Aphasia and Its Impact on an Individual's Ability to Communicate - Essay Example

Aphasia and its Impact on an Individuals Ability to Communicate Aphasia is defined by the National Institute on Deafness and Other Communication Disorders (2008) as a “disorder that results from damage to portions of the brain that are responsible for language”. This disorder mostly manifests in affectations of the left side or hemisphere of the brain. The nature of this disorder involves an interruption in the use of language as a result of brain damage manifesting with symptoms which affect a person’s ability to ability to express thoughts and emotions and to communicate with other people (Wertz, as quoted by Papathanasiou, 2005, p. 3). There are various classifications of this disease. Major categories of the disease are known as fluent and non-fluent aphasia. Fluent aphasia results from damage to the temporal lobe of the brain; this type is also otherwise known as Wernicke’s aphasia (National Institute on Deafness and Other Communication Disorders, 2008). Patients with Wernicke’s aphasia often speak in long sentences that have no meaning at all, or use unnecessary or made-up words in their sentences. A type of non-fluent aphasia is known as Broca’s aphasia and this disorder is mainly due to damage to the frontal lobe of the brain. Patients with Broca’s aphasia often understand language and speak fairly well (National Institute for Deafness and Other Communication Disorders, 2008). However, they have trouble using and speaking the exact words that refer to their thoughts or emotions. Global aphasia results from damage to many parts of the brain controlling language. These patients have severe communication problems and are limited in their ability to express and understand language. Other types of aphasia manifest with different kinds of damages or language problems depending on which parts of the brain are affected (National Institute for Deafness and Other Communication Disorders, 2008). Aphasia is caused by a variety of factors. Benson & Ardila (1996, pp. 69) discuss that it may be caused by (a) trauma from falls, accidents, or other injuries, (b) neoplasms, (c) infections, (d) other diseases which affect brain function. Neoplasms may infiltrate areas of the brain controlling speech and language. As these neoplasms grow, more physiologic functions eventually become affected, hence, the aphasia may gradually become more pronounced in patients with neoplasms (Benson & Ardila, 1996, p. 69). Intracranial infections also affect brain function through bacteria or virus. These infections sometimes cause abscesses which enlarge and compress into different parts of the brain – some affecting speech and language thereby causing aphasia. Other diseases like Huntington’s disease, multiple sclerosis, Parkinson’s disease, dementia, epilepsy, and similar diseases which affect brain function may manifest with symptomatology relating to aphasia (Benson & Ardila, 1996, p. 69). The impact of aphasia may be seen in a variety of ways, but mostly in a person’s ability to communicate and on the consequent effect on the quality of his life. A study by Friedman (as cited by Payne, 2009) emphasized that aphasia “severely limits a person’s ability to speak and understand others, and most people experience difficulty reading and writing”. This disease impacts on children, adults, and older adults in different ways. In general, it often causes frustration on a person while expressing his emotions or his thoughts and in trying to understand other people as well. The quality of life for people with aphasia is often diminished by this inability to communicate and to understand other people. In their website, the National Aphasia Association (2005) points out that adult people with aphasia are often prompted to work in jobs which have minimal demands. A survey of adults with aphasia revealed that about 70% of them felt that other people avoided contact with them because of their inability to communicate. As a result, aphasic patients mostly live lonely lives because they do not feel free to visit or to relate socially with other people. These patients point out that they hardly have any visitors at all, and oftentimes, even their family members make them feel like outsiders (National Aphasia Association, 2005). These aphasic patients also indicate that they feel very much isolated, left out of activities they enjoyed before. Other people, even their close friends often ignore them and treat them as if they were not actually there (National Aphasia Association, 2005). It is also important to note that people with aphasia often do not return to the lives they had before, and this inability to get back to their normal lives cause aphasic patients to be frustrated and angry with their lives and with themselves. Aphasic patients sometimes return to families who are not ready to face the abrupt physical and psychological changes brought on by their aphasia (National Aphasia Association, 2005). Families of aphasic patients often feel helpless and guilty about being unable to understand the patient and about being unable to do something more productive in order to help their relative communicate their needs, desires, thoughts, and emotions. The frustration in dealing with this disease is seen in family members and also in the patient. On the part of the family members, they cannot understand what the patient is trying so hard to express and on the part of the patient, he feels the frustration of not being able to express his thoughts and his needs to his family. For older adults, aphasia also has a devastating impact on their ability to communicate. In a study by Davidson, et.al., (2006) they established that as regards various aspects of older adults’ lives like family, friendship, leisure, domestic life, and community services, those who were aphasic had “fewer communication partners and the majority occurred at home”. There is an indication of isolation among aphasic patients; they often do not feel comfortable in socializing because of their inability to communicate properly and, more often than not, they just stop trying. This may create a bigger dilemma in instances when an older client needs to communicate pain, shortness of breath, difficulty of breathing or any other symptom that implies a disease or an underlying medical condition. With regard to the quality of life of aphasic patients, there are some variations. “Some affected individuals report that aphasia forms a large reason for their poorer quality of life, while for others aphasia is responsible for only a small part of their overall quality of life” (Worrall & Holland, 2003, p. 330). Again, because the quality of life of these patients is largely affected, many of them experience depression. With depression, further risks to the patient’s life and health may be incurred. An article by MacDonald (2009) discusses how some stroke patients who later manifest with aphasia are often confused with their words. These patients also often mix their tenses in communicating with other people. Stroke patients suffering from aphasia find it difficult to communicate to other people that they are feeling something medically relevant, even something which refers to complications from their stroke like paralysis, difficulty of breathing, or pain. They are also scared about being unable to communicate freely with other people (MacDonald, 2009). Some patients, who have trouble with numbers, find it difficult to withdraw money from their ATM because they forgot their PIN; they also find it complicated to call anyone – especially their homes, because they do not remember their phone numbers. The quality of their lives is often lessened because of their inability to communicate simple needs like going to the toilet, needing help in grooming, or attending to their activities of daily living (ADLs) (MacDonald, 2009). A speech therapist working closely with aphasic patients succinctly described the situation of these patients as akin to being in a foreign country without being able to speak or learn the language. It is a complete shutdown of communication, and simple yes or no questions or answers cannot be expressed or understood by these patients (MacDonald, 2009). Duchan & Byng (2004, p. 22) discuss that aphasic patients become more aware of the network of communication that connects them to the outside world in almost all aspects of their lives. This network depends, to a large extent, on a person’s ability to communicate. Unfortunately, “aphasia not only disconnects the persons from the community but invariably alters the person’s identity and sense of self” (Duchan & Byng, 2004, p. 22). By being disconnected from the community, the aphasic patient’s psychosocial life is greatly affected. Eisenson (1984, pp. 257-258) discusses that the aphasic’s psychosocial reactions include ego destruction, disruption of conventional family dynamics, loss of identity, withdrawal, and apathy. For the patient’s family, they have “severe feelings of loss, helplessness, anger, frustration, and depression (Eisenson, 1984, p. 257). The experience is very much like losing a family member and the family also goes through the same process of grieving. Baum (1997, p. 369) explains how the different stages of grieving are also often undertaken by the aphasic and his family. The patient’s ability to cope or ability to adapt to changes has to be undertaken based on the five stages of grieving (denial, anger, bargaining, depression, and acceptance). In the process of ‘grieving’, the patient and his family would often ask themselves, “why me?” or “why us”. In aphasic patients, the caregiver will find it hard to determine what stage the patient is in because the best method of assessment – that of asking the patient personally – cannot be undertaken on the patient. Some practitioners note that it is sometimes quite unclear “whether the apparent emotional deficit of right hemisphere-damaged patients is an impairment of emotional processing, or reflects impairment in actual communication of emotion” (Baum, 1997, p. 369). The self-reporting process cannot be undertaken on patients; this entails the cooperation and collaboration of clinicians and of family and friends caring for the patient in order to verify the accuracy of the assessment process. On the part of caregivers, medical health professionals, friends, family who are involved in the aphasic patient’s care, there is a need for them to make the necessary adjustments in patient care. More specifically, there is a need for them to learn and possibly master non-verbal methods of assessment like the Visual Analogue Mood Scale; and to be more adept at reading the patient’s facial expressions and non-verbal gestures or cues (Baum, 1997, p. 370). In the families of stroke patients with aphasia, the personal roles of each member of the family are often dramatically changed. In instances when the breadwinner of the family is the stroke/aphasia patient, his inability to return to work often prompts other family members to step into the breadwinner’s role prematurely or with hardly any preparation at all (Ball & Damico, 2007, p. 87). The reversal in family roles can add to the feeling of helplessness on the part of the patient who is now totally dependent on his other family members for support. On both the patient and the members of the family, the usual roles are now transformed into unfamiliar and frightening roles (Ball & Damico, 2007, p. 87). In a paper by Heacock & Mizuko (2009), they sought to assess the effects of aphasia on marital satisfaction and the study revealed that aphasia has a negative impact on marital satisfaction. In a study covering three couples with one of the spouses suffering from aphasia, the study revealed that as the degree of aphasia increased, marital satisfaction steadily decreased (Heacock & Mizuko, 2009). This study emphasized that there is a strong correlation between the severity of the aphasia and the degree of satisfaction in the couple’s marriage considering that as the aphasia often progressed, it presented more challenges for the couple to face. Aphasia also eventually implies the need to implement certain modifications in the home and among family members. First and foremost, the involvement of the family is crucial because they are the ones who need to learn to communicate with their loved one. Family members are often prompted to adapt simple, short, and uncomplicated ways to communicate with their loved one (Department of Health and Human Services, 2008, p. 3). This will often require them to list keywords for vital items or activities essential to the family’s and the patient’s daily activities such as needing to use the bathroom, needing a drink of water, feeling hot, feeling cold, needing to relive oneself, feeling pain, being unable to breath and such other essential activities or medical complaints. All family members are prompted to learn what keywords or hand gestures actually mean to all parties involved (Department of Health and Human Services, 2008, p. 3). The family is also often financially affected by aphasia, not just because of a possible loss of a breadwinner, but also because of the financial drain that medical expenses would bring to the family. It is often inevitable that aphasia would cause stress, sleep disturbance, and health problems to other family members, especially the children (Eisenson, 1984, p. 258). Because of the inability to cope with growing family problems and stress, spouses of aphasics often end up resenting the aphasic patient. Afterwards, feelings of guilt for harbouring such resentment often follow (Eisenson, 1984, pp. 258-259). This vacillating between emotions can occur several times while caring for the aphasic family member. Aphasia is a disorder caused by trauma or injury to areas of the brain controlling language and speech. Its physiological effects manifest in the patient’s inability to communicate and his difficulty in finding the right words to use to express his needs, his thoughts, or his feelings. This disease has a devastating impact on the patient and on his family, mostly manifesting in the patient’s psychological well-being and activities of daily living. Aphasic patients often end up being frustrated, and eventually depressed due to the limitations in their ability to communicate. This frustration is also often mirrored in the patient’s family as they make the necessary adjustments in order to communicate and cope with the demands of caring for the patient. As can be evaluated from the discussion above, the impact of aphasia on an individual’s ability to communicate covers various aspects of a person’s life – from the physiological to the psychological. It limits the patient’s life to the personal space he inhabits while limiting his psychosocial interactions with the outside world. Consequently, aphasia can cause difficulties, not just to the patient, but also to the patient’s family. Works Cited Aphasia, October 2008, National Institute on Deafness and Other Communicable Diseases, viewed 10 December 2009 from http://www.nidcd.nih.gov/health/voice/aphasia.htm Ball, M. & Damico, J., 2007, Clinical Aphasiology: Future Directions, p. 87. East Sussex: Psychology Press Baum, A., 1997, Cambridge handbook of psychology, health, and medicine, pp. 369-370, UK: Cambridge University Press. Benson, D. & Ardila, A., 1996, Aphasia: a clinical perspective, p. 69, Oxford: Oxford University Press Davidson, B., Worrall, L., & Hickson, L., June 2006, The impact of aphasia on the everyday communication of older people, http://aphasiology.pitt.edu/archive/00001687/01/Davidson_et_al_1.doc Duchan, J. & Byng, S., 2004, Challenging aphasia therapies: broadening the discourse and extending the Boundaries, p. 22, East Sussex: Psychology Press Eisenson, J., 1984, Adult Aphasia, 2nd edition, pp. 257-259, Englewood Cliffs, New Jersey: Prentice-Hall Publishers Heacock, A. & Mizuko, M., 2009, Aphasia’s Effects On Marital Satisfaction, Convention on ASHA, viewed 10 December 2009 from http://convention.asha.org/2009//handouts/1645_1816Heacock_Angela_139891_Nov16_2009_Time_051238PM.doc Impact of Aphasia on Patients and Families: Results of a Needs Survey, 2005, National Aphasia Association, viewed 10 December 2009 from http://www.aphasia.org/aphasia_community/impact_of_aphasia_on_patients_and_families.html MacDonald, N., 19 June 2009, When aphasia locks up your language, Brain Injury Research Foundation, viewed 10 December from http://www.birf.info/home/library/med_cond/mci_aphasia.html NIDCD Factsheet: Aphasia, October 2008, Department of Health and Human Services, p. 3, viewed 10 December 2009 from http://www.nidcd.nih.gov/staticresources/health/voice/FactSheetAphasia.pdf Papathanasiou I., 2002, Acquired Neurogenic Communication Disorders: A Clinical Perspective, p. 3, UK: Athanaeum Press Ltd: Gateshead, Tyne & Wear Payne, S., 22 April 2009, Rhonda Friedman: Aphasia Research Gives Hope to Patients, Georgetown University, viewed 10 December 2009 from http://gumc.georgetown.edu/news/71053.html Worrall, L. & Holland, A., April 2003, Quality of Life in Aphasia, p. 330, London: Taylor & Francis     Read More