What strategy should the nurse use when speaking to a client with aphasia?
Improving support for patients with aphasiaDigital Edition: Improving support for patients with aphasia 16 June, 2014 Show
Aphasia can put patients’ sense of self and relationship-building skills at risk. Nurses must recognise how aphasia affects patients’ whole lives to provide high-quality care To continue reading this clinical article please log in or subscribe. Subscribe for unlimited access
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Register Already have an account, to sign in Verbal communication includes any mode of communication containing words, spoken, written, or signed. People communicate verbally through the vocalization of a system of sounds that has been formalized into a language. Our capability to communicate with a language that is supported by an organized system of words, rather than merely sounds, is what sets us apart from lower species. It indicates the sending of information and receiving information. Clarification is a key component of verbal communication. Effective communication does not only requires the transmission of information but also clarification of points made, expansion of ideas and concepts, and exploration of factors that fall out of the original thoughts transmitted. A variety of challenges may arise when using verbal communication to express oneself. Misunderstandings can arise because of impaired communication. The responsibility for the nurse, whether encountering the patient in the hospital or in the community, becomes recognizing when communication has become ineffective and then using strategies to improve the transmission of information.
Nursing AssessmentThe following are the comprehensive assessments for Impaired Verbal Communication: ADVERTISEMENTS AssessmentRationalesAscertain circumstances or situations that may limit the patient’s ability to use or comprehend language, such as the following:Several clinical conditions may change the person’s ability to communicate effectively.
Nursing InterventionsThe following are the therapeutic nursing interventions for Impaired Verbal Communication: InterventionsRationalesLearn patient needs and pay attention to nonverbal cues.The nurse should set aside enough time to attend to all of the details of patient care. Care measures may take longer to complete in the presence of a communication deficit.Place important objects within reach.To maximize patient’s sense of independence.Provide an alternative means of communication for times when interpreters are not available (e.g., a phone contact who can interpret the patient’s needs).An alternative means of communication (e.g., flash cards, symbol boards, electronic messaging) can help the patient express ideas and communicate needs.Never talk in front of patient as though he or she comprehends nothing.This increases the patient’s sense of frustration and feelings of helplessness.Clarify your understanding of the patient’s communication with the patient or an interpreter.Feedback promotes effective communication.Keep distractions such as television and radio at a minimum when talking to patient.To keep patient focused, decrease stimuli going to the brain for interpretation, and enhance the nurse’s ability to listen.Avoid talking with others in front of the patient as though he or she comprehends nothing.Excluding the patient from an interaction increases the patient’s sense of frustration and feeling of helplessness.Do not speak loudly unless patient is hearing-impaired.Loud talking does not improve the patient’s ability to understand if the barriers are primary language, aphasia, or a sensory deficit.Maintain eye contact with patient when speaking. Stand close, within patient’s line of vision (generally midline).Patients may have defect in field of vision or they may need to see the nurses’ face or lips to enhance their understanding of what is being communicated.Individualize techniques using breathing for relaxation of the vocal cords, rote tasks (such as counting), and singing or melodic intonation.To assist aphasic clients in relearning speech.Give the patient ample time to respond.It may be difficult for patients to respond under pressure; they may need extra time to organize responses, find the correct word, or make necessary language translations.Maintain a calm, unhurried manner. Provide sufficient time for patient to respond.Individuals with expressive aphasia may talk more easily when they are rested and relaxed and when they are talking to one person at a time.Praise patient’s accomplishments. Acknowledge his or her frustrations.The inability to communicate enhances a patient’s sense of isolation and may promote a sense of helplessness.Provide environmental stimuli as needed.To maintain contact with reality; or reduce stimuli to lessen anxiety that may worsen problem.Use confrontation skills, when appropriate, within an established nurse-patient relationshipTo clarify discrepancies between verbal and nonverbal cues.Try to phrase questions requiring a “yes” and “no” answers.Patients can be frustrated when they cannot communicate in a simple manner.Use short sentences, and ask only one question at a time.This method allows the patient to stay focused on one thought.Speak slowly.This approach provides the patient with more channels through which information can be communicated.Provide concrete directions that the patient is physically capable of doing (e.g., “point to the pain,” “open your mouth,” “turn your head”).Simple, one-action directions enhance comprehension for the patient with language impairment.Provide practice sessions within the day.Practice will increase the patient’s communication.Correct errors.Not correcting errors reinforces undesirable performance and makes correction more difficult later.Create a list of words that the patient can say; add new words to it as needed. Share this with family members, significant others, and other care providers.Sharing information with others broadens the group of people with whom the patient can communicate.Provide word-and-phrase cards, writing pad and pencil, or picture board. Use eye blinks or finger movements for “yes” or “no” responses.Supplemental communication devices are especially helpful for intubated and tracheal patients or those whose jaws are wired.Use and assist patient or significant others to learn therapeutic communication skills of acknowledgment, active-listening, and Imessages.Improves general communication skills.Involve family and significant others in plan of care as much as possible.Enhances participation and commitment to plan.Carry on a one-way conversation with a totally dysphasic patient.It may not be possible to determine what information is understood by the patient, but it should not be assumed that the patient understands nothing about his or her environment.Consider the use of an electronic speech generator in post-laryngectomy patients.Adaptive devices can aid communication with patients who cannot produce vocal speech.Assist the patient in seeking an evaluation of his or her home and work settings.This evaluation will help the patient make decisions about the need for assistive devices such as talking computers, telephone typing devices, and interpreters.Allow significant others the opportunity to ask questions about the patient’s communication problem.It is vital for the family to know that there are many ways to send information to someone and that time may be needed to understand the special needs of the patient.Refer to appropriate resources (e.g., speech therapist, group therapy, individual/family and/or psychiatric counseling).Specialized services may be required to meet needs.Refer to NDs ineffective Coping; disabled family Coping (as indicated); Anxiety; Fear.To promote wellness.Recommended ResourcesRecommended nursing diagnosis and nursing care plan books and resources. Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy. What are some strategies for communicating effectively with someone with aphasia?You can encourage the person with aphasia to use other ways to communicate, such as:. Pointing.. Hand gestures.. Drawings.. Writing out what they want to say.. Signing out what they want to say.. How can a nurse communicate with a patient who has aphasia?The most frequently mentioned strategies were gestures (100%), verbal communication (33.3%), written communication (29.6%) and the touch (18.5 %). Among the observed strategies, the gestures reached 40.7% and the touch was present in all situations, given its instrumental character essential to care.
Which nursing intervention is most appropriate when communicating with a client having expressive aphasia?When communicating with a patient with aphasia, the nurse should present one thought or idea at a time. Ask questions that can be answered with a "yes," "no," or simple word. Use visual cues and allow time for the individual to comprehend and respond to conversation.
Which intervention is most appropriate when communicating with a patient with aphasia after a stroke?By far, the most common approach to aphasia rehabilitation is behavioral speech and language therapy (SLT).
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