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The Role of Hospice When Dealing With Aphasia

June is National Aphasia Awareness Month, so what better time to discuss hospice as it relates to this condition? Aphasia, a communication disorder, impairs a person’s ability to process language, speak, and understand others, yet it does not affect intelligence, according to the National Aphasia Association. Often times, it arises from some type of brain injury, such as stroke, infections or tumors. It affects older adults, and is a fairly common affliction. In fact, two million Americans have aphasia, which is more than those who suffer from Parkinson’s Disease, cerebral palsy or muscular dystrophy. New cases emerge every year: about 180,000 Americans acquire this disorder every year. There are many types of aphasia, such as:

  • Global
  • Broca’s
  • Wernicke’s
  • Primary Progressive
  • Anomic
  • Mixed Non-fluent aphasia

No matter which type your loved one has, there is help out there. Patients who have declined in health rapidly and have less than six months to live can enter hospice as they deal with the effects of aphasia and other health conditions. A hospice care team can come together to develop a plan for your loved one. Comprised of nurses, doctors, aides, social workers, and therapists, the role of the hospice care team is key in managing the symptoms of aphasia. No longer looking to prolong life or treat the underlying condition, the goal of hospice is to improve the patient’s quality of life and manage their pain.


Those with aphasia may exhibit any of the following symptoms, according to DementiaToday:

  • Slowed or halting speech
  • Decreased use of language
  • Word-finding hesitations
  • Sentences with abnormal word order in speech or e-mails
  • Substitution of words
  • Mispronounced or incomprehensible words
  • Talking around a word, saying “we went to the place where there are a lot of stores” to refer to “mall”
  • Difficulty understanding or following conversation
  • Sudden lapse in understanding easy words
  • Forgetting the names of familiar objects
  • Inability to think of names of people, even though they recognize who they’re interacting with
  • Problems writing, i.e., letters or checks
  • Difficulty following written directions or reading signs
  • Spelling impairments
  • Problems in arithmetic and calculations, such as leaving a tip at a restaurant

At the very root of aphasia is the inability to communicate. Few things are more frustrating than not being able to say what you need to say. As a result, patients may withdraw into themselves and only use simple signs to communicate what they want. Oftentimes, it’s not just speech or not just reading that is affected: rather, many channels are affected at once. The hospice professional’s job is to determine the amount of function available in each of the channels for the total comprehension of language, assessing which approach is the right one during hospice care.

How Hospice Helps

Family members must be comfortable with nurturing what remains of the affected person’s function, adjusting to the diminished capacity and the end stages of life, according to Today’s Geriatric Medicine. This is where hospice can provide a great value. However, as with Alzheimer’s patients, hospice tends to be vastly underutilized for these illnesses. That’s because aphasia and dementia are often hard to diagnose in terms of pinpointing an exact time of projected death. Doctors simply can’t predict with any certainty when an aphasia patient has only six months left to live. As a result, they don’t often make it into hospice care at all, or too late.

On the bright side, those aphasia patients who do take part in hospice can benefit from the care and compassion found there by nurses, aides, therapists and social workers. Frustration is often a big part of having aphasia. Because this condition doesn’t affect intelligence, patients often know exactly what they want to say, but can’t vocalize it. That’s where a big dose of compassion and patience comes in on the part of the hospice team.

Here are some ways in which the hospice team can help the patient with aphasia:

  • Allow the patient to have enough time to impart their message.
  • No rushing: the patient can form words and express ideas on their own time table.
  • Teaching compensatory strategies for communicating.
  • Help them communicate through other means, such as drawings and music therapy.
  • Use memory enhancement stories, cards, and strategies.
  • Work out a simple system of communication to indicate pain, hunger, etc.
  • Use speech and language therapy, says the Mayo Clinic, and allow family members to get involved in this process.

A big part of what hospice care givers do is provide advice for family members on how better to communicate with their loved one.

  • Get their attention before you start speaking.
  • Turn off the TV or any other source of background noise.
  • Speak at a normal level. No need to shout. Their hearing is usually fine.
  • Keep your sentences short and simple. No need to talk down to the patient. Simply emphasize key words.
  • Use gestures and facial expressions in addition to speech.
  • Allow them sufficient time to respond to your side of the conversation.
  • Preferably ask questions with yes or no answers.
  • Praise their efforts.
  • Rather than ignore the patient in family conversation, keep them involved and engaged.

Dealing with an aphasia patient in the above ways respects their dignity and makes it less stressful for them to communicate. Meet with your loved one’s hospice care team weekly to get more strategies that can help the patient improve their quality of life during this difficult time.

Contact Pathways Home Health and Hospice

Learn more about how Pathways Home, Health and Hospice can help with hospice care and your loved one suffering from aphasia. Contact us at 888-755-7855 to ask more questions and find out about what our hospice team can do.