What is aphasia? Communication tips for caregivers

Aphasia—the impairment of language that is a result of injury to the brain is frustrating and difficult for the person experiencing it. They can lose the ability to find or form words, read, or write.

It is also hard on the care support associates, who need to learn new ways of communicating with their patients.

Aphasia affects millions of people, especially older individuals with dementia or people who have experienced strokes or other brain injuries.


The most common cause of aphasia is having a stroke. Between 25% and 40% of stroke survivors experience aphasia. Head injuries and other neurological issues are also common causes of aphasia.

Even though many people aren’t familiar with the term aphasia, it is more common than Parkinson’s disease, cerebral palsy, or muscular dystrophy.

One particular type of aphasia, primary progressive aphasia, results from the deterioration of brain tissue caused by diseases such as Alzheimer’s.


The National Aphasia Association identifies several different types of aphasia: Global, Broca’s, Wernicke’s, Primary Progressive, Anomic, and Mixed Non-fluent aphasia. The following is a brief description of each type:

Global aphasia is when someone has very little ability to make words or understand spoken language. They can’t read or write. When someone has a stroke, they might have global aphasia right afterward but recover some ability as the brain heals. The more damaged the brain is, the more lasting the aphasia will be.

Broca’s aphasia (non-fluent aphasia): is when a patient has a limited vocabulary and uses short, four-word utterances. They still understand other people’s speech and might be able to read, but their language is halting and clumsy.

Mixed non-fluent aphasia: is similar to Broca’s, but people with this type of aphasia have limited ability to comprehend, and their reading and writing are at the elementary level.

Wernicke’s aphasia (fluent aphasia): is when the ability to understand the meaning of speech is affected. People are still able to speak, but their speech is jumbled and includes irrelevant words. The ability to read and write is severely diminished.

Anomic aphasia is when people cannot find the words for the things they want to talk or write about, especially nouns and verbs. They might use fluent grammar, but they are trying to substitute words and get frustrated. They understand others well and can often read.

Primary progressive aphasia (PPA): is caused by neurodegenerative diseases, not by stroke or brain injury. It is often a result of Alzheimer’s disease or frontotemporal lobar degeneration. The first symptoms of this type of aphasia are speech and language problems.

No matter what type of aphasia a person has, they are still experiencing a major and difficult life change. Aphasia does not affect intelligence, but sometimes people assume people with aphasia are cognitively impaired because of their difficulty communicating.


Most of the time, aphasia affects language, not thoughts.

One of the most important things to know when communicating with someone with aphasia is that their intelligence is intact, even when they have difficulty finding words and names. 

Below is a list of dos and don’ts for communicating with aphasia patients.

  • Make sure you have the person’s attention before talking to them.
  • Eliminate background noises: TV, radio, other people.
  • Speak at a normal volume, unless the person asks you to be louder.
  • Keep sentence construction simple and slow your pace, but don’t “talk down” to them.
  • Give them time. Don’t finish their sentences or offer words.
  • In addition to speech, use drawings, gestures, writing, or facial expressions.
  • Use “yes” or “no” questions to confirm that you are communicating successfully.
  • Encourage their attempts to speak, even when it is not perfect.
  • Engage in normal activities such as group conversations and decision-making. Don’t ignore them or exclude them. Keep them informed without burdening them with too many details.
  • Encourage independence and don’t be overprotective.