20 Questions – Helping Aphasia with Word-Retrieval

20 Questions–Helping Aphasia with Word-Retrieval

Playing "20 questions" seems to be a common, sometimes frustrating, issue within families with aphasia. No one likes to have to do this all the time. However, when there are "communication breakdowns", sometimes it's the only way to figure out what your loved one is trying to say. This can be an easy way to get all participants frustrated.  The caregiver may feel like the person with aphasia wants you to be a mind-reader. The person with aphasia may feel that you should know what he's talking about and may feel he's given you enough information.

A real-life example of this with a former client went as follows:  Bob (has aphasia), saw that his boat was dirty and wanted to call someone to clean it. His wife, Susan, saw him rifling through the address book and asked him what he was looking for. Bob has a few ways he can handle this: a) use gestures  b) pointing at the point or taking her to the boat, c) writing or drawing a boat. What he did was continue to look through the address book and made vague gestures.

Susan didn't understand.

Eventually they both became very frustrated as Susan had to ask him several questions, trying to even figure out the topic so she could help him. He couldn't give information in a meaningful way.  He has aphasia. He may have answered "yes" when the answer was "no" (who hasn't been down that road?). Finally she asked the right question at the right time and found the phone number for the boat cleaner. Both Bob and Susan described being angry and frustrated over the situation.

Susan thought "Why didn't he use his picture book or just tell me what he wanted?"
Bob has aphasia. If he could say what he wanted, he wouldn't have aphasia. Bob thought that Susan should know already what he was looking for without having to explain it. Bob doesn't understand that what information he gives isn't specific enough. This is where I came in.

Many persons with aphasia don't understand that they aren't providing you with useful clues. I may ask "What did you do last night?" and get "Mexico" as a response. What does that mean? Lots of options.

People with aphasia are doing the best they can. They may not be able to sequence the information or give the most relevant details to help you out. It's not purposeful. You are doing the best job that you can. Have your speech therapist help with you with strategies to avoid or minimize this situation.

Some ways to help your loved one express himself/herself include asking them to try to write out a word (even a first letter can be helpful!) or to draw the item/scenario. It may be helpful to have frequently discussed pictures or words already written out in a notebook, and ask your loved one to point to them. It can also be helpful to rephrase, such as "I understand you're talking about going out Saturday, but I don't know where you want to go". For more ideas, order some free Aphasia Communication Tip cards.

Visit our Case Studies page to see how we've helped other families with aphasia.

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About Dr. Bartels

Dr. Bartels is a published aphasia researcher, presenter, author, and founder of The Aphasia Center Intensive Aphasia Program. She is an aphasia diagnostic and treatment expert with over 11 years of daily experience. She helps families with aphasia all over the world plan their recovery and exceed their goals.

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