr. Zand or another neurologist, please call 570-271-6590 or visit Geisinger.org.