Trouble Talking: Finding Your Voice After Speech Loss from Stroke

Has a loved one had a stroke? Unfortunately, many people do. A stroke occurs when blood flow to the brain is either blocked or there is bleeding in the brain. According to the Centers for Disease Control and Prevention (CDC), someone in the United States has a stroke every 40 seconds.

Strokes can happen to anyone, but there are people at higher risk. High blood pressure, high cholesterol, smoking, obesity, and diabetes are leading causes of stroke. The CDC says that one in three U.S. adults has at least one of these conditions or risk factors.

Strokes are a leading reason for disability and the need for long-term care. The most common types of disability after a stroke include impaired speech, restricted physical abilities, weakness or paralysis on one side of the body, difficulty gripping or holding objects, and a slowed ability to communicate.

There are three main types of strokes: ischemic, hemorrhagic, and transient ischemic attacks (TIAs). Ischemic strokes, the most common type, occur when a blood clot blocks or narrows an artery leading to the brain, reducing blood flow. Hemorrhagic strokes happen when a blood vessel in the brain bursts, causing bleeding and damage to surrounding tissues.

TIAs, often called mini-strokes, are temporary blockages of blood flow to the brain that typically resolve within minutes to hours but are warning signs of a potential future stroke. Understanding these types helps in identifying symptoms and seeking prompt treatment.

Communication issues are a big concern; one in three people experience difficulty communicating following a stroke. These difficulties can impact many different elements of communication, including comprehension, reading and writing, and speech.

If a loved one is one of the many people who have trouble talking following a stroke, the good news is that things can improve over time, especially with professional treatment. Consulting with a licensed speech pathologist from a nationally recognized program, such as Ithaca College's online speech pathology program, can help a stroke survivor find their voice again.

How Stroke Can Cause Speech Loss

Several factors are at play. First, a stroke can cause language processing and comprehension issues, known as Aphasia. Aphasia affects the stroke survivor's ability to understand, process, and use language. Celebrities like Bruce Willis and Wendy Williams have suffered from Aphasia. Some symptoms of Aphasia include:

• Difficulty following conversations or understanding what people are saying.
• Trouble finding the correct word or phrase to express oneself.
• Using strange or unrecognizable words in speech.
• Struggling to form coherent sentences.

A stroke can also affect the ability to produce speech. Two different types of speech problems can arise following a stroke:

Apraxia of Speech

Apraxia of speech is caused by stroke survivors' inability to move their oral muscles to produce the sounds required to talk. It's a neurological condition that can develop from brain damage experienced during a stroke. Also known as verbal apraxia, the condition means that the patient is unable to form words using their tongue and mouth.

Dysarthria of Speech

Dysarthria of speech is also caused by stroke-induced brain damage. However, this condition is more related to the quality of the sounds being produced while speaking. Dysarthria is characterized by slurred and slow speech and a lack of volume and projection. This is because the muscles required to talk have been weakened following the stroke.

Post-Stroke Speech Loss Treatment and Recovery

As part of rehabilitation after a stroke, patients often need to undergo speech therapy to learn how to communicate again. Working alongside a speech-language pathologist, stroke survivors who have lost the ability to communicate will relearn speech, expression, and other communication skills. Some techniques a speech-language pathologist will employ to assist patients in recovering from speech loss post-stroke include:

• Tongue and oral muscle motor skill strengthening exercises.
• Speech recovery skills, including practicing word and phrase pronunciation.
• Breathing exercises to regulate respiratory function and facilitate easier speech.
• Identifying and naming graphics and images to help with cognition and understanding.
• Melodic intonation therapy, also known as singing therapy.
• Electrical stimulation therapy awakens the oral muscles involved in producing sounds.

The time it takes to recover speech after a stroke varies greatly depending on the patient. Significant improvement is common early on, as the first few months usually involve the most active brain recovery.

Steady progress can generally be observed in most patients over the next 3-6 months of speech therapy treatment. However, some patients may experience difficulty speaking for many years following a stroke.

If your loved one is having trouble speaking after experiencing a stroke, there is light at the end of the tunnel. Working with a speech-language pathologist can regain the ability to communicate. A speech-language pathologist will provide tongue-and-mouth exercises to practice and help pronounce words and phrases to relearn how to speak.

It's important to remember that every patient's rehabilitation and recovery timeline is different. While some stroke survivors may bounce back more quickly, others may take longer to find their voice again after a stroke.

However, sometimes the stroke will cause permanent disability and even memory loss. What then?

Understanding Stroke-Induced Disability and Memory Loss

When a stroke occurs, it can lead to significant and lasting disabilities, affecting a person's ability to perform daily activities independently. The severity and type of disability depend on the location and extent of the brain damage caused by the stroke. The CDC says the most common disabilities resulting from a stroke include impaired speech, restricted physical abilities, weakness or paralysis on one side of the body, difficulty gripping or holding objects, and a slowed ability to communicate.

Cognitive and Memory Impacts

Strokes can also have a profound impact on cognitive functions, including memory. Memory loss after a stroke can vary from mild forgetfulness to severe memory impairment. This can be particularly challenging as it affects the individual's ability to remember important information, recognize familiar people and places, and perform routine tasks. The American Stroke Association notes that memory loss and cognitive impairments can significantly affect a stroke survivor's ability to live independently, often necessitating long-term care.

Role of Long-Term Care

For many stroke survivors, long-term care becomes essential to manage the disabilities and cognitive impairments caused by the stroke. Long-term care services can include assistance with daily living activities such as bathing, dressing, eating, and mobility. These services can be provided in various settings, including at home, assisted living facilities, or nursing homes.

Finding quality care and paying for it are major concerns for families dealing with a loved one who has had a stroke. Health insurance, including Medicare and supplements, only pays for short-term skilled care. Those with limited financial resources may qualify for Medicaid, but that limits the care to pre-approved caregivers and facilities. Those with Long-Term Care Insurance have the insurance benefits to pay for the quality care they need and deserve.

You can find quality caregivers, senior communities, and long-term care facilities by using the free and comprehensive LTC NEWS Caregiver Directory.

Quality Long-term care services are crucial for ensuring stroke survivors receive the continuous support, medical attention, help with daily living activities, and supervision needed to improve their quality of life. For instance, professional caregivers can help with physical therapy exercises to regain strength and mobility, and speech therapists can assist with communication skills. The goal of long-term care is to help stroke survivors maintain as much independence as possible while providing the necessary support to manage their disabilities and cognitive impairments.

Planning for Long-Term Care

Given the potential for severe and lasting impacts of a stroke, planning for long-term care is a critical component of financial and retirement planning. Long-Term Care Insurance is a valuable tool that can provide the necessary funds to cover the cost of care services. LTC Insurance policies offer guaranteed tax-free benefits that can be used to pay for care in various settings, ensuring that stroke survivors have access to quality care without depleting their savings or becoming a financial burden on their families.

Ideally, the best time to acquire an LTC policy is before you retire, and most people do so in their 40s or 50s when their health is better and premiums are lower. However, you can find affordable options in your 60s and even older if you have fairly good health.

What to Do When Someone Has A Stroke

When a stroke occurs, Dr. Amre Nouh, regional chairman of neurology for Cleveland Clinic Florida, says the sudden loss of neurologic function can be very devastating, ranging from loss of vision and speech to loss of motor function or even complete incapacitation.

Dr. Nouh advised that if you suspect someone is having a stroke, remember the acronym "BE FAST":

• Balance: Is the person experiencing sudden issues with their balance or coordination?
• Eyes: Are they having trouble seeing?
• Face: Do you notice any drooping or numbness in their face?
• Arm: Is there a weakness in their arm?
• Speech: Are they having difficulty with their speech?
• Time: Call 911 immediately.

It's best to avoid bringing someone in by car because there are many other issues that can happen during a stroke, such as hemodynamic instability and blood pressure issues. Leave it to the professionals and call 911 to wait for the ambulance.

Treatment options and recovery vary based on the severity of the stroke. In some cases, a person may suffer permanent injuries, like paralysis on one side of the body.

Health can change at any moment, and aging brings many challenges as older people see a decline in their health, body, and mind. Understanding the risks, taking proactive steps with health and planning, and getting quality care when necessary, will help families deal with health events and aging.

The goal, either for your loved ones now or for you in the decades to come, is to access quality care services without draining assets or burdening those they love.