specialty focus it ’ s just so difficult for them to be able to communicate .
What parts of the brain are affected and how are they different from each other ? There ’ s two main language areas of the brain called Broca ’ s area and Wernicke ’ s area , and they do slightly different things . Wernicke ’ s area of the brain is mostly involved in comprehension and producing words that have some meaning behind them , whereas Broca ’ s area is much more about putting the words into a sentence .
What we find in people who have what we used to call Wernicke ’ s aphasia is they tend to have difficulties with the comprehension . They can produce lots of language but it doesn ’ t quite make sense , and so they might say some random words which don ’ t seem to be appropriate for what they ’ re trying to talk about .
With Broca ’ s type of aphasia , they ’ ll have difficulty putting the words into a sentence , and so they produce what we call telegraphic speech . It can be quite halted with just some keyword , and often you can understand what they ’ re trying to get across by joining the dots of the keyword .
How common is aphasia for older people and how does it affect them ? There ’ s about 140,000 people living with aphasia and those stats mostly relate to people who ’ ve had a stroke . Older people are more likely to have a stroke , and they ’ re also more likely to have the primary progressive aphasia type .
We don ’ t know the full stats because it ’ s quite rare and it ’ s also quite difficult to diagnose , and sometimes people will go through quite an assessment process before they come to that diagnosis .
It ’ s a sub-type of dementia where the language is the first thing to go , is the first thing to be affected .
Aphasia ’ s always a result of an underlying neurological condition . It doesn ’ t just happen on its own . So having a stroke , having a brain injury , having a brain tumour , and it ’ s the language areas of the brain that have been damaged which results in them having aphasia .
The impact for older adults is you can ’ t communicate . It can make it very , very challenging for you to be able to get out and about . Just even going to a restaurant and ordering a meal can be very challenging for people with aphasia because they just can ’ t say the words that they need to say . So , it is really a significant impact on people ’ s lives .
In saying that , I ’ ve met some amazing people with aphasia who are incredibly inspirational who have done some amazing things , and they can often draw on some really amazing resources to communicate in different ways .
Some people will use art to help them to communicate how they ’ re feeling about something , or they ’ ll be able to write some initial letters and be quite creative in the way that they can communicate , or use quite detailed gestures .
Is there room for recovery , and how can speech pathologists help ? If they ’ ve had an acute incident like a traumatic brain injury , or they ’ ve had a stroke , there is some element of recovery , and that is the same with the language symptoms .
With the primary progressive aphasia type , unfortunately , that gets worse over time . However , speech pathologists can really help both groups of people . We can work with people to find different ways to access words . We can give different strategies which means different pathways within the brain are activated which can find an alternative route into the words that they ’ re trying to access .
There is a bit of flexibility within the brain after brain damage . We can sometimes find different pathways in , or different parts of the brain can compensate a bit . Our job is to try and find those alternative pathways . Part of that is to work out what works for that person and which words are not being activated , and what we can do to try and activate those words again .
Sometimes that ’ s just too challenging and we can ’ t help them to activate those words again , and that ’ s when we will look at alternative means of communication .
People could know the first letter of the word they ’ re trying to access and they ’ ll write the letter and the family members have to guess , or sometimes they can use a gesture . So we sometimes use those sorts of total communication approaches where we are looking at lots of different strategies to help them to communicate .
We also work with the partners of people who have aphasia to try and
“ The worst thing we can do is not communicate with people with aphasia .
get them to use some different ways of communicating . They might offer some choices , for example , and that way the person just has to identify which one they want , rather than trying to communicate the whole sentence .
With primary progressive aphasia , it ’ s a little bit different . We try and maintain what they have . So , we ’ re trying to support them to keep using communication , but we ’ re also preparing them for when their language does get worse .
How can aphasia be problematic in residential aged care ? It can be really problematic if the staff don ’ t know how to support that person ’ s communication . It ’ s really important that staff who work in residential care get some training in how to help people communicate , but also get to know their residents and know what works for that person .
Different things will work for different people . Working with the speech pathologist to decide how to support that person to be able to communicate is really important . The worst thing we can do is not communicate with people with aphasia . We need to keep them using communication , but also from a quality of life point of view , ensuring that they ’ re still engaged with social interaction . It ’ s very important for people to still feel like they have choices and can communicate those choices . What sometimes happens with people with aphasia is other people start making choices for them , but there are ways we can support people to make choices about their meals , for example , or about what they want to do that day .
We can support them by providing pictures and words , and giving them that opportunity to point to a picture , for example , to ask what they would like to do today , or having aphasia friendly menus , to ask them which food they would you like today .
It ’ s also about making sure that they ’ re still engaged in social interactions by sitting down and talking to them , and finding ways to help them to communicate . ■ agedcareinsite . com . au 23