Excerpted from the article "Becoming a Communication Partner," Stroke Connection Magazine November/December 2003
The Scenario (Skip the scenario, take me to the tips)
“John, no, well, um, Jean, no, Jen, Jean, well, you know….” My husband struggles to tell me who called on the phone while I was out in the driveway chatting with my neighbor, Joan. Ever since Bob’s stroke last fall, Joan has brought me casserole dishes once a week and tended our yard and picked up our mail during the first couple of months of hospital and rehab stays. It was a great 10-minute respite to chat and look at her smiling face.
The ringing phone had interrupted our conversation, and by the time I realized it was ringing in my house, even my sprint from the front yard wasn’t fast enough to catch the phone before Bob had answered and hung up. “Phone!” he says triumphantly. “You?”
“I was chatting with Joan,” I answer, panting. “Who was it?”
“Joan?” Bob asks, pointing towards the neighbor’s house.
“Yes, Joan next door. Who was on the phone?” I’m already starting to wonder if Bob will remember who was on the phone and, even if he does, whether he will be able to communicate it to me.
Bob begins a series of false starts that all begin with “J.” I realize from watching many speech-language treatment sessions that this may be a “leftover” from the last word he said — “Joan.” The name of the person who called on the phone may not begin with a “J” at all. I consciously inhale and focus on the communication strategies we’ve been practicing.
Bob is still standing by the phone on the hallway table. I nod toward the dining room table where we have stacks of paper, pens and a little notebook with family photos, lists of restaurants, and words that have to do with Bob’s business.
“Yes, yes!” Bob booms, as he grabs his cane and heads for the table.
Only a month or two ago I couldn’t get Bob anywhere near the table with the paper, pens and notebook. We would both stand in the hallway, desperately trying to figure out what he wanted to say.
Word after word would tumble out of his mouth, unsuccessfully. I would say things like, “OK, it starts with ‘D’, it’s a ‘da_’,” guessing, hoping desperately that the word he was chasing really did start with a “D.” After a few exchanges like this, Bob would leave the room in frustration, pounding his cane on the floor as he limped into the study.
I would be on the verge of tears because my strong, smart husband of 23 years couldn’t tell me where he wanted to go for dinner. Every night I would pray that the next day Bob would be able to “just say something.”
During Bob’s rehab, I modeled myself on the therapist, who was always giving him cues and getting him to say the target words. If that’s what worked, I felt I should do it, too.
But when we started attending an aphasia community group, I noticed that the couples smiling the most were NOT using “therapist” cues. I met Susan and Kent, who actually laughed when they couldn’t get the message and just tried again after a few minutes. Thinking of them now, I take a deep breath.
At the dining room table, Bob grabs a pad of paper and a pen and pushes them toward me. I write down three possibilities. “Was it a family member? Someone from church? A sales call?”
“No, no. This one.” With his good left hand, Bob uses two fingers to gesture “scissors” and waves it toward my head.
“Oh! Was it the hairstylist?”
“YES! OK, you know.”
“Was it about my appointment tomorrow?”
“Yes, yes…and…,” Bob uses his intonation to let me know there’s a little more to it.
“Were they calling to remind me about the appointment?”
“Well, yes and no.” Bob spreads his fingers out and teeter-totters his hand.
Bob takes the paper and pen, and writes “10 » 11.” He smiles.
“Did they call to ask if I could change my appointment from 10 o' clock to 11 o' clock tomorrow?”
“OK! Yes.” Bob grins. I can’t help grinning too.
“OK. Am I supposed to call back and confirm?”
“Well, yes or no, but OK.”
“I can if I want to, but I don’t have to.”
“Great. Thanks, Bob. I’m going to have to call back because we have a doctor’s appointment at 11:45 and I don’t want to cut it too close.”
“Oh, yeah. Forgot. OK.” Bob gets up and returns to the living room, where he had been watching the TV news.
I head back outside, where Joan is still waiting. “Bob got the phone. They wanted to change my hair appointment tomorrow.”
“Bob can answer the phone and take a message now? That’s fantastic!” Joan’s smile brightens.
My own smile broadens as I reply, “Yes, he can.”
- Be a partner — not a therapist.
- Be willing to set the stage for communication — good lighting, relaxed atmosphere.
- Speak at a normal rate with pauses at phrase and sentence endings. Don’t use “baby talk.”
- Aid comprehension by writing down key words.
- Provide choices to get going in the right category.
- Be willing to accept ANY form of communication as equally valid: gestures, writing, drawing, using a communication notebook, intonation or speech.
- Make sure you sit down at least once a day and have a pleasant conversation with your partner. After dinner is a nice time to talk.