I currently work in a long term care facility where I am responsible for many different people every day. Almost every one of my patients are there because they need assistance in their everyday lives. They are not able to care for themselves completely on their own anymore. I would say that over half of them have been affected by a stroke or have some degree of dementia, or both. I struggle everyday trying to figure out what they are trying to communicate due to having damage done to a part of their brains. In chapter 2 of our textbook, we read about two types of aphasia, Broca’s and Wernicke’s aphasia. Both affect a different part of the brain and impair the ability to communicate.
In Broca’s aphasia, the frontal lobe of the brain is damaged; the specific part is called the Broca’s area (Goldstein, 33). This type of aphasia can affect speech in a way that the person is able to understand what is being said to them but is difficult to be, or not at all understood. It is also common to have right sided weakness in the arm and leg muscles due to the Broca’s area being located in the left hemisphere of the brain (What is Broca’s Aphasia?, 2015). I have someone right now under my care that I struggle to understand. She is unable to form words but can understand what I am saying to her. She has difficulty producing the proper sounds because her tongue, lips, jaw and vocal folds cannot function to form the patterns that are required (What is Broca’s Aphasia?, 2015). I have a note card with ‘yes’ or ‘no’ and some simple pictures in order to communicate with her. She will shake her head for simple questions and will often times write barely legible phrases out for me. It is frustrating for her to be able to form thoughts and requests and not be able to tell anyone them.
Wernicke’s aphasia is a little different in a way that it’s almost the opposite of Broca’s. Wernicke’s aphasia affects the ability to understand speech and writing but the person may be able to produce coherent words or phrases (Goldstein, 33). The words and phrases may be easily understood but they may not make sense or be appropriate to the conversation. The area that is damaged in this type of aphasia is in the anterior of the brain located in the left temporal lobe and this area is responsible for thinking of wheat to write, reading and, understanding information (What is Wernicke’s Aphasia?, 2015). I also have a patient that is affected by this. She is unable to clearly understand what is being said or asked. She can hold a conversation with you but is mostly jumbled nonsense that has no meaning. I can say “good morning” and she will respond with something like “I will not bend the silverware.” Like Broca’s aphasia, this type is also frustrating for both sending and receiving information.
I struggle every day that I go to work due to brain damage. I have to be creative in ways of communicating and trying to understand or get people to understand me. A simple greeting like “good morning” cannot be communicated to certain people due to this. Someone who is in immense pain cannot tell me that their knees hurt and they need a pain pill. I take for granted my ability to communicate with my friends, family or just to be able to type up this blog. For someone who is suffering from a type of brain damage, they are not able to do any of those things. Just try, for a few short hours, to tell your boyfriend, girlfriend, husband, wife, or kids something as simple as “I want a drink.” without using words. It’s harder than you think.
References:
Goldstein, E. B (2011). Cognitive Psychology: Connecting Mind, Research, and Everyday Experience. 3rd ed). Belmont, CA: Wadsworth.
Bartles, Dr. “What is Broca’s Asphasia?” The Aphasia Center. 31 Jan. 2012. Web. 31 Jan. 2015
Bartles, Dr. “What is Werniccke’s Asphasia?” The Aphasia Center. 31 Jan. 2012. Web. 31 Jan. 2015
Expressive and Receptive Language – Subtle but Devastating
I appreciated your post on language and communication. I empathize with how difficult it must be to work with people who have little use of language. My son has an expressive and receptive language disorder. While, his disability is not as severe as having Broca’s or Wernicke’s aphasia, he struggles everyday in subtle yet frustrating ways. He is a brilliant mathematician, yet he cannot manage word problems because he cannot decipher what the question is asking. He has an incredible ability to manipulate objects in space and will someday be a gifted engineer, however, in high school, he struggles to write a simple paper because he cannot express himself verbally in a way that matches the sophistication of his thought.
Adam J. Cox, PhD, the author of Boys of Few Words, states that “Words matter because they allow boys to articulate goals and thus give them something to achieve; and achievement is the source of self-esteem” (Cox, 2006). My son struggles enormously with self-esteem. In grade school he could not pass a multiple choice test to save his life. After years of language therapy and some very supportive teachers, he has come a long way. At 16 years old, the amount of gray matter is peaking in his temporal lobes which helps with language (Feldman, Martorell, & Papalia, 2014). However, his ability to participate in team sports is still affected due to the speed of communication between teammates. He also struggles emotionally because he has difficulty expressing himself verbally. Cox says that words matter because they are the passport to social connection, whether it be friendships, getting along with co-workers or having a general feeling of community (Cox, 2006).
So, while your patients struggle with basic communication, there are many people with subtler communication challenges which confound their lives in many ways as well. Language is so important! I agree with you that most of us take it for granted.
References
Feldman, R. D., Martorell, G., & Papalia, D. E. (2014). A Child’s World Infancy through Adolescence. New York, NY: McGraw-Hill Education.
Cox, A. J. (2006). Boys of Few Words. New York, NY: The Guilford Press.
I really enjoyed reading your post as it is a subject that is dear to my heart. On a normal sunny morning, just as my dad was about to take me to school he collapsed right in front of me. He had a stroke, I was 15 years old at the time. He had a hemorrhagic stroke which is a burst and bleed of the vein or artery causing hemorrhages in the brain. The burst was in the frontal left hemisphere of the brain. When he finally woke up after a month in ICU he could no longer move his right hand and leg and he could not speak. The damage has affected his motor skills, speech perception, semantic association and speech production. Suffering such impairment may have trouble articulating a language utterance, the brain centers moderating language are presumably intact.(National Academy of Neuropsychology 2000) He knows when people are talking to him and seems to understand what they are saying but has difficulty connecting words to object and responding. He also had difficulty making more than one sound at a time. With the help from the speech therapist, we started the rehabilitation process. As you mentioned, it was extremely painful, difficult and frustrating. It takes great amount of care, love and patience to assist and communicate with someone that has suffered an aphasia. I truly admire what you do and I will forever be grateful for what I’ve been blessed with.
Reference
Behavioral Neuropsychology Aphasia. Retrieved from
http://schatz.sju.edu/neuro/clinneuro/index.html?aphasia