A Letter on Aphasia from a Concerned Son

October 30

Dear Sarah,

It's been 2 weeks since Mom's stroke and things at home have calmed down considerably. I wanted to follow-up on my last phone call with more details about Mom's condition. On Monday, I was invited to attend a care planning meeting at the hospital and meet the entire team of professionals who are treating mom. First, the cardiologist explained that Mom's stable now, but paralyzed on her right side. He said she still needs nursing care and medication.

Then I met the speech-language pathologist and listened while she explained the results of Mom's evaluation. It seems that Mom has something called Broca's aphasia, due to the brain damage caused by the stroke. This means that Mom has trouble understanding long or complex sentences, but that she is able to comprehend most directions given to her and to follow simple conversations.

Her ability to express herself is more affected. The speech-language pathologist explained that Mom knows what she wants to say, but is having problems recalling and organizing language in order to make her needs known. At times she is able to say things automatically like greetings, but won't be able to repeat it again a minute later! Besides all this, her speech is not too clear and she sometimes has trouble swallowing.

Let me give you an example by telling you what happened when I visited her the other day. She was all smiles when she saw me and easily said "Hi, son." I told her, jokingly, that she didn't have to be so formal - just call me "Joe". Well, although she seemed to understand what I said, she couldn't say my name. Later on, she repeated "Want...lady...you" over and over while she pointed to the other bed in her room. It was like playing a guessing game until I finally realized she wanted me to meet her new roommate.

I decided that I really needed help learning to communicate with Mom so I called the speech-language pathologist who suggested that I observe one of mom's therapy sessions, which I did today. At first, I thought they were just having a conversation about hospital routines, meals and therapy schedules. Mom didn't seem to be struggling to express herself as she did when I visited. The speech-language pathologist explained her method of cueing Mom by giving her the first sound of a word, or the beginning of a sentence to be completed. And believe me, she knows what she's talking about because it made communication with Mom much easier!

The speech-language pathologist also told me that Mom's prognosis is good, but that she may never speak as well as she did before the stroke. Continued therapy is recommended, either as an outpatient at the hospital, or through other community resources, including home care.

Right now, Joanne and I are considering having her therapy services continued at home so that the speech-language pathologist can take advantage of our normal household routines to make treatment more meaningful for Mom.

We are really hoping that, with the help of physical and occupational therapy professionals also working in our home, Mom will be able to walk and take care of her daily needs. Hopefully, they can help restore her functioning to the point that she will be able to cook and bake again. We all miss those chocolate chip cookies, especially the kids!

The speech-language pathologist also felt that the family support group at the hospital would help us learn more about aphasia and how to handle communication situations with Mom at home. So, we're going to the meeting next month, where the guest speaker will be an accountant who had a stroke 18 months ago. Sounds interesting!

It's time to close for now. I'll drop you a line soon to keep you posted on Mom's progress. My love to Ed Sr. and Ed Jr.!