{"id":1608776,"date":"2022-05-15T22:00:30","date_gmt":"2022-05-16T02:00:30","guid":{"rendered":"https:\/\/divine.ca\/?p=1608776"},"modified":"2022-05-15T22:12:04","modified_gmt":"2022-05-16T02:12:04","slug":"aphasia-what-you-need-to-know","status":"publish","type":"post","link":"https:\/\/divine.ca\/en\/aphasia-what-you-need-to-know\/","title":{"rendered":"Aphasia: What You Need to Know"},"content":{"rendered":"<p>June is National Aphasia Awareness Month. Until recently, people were unfamiliar with the condition. In March, Bruce Willis&#8217;s family revealed his diagnosis with the condition through&nbsp; Instagram and announced his retirement from acting:<\/p>\n<div class=\"sbi-embed-wrap\">\n<blockquote class=\"instagram-media sbi-embed\" data-instgrm-captioned data-instgrm-permalink=\"https:\/\/www.instagram.com\/p\/Cbu-T0VAukL\/?utm_source=ig_embed&amp;utm_campaign=loading\" data-instgrm-version=\"14\" style=\" background:#FFF; border:0; border-radius:3px; box-shadow:0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width:658px; min-width:326px; padding:0; width:99.375%; width:-webkit-calc(100% - 2px); width:calc(100% - 2px);\">\n<div style=\"padding:16px;\"> <a href=\"https:\/\/www.instagram.com\/p\/Cbu-T0VAukL\/?utm_source=ig_embed&amp;utm_campaign=loading\" style=\" background:#FFFFFF; line-height:0; padding:0 0; text-align:center; text-decoration:none; width:100%;\" target=\"_blank\" rel=\"noopener\"> <\/p>\n<div style=\" display: flex; flex-direction: row; align-items: center;\">\n<div style=\"background-color: #F4F4F4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;\"><\/div>\n<div style=\"display: flex; flex-direction: column; flex-grow: 1; justify-content: center;\">\n<div style=\" background-color: #F4F4F4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;\"><\/div>\n<div style=\" background-color: #F4F4F4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;\"><\/div>\n<\/div>\n<\/div>\n<div style=\"padding: 19% 0;\"><\/div>\n<div style=\"display:block; height:50px; margin:0 auto 12px; width:50px;\"><svg width=\"50px\" height=\"50px\" viewBox=\"0 0 60 60\" version=\"1.1\" xmlns=\"https:\/\/www.w3.org\/2000\/svg\" xmlns:xlink=\"https:\/\/www.w3.org\/1999\/xlink\"><g stroke=\"none\" stroke-width=\"1\" fill=\"none\" fill-rule=\"evenodd\"><g transform=\"translate(-511.000000, -20.000000)\" fill=\"#000000\"><g><path d=\"M556.869,30.41 C554.814,30.41 553.148,32.076 553.148,34.131 C553.148,36.186 554.814,37.852 556.869,37.852 C558.924,37.852 560.59,36.186 560.59,34.131 C560.59,32.076 558.924,30.41 556.869,30.41 M541,60.657 C535.114,60.657 530.342,55.887 530.342,50 C530.342,44.114 535.114,39.342 541,39.342 C546.887,39.342 551.658,44.114 551.658,50 C551.658,55.887 546.887,60.657 541,60.657 M541,33.886 C532.1,33.886 524.886,41.1 524.886,50 C524.886,58.899 532.1,66.113 541,66.113 C549.9,66.113 557.115,58.899 557.115,50 C557.115,41.1 549.9,33.886 541,33.886 M565.378,62.101 C565.244,65.022 564.756,66.606 564.346,67.663 C563.803,69.06 563.154,70.057 562.106,71.106 C561.058,72.155 560.06,72.803 558.662,73.347 C557.607,73.757 556.021,74.244 553.102,74.378 C549.944,74.521 548.997,74.552 541,74.552 C533.003,74.552 532.056,74.521 528.898,74.378 C525.979,74.244 524.393,73.757 523.338,73.347 C521.94,72.803 520.942,72.155 519.894,71.106 C518.846,70.057 518.197,69.06 517.654,67.663 C517.244,66.606 516.755,65.022 516.623,62.101 C516.479,58.943 516.448,57.996 516.448,50 C516.448,42.003 516.479,41.056 516.623,37.899 C516.755,34.978 517.244,33.391 517.654,32.338 C518.197,30.938 518.846,29.942 519.894,28.894 C520.942,27.846 521.94,27.196 523.338,26.654 C524.393,26.244 525.979,25.756 528.898,25.623 C532.057,25.479 533.004,25.448 541,25.448 C548.997,25.448 549.943,25.479 553.102,25.623 C556.021,25.756 557.607,26.244 558.662,26.654 C560.06,27.196 561.058,27.846 562.106,28.894 C563.154,29.942 563.803,30.938 564.346,32.338 C564.756,33.391 565.244,34.978 565.378,37.899 C565.522,41.056 565.552,42.003 565.552,50 C565.552,57.996 565.522,58.943 565.378,62.101 M570.82,37.631 C570.674,34.438 570.167,32.258 569.425,30.349 C568.659,28.377 567.633,26.702 565.965,25.035 C564.297,23.368 562.623,22.342 560.652,21.575 C558.743,20.834 556.562,20.326 553.369,20.18 C550.169,20.033 549.148,20 541,20 C532.853,20 531.831,20.033 528.631,20.18 C525.438,20.326 523.257,20.834 521.349,21.575 C519.376,22.342 517.703,23.368 516.035,25.035 C514.368,26.702 513.342,28.377 512.574,30.349 C511.834,32.258 511.326,34.438 511.181,37.631 C511.035,40.831 511,41.851 511,50 C511,58.147 511.035,59.17 511.181,62.369 C511.326,65.562 511.834,67.743 512.574,69.651 C513.342,71.625 514.368,73.296 516.035,74.965 C517.703,76.634 519.376,77.658 521.349,78.425 C523.257,79.167 525.438,79.673 528.631,79.82 C531.831,79.965 532.853,80.001 541,80.001 C549.148,80.001 550.169,79.965 553.369,79.82 C556.562,79.673 558.743,79.167 560.652,78.425 C562.623,77.658 564.297,76.634 565.965,74.965 C567.633,73.296 568.659,71.625 569.425,69.651 C570.167,67.743 570.674,65.562 570.82,62.369 C570.966,59.17 571,58.147 571,50 C571,41.851 570.966,40.831 570.82,37.631\"><\/path><\/g><\/g><\/g><\/svg><\/div>\n<div style=\"padding-top: 8px;\">\n<div style=\" color:#3897f0; font-family:Arial,sans-serif; font-size:14px; font-style:normal; font-weight:550; line-height:18px;\">View this post on Instagram<\/div>\n<\/div>\n<div style=\"padding: 12.5% 0;\"><\/div>\n<div style=\"display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;\">\n<div>\n<div style=\"background-color: #F4F4F4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);\"><\/div>\n<div style=\"background-color: #F4F4F4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;\"><\/div>\n<div style=\"background-color: #F4F4F4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);\"><\/div>\n<\/div>\n<div style=\"margin-left: 8px;\">\n<div style=\" background-color: #F4F4F4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;\"><\/div>\n<div style=\" width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg)\"><\/div>\n<\/div>\n<div style=\"margin-left: auto;\">\n<div style=\" width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);\"><\/div>\n<div style=\" background-color: #F4F4F4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);\"><\/div>\n<div style=\" width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);\"><\/div>\n<\/div>\n<\/div>\n<div style=\"display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;\">\n<div style=\" background-color: #F4F4F4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;\"><\/div>\n<div style=\" background-color: #F4F4F4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;\"><\/div>\n<\/div>\n<p><\/a><\/p>\n<p style=\" color:#c9c8cd; font-family:Arial,sans-serif; font-size:14px; line-height:17px; margin-bottom:0; margin-top:8px; overflow:hidden; padding:8px 0 7px; text-align:center; text-overflow:ellipsis; white-space:nowrap;\"><a href=\"https:\/\/www.instagram.com\/p\/Cbu-T0VAukL\/?utm_source=ig_embed&amp;utm_campaign=loading\" style=\" color:#c9c8cd; font-family:Arial,sans-serif; font-size:14px; font-style:normal; font-weight:normal; line-height:17px; text-decoration:none;\" target=\"_blank\" rel=\"noopener\">A post shared by Emma Heming Willis (@emmahemingwillis)<\/a><\/p>\n<\/div>\n<\/blockquote>\n<p><script async src=\"\/\/platform.instagram.com\/en_US\/embeds.js\"><\/script><\/div>\n<p>The actor isn&#8217;t the only Hollywood star to have the condition. Sharon Stone, Emilia Clarke and others have had it, but there is still a lack of awareness about aphasia. According to the <a href=\"https:\/\/www.aphasia.org\/\" target=\"_blank\" rel=\"noopener\">National Aphasia Association<\/a>, only seven percent of people are able to accurately identify it as a language disorder. Yet, aphasia is&nbsp;<a href=\"https:\/\/divine.ca\/en\/womeninspiringwomen-linda-berard-founder-of-entraidonsnous\/\"><u>more common than Parkinson\u2019s Disease<\/u>.&nbsp;<\/a><\/p>\n<p>We had the opportunity to speak with Dr. Brad Dickerson, MD Director, Frontotemporal Disorders Unit Staff Behavioral Neurologist, <a href=\"https:\/\/www.massgeneral.org\/\" target=\"_blank\" rel=\"noopener\">Massachusetts General Hospital<\/a> &amp; Professor of Neurology Harvard Medical School to learn more about aphasia, what care partners can do and what the future holds for people with the disorder:<\/p>\n<h2 id=\"what-is-aphasia\">What is aphasia?<\/h2>\n<p>Aphasia is a problem with communication abilities because of a problem in the brain. A person with aphasia has difficulty communicating either through speech or writing because of a problem affecting the circuits in the brain that control language. The nuance to that is that it is not just a speech problem like stuttering, it\u2019s a language problem. Generally speaking, it\u2019s more of a problem with the aspects of language that are typically evident when a person is speaking or writing. &nbsp;<\/p>\n<p>There is a misconception that it only happens to the elderly. There are a lot of people in their sixties, fifties or younger that have it. It can affect people\u2019s ability to do their job or take care of their family.<\/p>\n<h2 id=\"aphasia-has-been-in-the-news-because-of-bruce-willis-typically-the-condition-is-caused-by-strokes-what-are-some-other-causes-and-symptoms\">Aphasia has been in the news because of Bruce Willis. Typically, the condition is caused by strokes. What are some other causes and symptoms?<\/h2>\n<p>The most common cause of aphasia is a stroke, so it comes on suddenly. That\u2019s a medical emergency that people need to go to the hospital for. It\u2019s less commonly caused by other conditions that can come on suddenly like a brain infection. There are certain types of encephalitis or medical conditions that can cause aphasia and leave people with it permanently, like a stroke. It can also be caused by a traumatic brain injury. All those things cause a person to lose their communication ability suddenly. Then, potentially, a person will gradually be able to recover some of those abilities because the injury is healed.<\/p>\n<p>Alternatively, there are types of aphasia that can be progressive, where it comes on gradually. People think that it\u2019s the changes are happening because you are getting older, you are under stress or depressed. It may be either a brain tumour that is gradually growing and affecting the circuits in the brain for language or a nerve degenerative disease like Alzheimer\u2019s disease or a related condition. That type of aphasia will gradually get worse.<\/p>\n<p>If it\u2019s a brain tumour and you can remove it, the person may recover. But if it\u2019s a progressive brain disease like Alzheimer\u2019s or a related condition, then the person\u2019s abilities will gradually get worse and typically, they will have problems that go beyond language itself. It may affect memory or other cognitive functions.<\/p>\n<h2 id=\"tell-us-a-little-bit-about-each-type-of-aphasia-and-how-you-determine-the-severity\">Tell us a little bit about each type of aphasia and how you determine the severity.<\/h2>\n<p>The traditional terminology that people are getting away from these days is Broca\u2019s aphasia and Wernicke\u2019s aphasia.<\/p>\n<p><strong>Broca\u2019s aphasia<\/strong>, named after the neurologist, that first described it, is typically a type of aphasia where the person has trouble speaking and they have broken or halting speech where the words do not come out as full sentences. They may be able to convey the meaning of what they are trying to say, but it\u2019s not in normally constructed sentences that flow well. People talk about that as a productive or expressive aphasia, so a problem with producing language and speech or expressing yourself.<\/p>\n<p><strong>Wernicke\u2019s aphasia<\/strong> is also referred to as receptive aphasia, which is a problem comprehending or understanding what people are saying to you and in some cases, understanding your own speech properly to make it come out right. The way I think about it is that sometimes people have problems producing language, sometimes they have problems understanding other people\u2019s language or may have problems that are mixture of both, which is the most common condition.<\/p>\n<h2 id=\"how-common-is-aphasia\">How common is aphasia?<\/h2>\n<p>There are estimates that two million Americans and approximately 100,000 Canadians have it. It\u2019s not rare, but it\u2019s surprising when you think that many people have it, that there isn\u2019t more awareness. Despite the tragedy of someone like Bruce Willis developing aphasia, it\u2019s helpful to the community because it builds that awareness that aphasia otherwise would not have had.<\/p>\n<h2 id=\"what-types-of-questions-should-a-care-partner-prepare-prior-to-an-appointment-with-a-doctor\">What types of questions should a care partner prepare prior to an appointment with a doctor?<\/h2>\n<p>Many people with aphasia have otherwise completely normal abilities to think, make decisions and remember things, but may have difficulties with some of those abilities. Whether a patient with aphasia needs a caregiver or needs someone who is a partner in their care, it can be important for them to have someone accompany them to their doctor\u2019s appointments to help facilitate communication.<\/p>\n<p>If it\u2019s an appointment about the aphasia, then typically the partner in care would help prepare questions having to do with:<\/p>\n<ul>\n<li>Is the condition getting better or worse?<\/li>\n<li>Is it stable or has it changed in some way in terms of the communication abilities?<\/li>\n<li>Is there evidence of other problems with thinking abilities that should be discussed at the appointment?<\/li>\n<li>The $1million question is what the cause is of the patient\u2019s aphasia is and what should we expect moving forward?<\/li>\n<\/ul>\n<p>Depending on the cause of the aphasia, it may be expected to get better like with a stroke. If it\u2019s a form of Alzheimer\u2019s or related conditions, it might be expected to get worse, and the questions related to a doctor\u2019s appointment will relate not only to the aphasia, but the causes of it, because that determines whether the patient and care partner should be expecting stable function over time. If the person is not stable, they need to help the doctor understand what has changed. If the person is worse, then they will need to communicate what specifically has gotten worse and if this were what you would expect. Are there things that have changed that you would not expect and should we evaluate any changes further?<\/p>\n<h2 id=\"what-types-of-rehabilitation-are-available-if-a-person-can-be-treated-can-a-patient-expect-to-recover-all-or-some-of-their-cognitive-and-communication-capabilities\">What types of rehabilitation are available if a person can be treated? Can a patient expect to recover all or some of their cognitive and communication capabilities?<\/h2>\n<p>The key member of a medical team for a person with aphasia is a speech-language pathologist. Speech-language pathologists are medical professionals trained to evaluate the way to treat patients with communication difficulties [including aphasia].<\/p>\n<p>Many people may think of a speech-language pathologist as someone who works with kids who have dyslexia or other learning disabilities. Many work with patients who have developed aphasia, and in my opinion, a speech-language pathologist should always be someone that a person with aphasia is evaluated by at some point in the process.<\/p>\n<p>Some patients with aphasia due to a stroke or brain injury work with a speech-language pathologist once or twice a week on various recovery-oriented activities that aim to try to help patients recover their language abilities. In some cases, they may make a complete recovery. Even if a person has a permanent or progressive type of aphasia, working with a speech-language pathologist can be invaluable because it can help the person develop compensatory strategies. They can help their care partner, often a spouse or adult child, also develop these strategies.<\/p>\n<p>There are a wide variety of things that can help facilitate communication. Often, it is not just the patient who should be doing those things, it\u2019s a family member as well and that is best determined under the care of a speech-language pathologist. They may work with them over the course of two or three months, then stop and try to implement those activities in their daily lives. Sometimes, it is ongoing care for a longer period. During the pandemic, we\u2019ve seen that type of treatment be done through Telehealth methods so that people can access these kinds of healthcare professionals without having to travel to a medical facility where the person practices.<\/p>\n<h2 id=\"is-the-treatment-just-as-effective-through-telehealth-and-video-meetings\">Is the treatment just as effective through Telehealth and video meetings?<\/h2>\n<p>That is an important question that is being studied right now. There is some evidence emerging from research that shows that you may be able to get just as much out of working with a good speech- language pathologist through Telehealth, Zoom or other video-based technologies as you are able to meeting in person.<\/p>\n<p>There are other people who feel that aspects of communication like body language are harder to assess through Telehealth and video platforms. It depends on the patient\u2019s particular circumstances or characteristics, but there is at least good reason to believe if you can do a good quality assessment that way, then the speech-language pathologist is able to tell the patient if it\u2019s better to come in person or if it\u2019s fine to work with Telehealth or video platforms going forward.<\/p>\n<h2 id=\"what-new-treatments-are-on-the-horizon-for-aphasia\">What new treatments are on the horizon for aphasia?<\/h2>\n<p>There are organizations that speech-language pathologists are part of like the <a href=\"https:\/\/www.asha.org\/\" target=\"_blank\" rel=\"noopener\">American Speech-Language-Hearing Association (ASHA)<\/a> that have regular annual meetings. There are a lot of discussions at those meetings and the presentation of research that highlights different kinds of rehabilitative approaches. Software apps are becoming a hot topic. There are a growing number of software applications aimed at helping people through either a computer, tablet or even a phone to assist or augment their communication abilities. They are called assistive augmentative communication devices.<\/p>\n<p>There are several types of neuromodulation devices like Transcranial Magnetic Stimulation (TMS) or Transcranial Direct Current Stimulation (TDCS). These electrical or magnetic stimulation approaches are non-invasive. Some of these methods are being evaluated to see if they can help improve language function in people with aphasia. If a person has Alzheimer\u2019s related aphasia, someday we hope that the medications that are being used to treat the underlying pathology of the disease will potentially help people with progressive aphasia due to Alzheimer\u2019s. There is an active group of researchers trying to develop these new treatments.<\/p>\n<h2 id=\"where-can-families-find-support-and-learn-more\">Where can families find support and learn more?<\/h2>\n<p>The biggest organization that has an online presence is the <a href=\"https:\/\/www.aphasia.org\/\" target=\"_blank\" rel=\"noopener\">National Aphasia Association<\/a> which is American. They have a wonderful website that has a huge amount of material to help patients and families understand all the facets of aphasia. There is also an organization called the <a href=\"https:\/\/www.aphasia.ca\/\" target=\"_blank\" rel=\"noopener\">Aphasia Institute<\/a>, a Canadian based organization that is focused on educating people with aphasia and their family members about the condition and help them find the resources that they need.<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"post-excerpt\">June is National Aphasia Awareness Month. Until recently, people were unfamiliar with the condition. In March, Bruce Willis&#8217;s family revealed his diagnosis with the condition through&nbsp; Instagram and announced his&hellip;<\/div>\n<div class=\"post-more\"><a href=\"https:\/\/divine.ca\/en\/aphasia-what-you-need-to-know\/\" class=\"button button-primary button-effect\"><span>View Post<\/span><span><i class=\"cs-icon cs-icon-arrow-right\"><\/i><\/span><\/a><\/div>\n","protected":false},"author":6,"featured_media":1608779,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13],"tags":[11124,11130,11129,11128,11125,11127,11126],"powerkit_post_featured":[2,10391],"class_list":{"0":"post-1608776","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-aphasia","9":"tag-aphasia-bruce-willis","10":"tag-aphasia-symptoms","11":"tag-aphasia-treatment","12":"tag-bruce-willis","13":"tag-expressive-aphasia","14":"tag-types-of-aphasia"},"_links":{"self":[{"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/posts\/1608776","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/comments?post=1608776"}],"version-history":[{"count":7,"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/posts\/1608776\/revisions"}],"predecessor-version":[{"id":1608785,"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/posts\/1608776\/revisions\/1608785"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/media\/1608779"}],"wp:attachment":[{"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/media?parent=1608776"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/categories?post=1608776"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/tags?post=1608776"},{"taxonomy":"powerkit_post_featured","embeddable":true,"href":"https:\/\/divine.ca\/en\/wp-json\/wp\/v2\/powerkit_post_featured?post=1608776"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}