What to do if someone suddenly loses their ability to speak

What to do if someone suddenly loses their ability to speak?

Case 1: One rainy evening, an elderly man came home after buying groceries at a nearby store. As he was walking on the sidewalk, he suddenly stumbled and fell on his side. People around him rushed to help and tried to help him stand up again. However, he kept falling as if he could not maintain balance. He wasn’t unconscious, but he looked extremely confused and shocked. The people who helped him tried to talk to him and confirm that he was fine, but he could not make any sound, nor could he nod and reply. People brought him a bottle of water to drink, but he couldn’t hold the bottle or drink it, and the water kept slipping from the side of his mouth.

Case 2: A lively young man walked out of his office and headed straight to the gym in the late evening. After recovery he started his regular and intense exercises. He was a dedicated bodybuilder and completed all routine exercises on time. After working out, he went home, showered and had dinner. He was fatigued from his busy day and thus made an alcoholic drink for himself and lit a cigarette. He wasn’t an alcoholic but didn’t mind having drinks or smoking now and then to relax.

He watched TV until he finished drinking and then went straight to bed as the next day was going to be more tiring. In the middle of the night when he was sleeping, he suddenly felt a severe headache that felt as if someone had hit his head with a sledgehammer. He was rolling back and forth on his bed with that dreadful headache and vomited. He felt as if he was losing his sight as well. He tried to scream and call for help but he couldn’t utter anything but a few grunts. When his family opened the door to his room because he was not up until late in the morning, they found him unconscious, lying on the bed.


Case 3: A housewife was doing her daily business when she suddenly felt weak and sat on the floor. She began to feel numbness in her right arm and right leg. Her face looked heavy on the right side, and she started to panic but did not lose consciousness. A member of her family came looking for her and found her sitting on the floor in embarrassment. When he tried to talk to her to see if there was anything wrong, her words sounded distorted, chatty, and overwhelmed. She was speaking incorrectly and seemed unable to understand what was being said.

Is there a common feature between the above three conditions?

Yes, they have all had a “stroke” episode. A person can have a stroke when there is a rupture (hemorrhagic stroke) or blockage (ischemic stroke) in the blood supply to the brain. Blood carries oxygen and nutrients essential to the functioning of brain cells. Such undesirable conditions can lead to a loss of oxygen (hypoxia) to the brain, resulting in permanent damage to brain cells and tissues.


Some of the common risk factors that can lead to strokes include:

· high blood pressure
Heart disease
· diabetic
smoking
Alcohol consumption
Drugs and narcotics
Previous history of a minor stroke – also called a ‘transient ISCHEMIC attack’.
obesity
Inactivity and lack of exercise
Few pills or birth control pills
· the elderly

Often, stroke symptoms can include different combinations of the following:

Numbness or weakness in the arm, face, and leg, especially on one side of the body.
Trouble speaking or understanding what others are saying – a condition known as ‘avasia’.
slurred speech or nonsense – a condition known as dysarthria.
Confusion, confusion, or unresponsiveness
Sudden behavioral changes that significantly increase agitation
Vision problems, such as difficulty seeing in one or both eyes, darkening, blurring, or double vision
Difficulty eating and swallowing – a condition known as ‘DYSPHAGIA’.
Sudden difficulty reading and writing
Loss of balance or coordination
Difficulty walking
– vertigo
A sudden, severe headache of unknown cause.
– Seizures, nausea or vomiting.
Loss of bowel and bladder control.

what should we do?

Suppose you experience one or see someone having symptoms of a stroke and seek medical help immediately. Delays in receiving medical care can worsen symptoms and lead to permanent brain damage, long-term disability and even death. Most multispecialty hospitals have adequate facilities for dealing with strokes.

Every year, the month of June is designated “Aphasia Awareness Month”. This month is dedicated to generating awareness, educating the public about this condition, providing needed support to stroke survivors, and training their caregivers to communicate effectively with a person with PWA.

What is aphasia?

Avasia – the loss of the ability to understand, speak, communicate, read and write – is one of the most devastating effects of a stroke. However, timely medical and surgical intervention cures most of the symptoms. Aphasia can also be caused by tumors, infections in the brain, neurodegenerative diseases (such as dementia), and traumatic brain injury.

It is scary to imagine waking up from a stroke and realizing that although one survived, they had lost a large part of themselves – their “ability to speak”. They suddenly become withdrawn and have to rely on others for basic needs such as eating, cleaning, using the toilet, or even standing or sitting. They can no longer do any of these things whenever they want, and they can’t ask anyone for help. There are very high chances of losing jobs, livelihoods, friends and family, and most importantly, ‘communicative freedom’. Aphasia is one of the frightening effects of a stroke.

Is a person’s intelligence affected by aphasia?

No, puerperium is not a mental disorder. A person with aphasia has difficulty speaking, understanding language, and recalling words and names, but their intelligence (thinking, remembering, presenting, and perceiving) is not affected. Because people with aphasia have difficulty speaking, some people with severe language impairment are often misclassified as mentally ill.

How common is aphasia?

According to a recent survey, aphasia is a disability that affects 21-38 percent of stroke survivors. The community incidence is 43 per 100,000 per year, with a prevalence of 3,000 per million. However, most of us had never heard of the term “APHASIA” and its devastating impact on stroke survivors.

What are the characteristics of aphasia?

Aphasia can be divided into two types: “fluent aphasia” and “non-fluent aphasia”. If a person can utter but respond irrelevantly to the question asked, the person can be classified under fluent aphasia. Conversely, if the person understands what is being said but fails or struggles to provide a verbal response, it will be considered non-fluent aphasia. A person with non-fluent aphasia struggles to identify the names of people or things or fails to ask for anything. They will know what the thing is or who the person is, but they seem to have lost the words, and their struggle to pronounce even simple words or sounds is very clear.

These differences depend on which part of the left hemisphere is affected. Our brains have distinct centers for each function, i.e. there are separate centers for understanding what we hear, processing what we say, centers that control and coordinate our extremities, etc. Depending on the location and extent of brain damage after a stroke, we can notice more loss of function.

How can we help someone who has had a stroke and aphasia?

Find out what causes a stroke and how it affects a person’s physical abilities and communication skills by doing some research. Communication skill will support patients’ efforts to achieve self-sufficiency. Patients’ confidence is enhanced by respecting them, refraining from criticizing them, and promoting independence.

Are there treatments for aphasia?

Always consult a qualified speech therapist approved by the Indian Rehabilitation Board and strictly follow the patient’s prescribed treatment regimen. Several remedial programs are available to improve speech production and sentence generation and reduce word-searching difficulties and grammatical errors. A speech therapist can make a comprehensive evaluation of a person with aphasia using several standardized tests and identify deficiencies in speech and language processing. Later, a speech therapist will design a treatment plan that best suits the person and begin treatment. Remember that one treatment approach may not work for all clients, and it takes years of dedicated learning, research, and practice to design a treatment plan and deliver effective treatment.

How long does it take to walk back after aphasia?

The recovery is gradual. Many people get better within months or even years after a stroke. However, be consistent and committed during the treatment program and don’t expect any magic cure. With patience and perseverance many people have succeeded in overcoming the barriers caused by strokes and rehabilitating themselves.

What precautions should one take while talking to people with aphasia?

Before you start talking, get their attention.
Keep your eyes fixed on them while speaking.
Observe their body language and gestures.
· Please talk to them in a calm environment.
Please turn off the television or radio while talking to them.
Maintain a normal tone of voice.
Unless they specifically request it, one need not speak louder.
Keep the language simple but mature. Please do not talk to them as children do.
Please do not degrade or undermine them.
Make the sentences shorter. Focus on getting the message across rather than giving the lecture.
Repeat the keywords you want to remember.
Reduce the speed of speech.
Give them time to talk. They may take longer to respond. All is well.
Most importantly please do not complete the words for them.
Use drawings, gestures, writing, and facial expressions whenever necessary. Sometimes people with aphasia tend to understand these words better than the words.
When they have problems speaking, ask them to draw or use gestures.
Ask them “yes” and “no” questions as often as possible instead of open-ended questions.
They may not always be able to transfer everything perfectly. Getting the message across is more important than grammatically speaking vocal sentences.
Let them try to take care of themselves. They may have to try a few times before they succeed.
When they ask for help, please do so.

Can aphasia be prevented?

Unavoidable events primarily lead to aphasia. However, steps are being taken to reduce one of the main causes of aphasia: stroke or traumatic brain injury (TBI). The following precautions should be taken to reduce the risk of an ischemic or hemorrhagic stroke:

Regular exercise is essential.
We maintain a healthy diet with an emphasis on lowering cholesterol.
Reducing alcohol consumption and abstaining from tobacco use.
Blood pressure management.
If there is swelling in a limb, warmth, redness, or soreness, go to the emergency room immediately. These are symptoms of deep vein thrombosis, which can lead to stroke.

To avoid aphasia caused by traumatic brain damage, take precautions when participating in harmful activities such as:

Always wear a helmet when riding a bicycle, motorcycle or other moving vehicle that could have an accident.
Use a seat belt when driving or riding in a car.
Head protection equipment should be used while playing sports to avoid head injuries.
If possible, avoid the use of anticoagulants (including aspirin) as they increase the risk of bleeding after a head injury.

Key messages at home:

Aphasia is a language disorder caused by brain damage.
Not a mental disorder.
With proper assessment, planning and treatment, successful rehabilitation is possible.
Always consult qualified speech therapists approved by the Indian Rehabilitation Board.
There are no magic cures.
Successful rehabilitation is possible only with patience, dedication and perseverance.

For more details contact: Contact number: 0824-2238022/8277546831

Authors:

Professor Waseem Ahmed, Associate Professor, Department of Speech and Hearing, Father Muller College, Kankanadi, Mangaluru.

Professor Akhilesh PM, Director and Professor, Department of Speech and Hearing, Father Muller College, Kankanadi, Mangalore

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