Wednesday, February 10

Aphasia: Word Jumbles in Alzheimer's

Jumble of words
LANGUAGE: Aphasia affects a person's ability to communicate. It affects language functions, such as speaking, understanding what others say, and naming common objects. Learn its causes, types and a few tips.

What is Aphasia

Aphasia (ah-FA-ze-ah) is a language disorder that affects the ability to communicate. "Aphasia" is a general term used to refer to deficits in language functions, such as speaking, understanding what others are saying, and naming common objects. It is caused by damage to the portions of the brain that are responsible for language. Aphasia is not a disease, but a symptom of brain damage. The type and severity of language dysfunction in Alzheimer's is somewhat random, as it depends on the precise location and extent of the damaged brain tissue.

Alzheimer's & Aphasia

Alzheimer's symptoms fall into two categories:

  1. Cognitive (Intellectual) Symptoms
  2. Psychiatric Symptoms

The cognitive symptoms include "The 4 Cognitive 'A's of Alzheimer's". These are:

  1. Aphasia
  2. Apraxia
  3. Agnosia
  4. Amnesia

4 Types of Aphasia

Generally, aphasia can be divided into four broad categories:

  1. Expressive aphasia involves difficulty in conveying thoughts through speech or writing. The patient knows what he wants to say, but cannot find the words he needs.

    Expressive aphasia may be non-fluent, in which case a person has trouble:

    • Finding the right words
    • Saying more than one word or phrase at a time
    • Speaking overall

    Another kind of expressive 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.

  2. Receptive aphasia involves difficulty understanding spoken or written language. The patient hears the voice or sees the print but cannot make sense of the words.
  3. Anomic or amnesia aphasia is the least severe form of aphasia. In this type of aphasia, people have difficulty in using the correct names for particular objects, people, places, or events.
  4. Global aphasia results from severe and extensive damage to the language areas of the brain. Patients lose almost all language function, both comprehension and expression. They cannot speak or understand speech, nor can they read or write.


Language therapy can help and should be tailored to the individual needs of the patient. Rehabilitation with a speech pathologist involves extensive exercises in which patients read, write, follow directions, and repeat what they hear. Computer-aided therapy may supplement standard language therapy.

Care Tips

There are simple ways to keep distractions and noise down, such as:

  1. Turn off background music, news or TV.
  2. Move to a quieter room.

Always assume that the person with aphasia is listening and understanding. Talk in adult language, never make them feel like children. Do not pretend to understand them if you do not.

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

When asking questions:

  1. Ask yes/no questions.
  2. Give clear choices for possible answers. Do not offer too many choices.
  3. Visual cues help.

When giving instructions:

  • Break them down into small, simple steps.
  • Allow time for the person to understand. Sometimes this can be a lot longer than you expect.
  • If frustrated, consider switching activities.

Encourage a person with aphasia to communicate in other ways, such as:

  1. Pictures
  2. Pointing
  3. Hand gestures

It may help everyone to have a book of pictures or words about common topics or people. This can make communication a lot easier.

Generally, it is a good idea to keep them involved in conversations. Check to make sure they understand, without pushing too hard or causing more frustration.

Do not correct when they remember a thing incorrectly.

When leaving anyone with speech problems by themselves, make sure they have ID with:

  • Contact info of family members or caregivers
  • An exlanation of their speech problem and basics on communicating.

Questions for your Doctor or Nurse

Take a few minutes to write your own questions for the next time you see your healthcare provider:
  1. How long will I need therapy?
  2. Will my aphasia go away?
  3. How can I find a stroke or aphasia support group?

Care Tips

How can family, friends and caregivers help?

A person with aphasia and family members will need the help and support of a doctor, counselor and speech pathologist. It's a good idea for family and friends to:
  1. Be open about the problem so people can understand.
  2. Set up a daily routine for the person with aphasia that includes rest and time to practice skills.
  3. Use sentences that are short and to the point.
  4. Stand where the person with aphasia can see you.
  5. Treat the patient as an adult, keeping him or her involved in all possible routines. No one likes to be ignored. Include the patient in your conversation.
  6. Help the person with aphasia cope with feelings of frustration and depression.
  7. Be patient with the person with aphasia. Give them the time they need to try to speak and get their point across to you. This respects their dignity.
  8. Talk to your doctor, nurse or other healthcare professionals.

Comment or Share:

  1. I sadly experienced all of this while visiting my husband last week! :'(

  2. I have a comment with regard to the part on "if you do not understand the person, do not pretend as if you do" during the same 6 year period caring for my father who had Alzheimer's and my wife's father who developed dimentia with sever aphasia, we found that our fathers mostly seemed to experience greater calmness when we acted as though we understood or engaged in what seemed to us as the "make believe" world each created. Many a negative situation developed when we tried to correct or get information we couldn't interpret. We learned quickly that emotions on their part would turn sour if they even caught an expression of frustration on our part. Communication was always secondary to sincerely creating that moment of just caring.

    1. I like this point and tend to agree. If it's not a situation of circumstance, I would like to take this approach. Thanks for chiming in!

    2. Agree completely with this comment!

    3. I totally agree with you, Enhancedcarpet. I am living with my husband's Primary Progressive Aphasia. It has been 2 years since diagnosis & lots of reading to research the topic. We had a great speech therapist for 6 months. At the renewal request, Humana Medicare Plus decided that speech therapy was not medically necessary. We switched Insurance companies as of the first of the year so we hope that Aetna Medicare Advantage is favorable of speech therapy to maintain lifetime communication goals! Ugh, I dislike the federally funded insurance game!

  3. My husband had a stroke 3 years ago and I was told he has expressive aphasia but he also has some of the symptoms of the other types of aphasia. Is this typical?

  4. So sad if your immediate family make fun of you when you struggle to find the words when communicating with them..It resulted in me refusing to speak to them and that alone brought a bag full of problems.


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