Psychosocial Adjustment To Aphasia and Quality of Life Issues Flashcards
Limited __________ Available
Fundamental link with other human beings and with his or her own sense of personhood is…
Clinicians need to consider…
Information
altered profoudly
patients as whole human beings not focus narrowly ion the language disorder.
Generalized Problems
Either do not understand the term “aphasia” or never hear the word.
People usually have never heard the word “aphasia”
SLP/aphasiologist must educate patient and family
What is an aphasic person?
Aphasic people do not talk as well as before becoming ill and all their other communicative acts are impaired in varying degrees as well. In addition they are likely to be more irritable, scared, depressed, and distractible than before they got sick.
Despite these changes….they are often unchanged at the core.
Sarno (1993) Article Review
Loss of language negatively effects all aspects of a person’s life
Aphasia rehabilitation is more than just treating words
Social isolation and loneliness occur
Anger and frustration may further isolate
Process of Grief
Elizabeth Kubler-Ross Steps of Grief
Denial
Anger
Bargaining
Depression
Acceptance
Changes to Family Life:
Role in the family
Sudden /unexpected decrease in income
Increase in expenses
Spouse has burden alone
Changes in sexual relations
“No one to talk to”-feel that they are living alone
Goals of Treatment
Review of Rosenbek:
1) To assist people to regain as much communication as their brain damage allows and their need drive them to
2) To help them learn how to compensate for residual deficits
3) To help them learn to live in harmony with the differences between the way they were and the way they are.
Rosenbek, LaPointe, & Wertz…….
“The most important goal is…
is usually to prepare patients for a lifetime of aphasia.”
Some have little or no trouble adjusting.
Others never adjust despite the clinician’s best guidance.
Some (majority) adjust and are helped in that adjustment by things their clinicians do
Rehabilitation
Few studies: most by Chris Code, Muller, Sarno
Emphasize impact of depression, chorine anxiety social dysfunction on aphasia rehab.
Social rather than medical construct” Muller(1999).
Recommends including psychological adjustment into treatment plans: make treatment social rather than medical
Code-Muller Protocols:10-item overview
Code-Müller Protocol
Developed over time
How psychosocial adjustment impacts aphasia recovery
Five components
Evidence-Based Practice
Muller admits there is a lack of evidence-based approaches to managing psychosocial adjustment .
Need to establish a stronger core body of knowledge.
Code-Muller Treatment Process
Five components, provide guidelines for clinicians to develop broader programs:
Therapy Emotional adjustment Social factors Autonomy Work/vocation
What can a clinician do?
Rosenbek, LaPointe, & Wertz say: “Keep the patient successful.”
Begin by providing a realistic guess about the future, even if that future includes severe, persisting deficits.
Most are not destroyed by a poor prognosis but they can be irrevocably harmed by unrealistic promises.
Counsel about the value of life during and after treatment has ended.
Equally important for them to know that treatment’s goal is not normal communication but making the best use of what remains.
Rosenbek, LaPointe, & Wertz…
“We believe that aphasia is a human disorder that alters not only a person’s language but also a person’s life and relationship to others. We believe aphasia is often modifiable and that an appropriate therapy is one that takes into account all the deficits- linguistic, cognitive, behavioral, social, and familial.”
Adjustment
“If they were doing their best before, they will set about doing the best they can to adjust to their disability and to the treatments that are likely to accompany it.”
Clinicians should reinforce a patient’s personal strengths and support their natural processes.
They should treat aphasic people and not aphasia.
