Talking with Someone Who Has Had a Stroke

When a stroke happens, blood stops going to the brain for a little while. This is what leads to problems with speaking and understanding things. About 1 out of 3 people who have a stroke face these issues. Talk with your loved one’s healthcare team to discuss what struggles they might be facing. Here are some communication challenges that can happen because of a stroke:

Aphasia. This is when a person finds it hard to talk, read, write, or understand what others are saying.

Apraxia. Imagine trying to speak, but your brain can’t tell your muscles how to move to make the words come out right (not due to paralysis or weakness of the speech muscles). This is called apraxia or sometimes dyspraxia.

Dysarthria. This happens when the muscles a person uses to speak become weak or can’t move. Their speech pronunciation might sound slurred or unclear. It may also affect the loudness of their voice and the ability to speak at a normal rate.

Dysphonia. Think of this like having trouble with the muscles around your voice box. The voice of a person with dysphonia might sound like a whisper, or it might sound scratchy. If they can’t make any sound at all, that’s called aphonia.

Cognitive difficulties. A person with cognitive difficulties might struggle with memory, thinking, and judgment. They also could find it hard to focus when people are talking to them. Understanding or speaking complex sentences might be challenging, too.

Each person who has a stroke is different. Some people might have one type of communication issue, while others may have multiple. When talking with a person who has had a stroke, here are some things to keep in mind:

• Be patient. People who have had a stroke might need more time to talk or understand words. Try not to rush them or finish their sentences for them.
• Use body language. If talking is hard, you can nod, smile, or frown to show what you mean. Pictures or written words can help, too. If your loved one can write or draw, they can do that to help communicate.
• Keep it simple. Use easy words and short sentences. Talk slowly and look them in the eyes so they know you’re talking to them.
• Stick to one thing at a time. Talking about too many things at once can be confusing. Try asking questions that need a yes or no answer, or give choices instead of posing open-ended questions.
• Listen well. Show them you’re really listening by nodding and looking them in the eyes. Give them feedback so they know you hear them.
• Use technology if you can. Some apps and tools can help people talk after a stroke. They might be a good resource if your loved one is technologically savvy.
• Make things comfortable. Communicating in a comfortable environment can help your conversation. Keep the noise down in the room that you’re in, or choose a quieter space to talk if that’s not possible. Make sure the room is at a comfortable temperature and has good lighting, too.
• Include them. Let the person participate in conversations and make their own choices as much as possible.
• Think about speech therapy. Talk with a speech-language pathologist (SLP) to see how they can help your loved one.

Talking with someone who has had a stroke can be hard and maybe even frustrating at times, but using some of these communication tips may help. Each person is unique, so try various approaches to see what works best. It might take time and creativity to find what works. But as long as you understand each other, that’s what matters.