Recovery from Stroke: Learning to Talk Again
Part 1: Aphasia and rehabilitation
by Joy Simpson
So it happened to your father. A brain attack. That's what they call a stroke. He survived, but he has trouble speaking and understanding what people say to him. It's a condition called aphasia. What are his chances of full recovery?
The National Aphasia Association says more than half the people with symptoms of aphasia recover in the first few days. But there are many factors to consider if recovery takes longer.
What is aphasia?
Aphasia has different forms. It can affect
the brain's ability to comprehend language and it can also
limit the ability to talk. Sometimes the person can speak,
but he doesn't make much sense.
Factors to consider in recovery
"Everyone should know the signs of stroke and be ready to get to the hospital," said Jackson. The National Institutes of Health has been educating the public on this point in their campaign called Know Stroke: Know the Signs. Act in Time.Stroke symptoms are:
When you talk with the doctor, three pieces of information will help you know more about the chances of recovery: the type of stroke, the part of the brain that was affected, and the size of the injury. If the stroke was caused by a blockage of the blood vessels, recovery can take place rapidly in the first few months. If it was caused by blood vessels that burst, healing will take longer. Knowing the location of the injury in the brain gives the medical team information about skills that will likely be affected. The size of the injury is also important. "In general, the larger the lesion, the less recovery," said Jackson.
Age is a factor in recovery. If your father is younger than 80, he'll have a better chance. Most people in the last decades of life have a precarious medical profile that complicates everything else.
Regardless of his age, the body will initiate a healing process. But rehabilitation therapy can take him the extra mile. With the help of a speech-language pathologist he can recover his ability to talk, or learn ways to compensate. "Every patient should have a shot at rehab," says Susan Jackson.
Despite evidence that rehabilitation is beneficial, the National Institute of Neurological Disorders and Stroke stated in their report Stroke Priorities for the Twenty-first Century: "Many stroke survivors receive limited therapy and are then discharged to the community, where they often remain chronically disabled, socially isolated, and at risk for common post-stroke rehabilitation complications " (Stroke Progress Review Group, 2002, p. 86).
"The reason stroke survivors receive limited therapy," said Jackson, "is in part because insurance companies make decisions about discharge instead of the professional in charge of their care." Therapists say it takes time to assess a person's potential and rebuild their skills. Discharge from the hospital or outpatient services may cut this short.
This is the first in a three-part series with Susan Jackson and Susan Kemper -- scientists at the Schiefelbusch Institute for Life Span Studies at the University of Kansas.
National Institute of Neurological Disorders and Stroke -- National Institutes of Health (2002, April). Report of the Stroke Progress Review Group. Stroke Priorities for the Twenty-first Century. www.ninds.nih.gov/about_ninds/04_2002_stroke_prg_report.htm
Wertz, Robert T., et al. (1986). Comparison of clinic, home and deferred language treatment for aphasia: A Veterans Administration cooperative study. Archives of Neurology 43, 653-658.
National Aphasia Association -- www.aphasia.org
National Institute of Neurological Disorders and Stroke - National Institutes of Health -- www.ninds.nih.gov
Kansas Speech-Language-Hearing Association -- www.ksha.org
U.S. Department of Health and Human
Services. Patient and Family Guide to Stroke Recovery on the University of Kansas Center for Aging web site
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