Imagine you are trying to help Mr. Jones with his lunch, but despite his best efforts, he cannot seem to find the words to tell you he wants the spoon. He looks frustrated, maybe even angry, but the words just won’t come out. This isn’t confusion; this is aphasia.
What is Aphasia?
Aphasia (uh-FAY-zhuh) is a language disorder that affects a person’s ability to communicate. It usually happens after a stroke or brain injury. It impacts speaking, understanding, reading, and writing. The most important thing for CNAs to remember is that aphasia does not affect intelligence. The resident’s mind is clear; the connection between the thought and the word is just broken.
Why Aphasia Matters in Your Daily Care
Communication is the foundation of safety and dignity. When a resident cannot express pain, hunger, or the need to use the bathroom, they are at risk for falls, pressure ulcers, and untreated pain. Furthermore, the frustration of being trapped inside a body that won’t “speak” can lead to depression or aggressive behaviors. You are their lifeline to the world. By learning to interpret their needs, you prevent suffering and show them the respect they deserve.
What You’ll See During Your Shift
You will notice residents struggling to find the right words, substituting made-up words, or speaking in sentences that sound fluent but make no sense. Some may understand everything you say but cannot reply. Others might not understand your instructions at all. You might see a resident pointing to a cup and saying “hammer” instead of “drink.”
“Nurse, Mrs. Higgins is getting really agitated during breakfast. She’s pointing to her mouth and saying ‘paper,’ but she won’t eat the eggs. She pushed the tray away. I think she might be in pain or having trouble swallowing, but she can’t tell me.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Assuming the resident is confused or has dementia because they aren’t making sense, and talking over them or to family members as if the resident isn’t present. This causes immense humiliation.
Pro Tip: Treat the resident as the intelligent adult they are. Speak slowly, maintain eye contact, and ask “Yes” or “No” questions. Instead of “What do you want to wear?” ask, “Do you want the blue shirt?” This gives them the power to answer and be understood.
Memory Aid for Aphasia
Remember: “The words are stuck, not the wits.”
This reminds you that just because the words aren’t coming out, the resident’s thoughts and feelings are still real and intact.
State Test Connection
Expect questions on how to communicate with a resident who has had a stroke. The answer almost always involves using simple words, gestures, and giving the resident ample time to respond.
Related Care Concepts
Understanding aphasia goes hand-in-hand with dysphagia (swallowing difficulties), as both often result from strokes. It also connects to cerebrovascular accident (CVA) recovery and non-verbal communication techniques. You may also see it alongside hemiplegia (paralysis on one side) if the stroke affected motor functions too.
Quick Reference
✓ Key signs to look for: Difficulty finding words, substituting wrong words, trouble understanding simple commands ✓ When to report: Sudden onset of symptoms (possible stroke), extreme frustration leading to aggression, signs of pain that cannot be voiced ✓ Care reminders: • Use gestures, pictures, or pointing to objects • Ask questions that require only a “Yes” or “No” answer • Eliminate background noise (TV/radio) when talking • Give them plenty of time to respond—don’t rush them • Watch for non-verbal cues like grimacing or restlessness
Bottom line: Patience is your best tool. When you take the time to decode the language of aphasia, you restore a resident’s dignity and ensure their needs are met safely.