Stroke can cause other problems that affect a person’s ability to communicate well. It may help to be aware of these during conversations:
A stroke can sometimes cause subtle changes to emotional aspects of speech. For example, a person's tone of voice may sound 'flat' or their facial expression may not vary. A person may have difficulty understanding humor or when to take turns in conversation. They may be aware of these effects and frustrated by them, or they may be unaware. These types of changes can happen even if there are no other communication problems after stroke. They are due to changes on the right side of the brain and can be misinterpreted as depression.
A stroke can alter vision and sometimes hearing. This can make reading and writing problems worse. Make sure the doctor is made aware of such problems so that they can be fully assessed.
Many people find that they feel very tired after a stroke, both physically and mentally. Having a conversation may also take more effort than it used to, and other people may not realize this. The ability to communicate can vary significantly depending on how tired or stressed someone is feeling.
Stroke can affect your short-term memory and aspects of your thinking processes, such as the ability to focus and concentrate. This can make communication slower and more difficult.
Physical weakness or paralysis after stroke may affect facial expressions and body language. Physical problems can also make writing difficulties worse if your dominant hand is affected. Physical pain or discomfort can be a distraction.
It can be frightening and frustrating if a stroke has affected your ability to communicate. Changes in the brain caused by the stroke can also affect mood, emotions and personality in other ways that can be difficult to control.
Anyone who has communication difficulties after their stroke should receive a full assessment of their difficulties from a speech and language therapist (SLT, also called speech-language pathologist or SLP) with specialized knowledge in stroke and rehabilitation. In the hospital, this should be arranged by the multi-disciplinary stroke team as soon as possible after the stroke. If the person affected is at home, their Primary Care Provider can make a referral to community SLT services or they can contact their local hospital’s Speech and Language Therapy Department directly.
First, the therapist will assess their strengths in language and communication skills. The SLT will use various tests to try to establish the precise nature of their problems. The therapist will establish the best methods of communication, and will explain the nature of the problem to the stroke survivor, their family and the rest of the medical team. The therapy someone has will depend on the nature of their communication difficulties and their general health following the stroke. It is likely to involve a variety of practical exercises to help rebuild their communication skills. The SLT will establish the stroke survivor's personal needs and priorities for communication and their goals for therapy. Their progress will be monitored and support will be offered for as long as therapy is beneficial.
It helps greatly if other people such as health professionals, care staff, family and friends can be involved in supporting communication needs. They may offer advice on how to communicate or help a loved one communicate effectively. Practicing communication skills may help recovery.