Finding yourself as a sudden caregiver to a stroke survivor can be a confusing and overwhelming experience. Unfortunately, over a third of survivors will also experience communication challenges following brain damage. While everyone is affected differently, it can impact a person’s speech patterns, ability to process and comprehend language, and their reading and writing skills.

Communication-related diagnoses that are common following a stroke include aphasia, apraxia, and dysarthria. Treatment from a certified speech-language pathologist is generally recommended; they are communication experts who can help individuals regain their normal speech function.

In our last article, we reviewed how speech therapy can benefit stroke survivors. Today, we want to discuss helpful tips and strategies you can use to more effectively communicate with your loved one. While these take practice and patience, it’s important not to give up! Recovery can take time, but your involvement is essential to helping loved ones relearn communication and improve their speech language abilities.

  1. Speak Face-to-Face: When expressing language, we use more than just our words. We point, gesture, use facial expressions, and more. Therefore, it's important to speak face-to-face with your loved one, making sure you have their full, undivided attention.

  2. Minimize Distractions: Speak in a quiet, relaxed environment and try to minimize as many distractions as possible. This can include turning off the television, electronics, or noisy appliances.

  3. One Person at a Time: When speaking in groups or at the dinner table, there’s often a chorus of voices at any given time. Try to take turns talking, speaking one at a time and putting the spotlight on your loved one when it’s their turn to contribute to the conversation.

  4. Speak Clearly: Speak in a slow, measured way and make sure to clearly enunciate your words. Use natural pauses and increase the inflection of your voice if there’s a certain point you want to emphasize.

  5. Use Simple Instructions: It’s important that your loved one fully understands what you’re trying to communicate. One way to do this is to ask simple and direct yes-or-no questions to ensure their comprehension.

  6. Treat Them as an Adult: Just because someone has communication challenges or comprehension difficulties, it’s imperative that we don’t unintentionally treat them like a child. This can feel frustrating, demoralizing, and infantilizing. They are still adults and, to the best of our abilities, we want to engage them in discussions and make sure they are included in decision making.

  7. Give Them Enough Time to Respond: It can take longer for a stroke survivor to process information, think through their answers, and produce legible speech. Make sure to give them enough time to respond and avoid interrupting them.

  8. Provide Hints: It’s common that day-to-day speech and language abilities may change. Just because a person produced clear speech or understood your questions yesterday, doesn’t mean they will today. Progress often it’s a straight line. Therefore, try to avoid saying things like “you said it yesterday so you can say it again today.” Instead, if you notice your loved one struggling, give them a hint by offering the beginning of a sound or word.

  9. Offer Positive Reinforcement: If your loved one is wrestling to produce a word, makes a mistake, or you're having trouble understanding them, try not to act frustrated. Keep a positive attitude. And when they do show progress, make sure to congratulate them.

  10. Avoid Corrections: Similarly, don’t overcorrect speech errors, or insist that every word must be produced correctly. This can cause unneeded frustration.

  11. Use Different Forms of Communication: Words by themselves don’t always get across your intended message. Try gesturing or using visual cues when communicating. Augmentative and Alternative Communication (AAC) devices, including visual aids, electronic devices, and picture boards, may also help.

  12. Try Singing: Singing or humming your favorite songs can help stimulate parts of the brain damaged by a stroke. You can always start simple, such as singing “Happy Birthday”

  13. Play Language-Rich Games: Playing board games or card games can also be an enjoyable way to stimulate language. Try to avoid some of the normal competitive pressures by removing the timer or just playing for fun, not for points. You can also watch trivia game shows like Jeopardy who Family Feud.

  14. Take a Break: If you notice your loved one is confused, fatigued, or frustrated, take momentary pause and revisit the subject at a later time. It’s important to remember that these strategies don’t work every time, however, it’s important not to feel discouraged.

  15. Enjoyable Topics: Talk about things your loved one enjoys, such as family, friends, or hobbies. Perhaps there’s a television show they particularly like, or pull out a photo album to help rekindle some favorite memories.

  16. Keep a Schedule: Setting a schedule or routine of expected tasks can give your loved one a greater sense of responsibility and improve their memory and cognitive abilities. Use visual cues to set reminders, or keep a calendar of daily activities.

  17. Build Strong Therapist Relationship: Speech therapists don’t just “treat” patients, they also “coach” caregivers. Even if you’re seeing a speech therapist several times a week, they don’t have the same level of insight or personal familiarity with your loved one that you do. Therefore, it’s important that you build strong working relationships with your speech therapist. In addition to providing speech therapy, they should be offering additional techniques, strategies, and exercises you can use at home with your loved one to incorporate new lessons. The more you keep your speech therapist in the loop about progress and setbacks, the better they can participate in your loved one’s care.

  18. Consider Online Speech Therapy: For stroke survivors with limited mobility, or who prefer the convenience of receiving speech therapy from the comfort of their home, consider online speech therapy. This is similar to traditional, in-person care, except you engage with your speech therapist using secure video chat technology (like Zoom). This can also be a much more affordable solution for individuals that have inadequate insurance coverage, or who can’t afford high out-of-pocket costs.