Many of us have heard about the possible signs of stroke from various media sources. One of the signs of stroke is a change in a person’s speech. When the person is actually diagnosed with a stroke, a speech/language pathologist will become part of the treatment team. Treating stroke patients has been a focus of my clinical practice while working in various assisted living facilities and the home care setting.

When a patient who has had a stroke comes to assisted living with concerns regarding speech and language, I will be asked to complete an evaluation and plan a treatment program which I will then carry out with the patient and family. Patients in assisted living facilities may have had strokes on the left or right side of the brain. All effects of a stroke on communication are different for each patient. This article will address speech/language concerns following a stroke on the left side of the brain.

During my career, I have worked with all types of communication issues related to a stroke. Many of the families of patients in assisted living have heard something about aphasia which is the name most frequently used for the communication problems caused by a stroke. There can be receptive aphasia (problems understanding), expressive aphasia (problems verbalizing), and something called dysarthria which refers to difficulty with the motor movements needed to produce sounds and combine them into words. A single patient in Assisted Living may have one of these problems or a combination of all of them.

For example, some of my patients had difficulty understanding others, following directions, mishear words (hear “fair” instead of “pair”) and might have a delay in responding because of difficulty processing what they are hearing.With regard to the verbal skills of my patients residing in assisted living facilities, I provided speech/language therapy services to both men and women who had various expressive communication abilities. Some of them had what are called word retrieval problems which means that they had difficulty finding the correct word or words to say what they meant.

Some of the folks used “choppy” sounding speech during which they switched around sounds in words, used words from the same category such as “cat” for “dog” or “knife” for “spoon.”There were also patients who spoke in sentences that sounded like a bunch of jumbled words but made no sense. This type of patient was not able to realize that there was anything wrong with what he/she said. On the other hand, there were those patients who could speak only a few simple words, but were aware that something that was wrong and became very frustrated.

My patients in assisted living facilities who were diagnosed with dysathria had problems physically producing words and sentences.They distorted vowel sounds and left off sounds at the beginning and ending of words. Their speech patterns usually repeated and listeners could often learn to understand the pattern. Such a person will sound “slurred” and might even be described as sounding “drunk.”
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