Social and emotional aspects Flashcards
What do people with aphasia experience changes in?
Abilities
Roles
Relationships
Community life
Reactions of others
Reactions and attitudes are different from what they were pre-aphasia.
Attitudes and reactions of others can influence emotional state and recovery.
feelings reported by PwA
Isolation Loss Identity Low self-esteem Social Exclusion Anger Frustration Guilt Anxiety Depression
Aphasia doesn’t just affect the PwA- it’s a ______ _________.
Family Problem.
Loss is experience by who?
PwA
Family
Friends
What has been reported regarding family problems associated with aphasia?
Family of PwA from stroke have reported more emotional and psychological difficulties
than
families of people who had a stroke but didn’t get aphasia.
Social life with aphasia
PwA have significantly fewer social contacts and activities than their peers
Friendships are particularly vulnerable- family tend to stay around but friends go away.
30% with chronic aphasia had no close friends.
Positive correlation between contact with friends and reported QoL- more contact, higher QoL
Those with reduced social support are more likely to be __________.
depressed.
What’s important to the PwA socially?
They feel isolated and want to be engaged.
They don’t care about number of activities- but their engagement in these activities
They feel burdensome to others and wish to function normally.
They want to know what’s going on, but getting info from convo can be really hard.
If they aren’t able to work they want to contribute to the community in other ways.
Often feel stigmatised and wish to be respected.
Emotional Impact on PwA
Varies individually and changes over time.
Type and location of brain damage may influence reaction.
Name individual influences on emotional impact
general health status personality resilience motivation age and stage of life responsibilities life experience
What doesn’t affect emotional reaction?
The severity of aphasia- it is completely individual, someone may have mild aphasia and it has a massive impact on them.
What is emotional reaction also affected by?
Family Response
What tends to be gradual?
The realisation of the extent of disability and the implications for life are gradual for PwA and family.
Common early reactions
Anxiety Panic Disbelief Apathy Apparent lack of concern Denial
What is a common early response that can be enouraged by others?
Denial- encouraged by others in attempt to reassure.
It’s important that we avoid false reassurance but still keep spirits up.
Some PwA and family can be in ____ for a long time. what is our job?
Denial.
To make their expectations realistic.
Name some later reactions
Sense of loss- realise extent of disability- lots of losses- role, dignity, self-confidence, physical abilities, appearence, employment etc.
Self-concept - sense of identity and self worth
Grief this is a complex process of emotional and intellectual adjustment which allows a person to cope with their loss DABDA grief Kubler Ross Denial Anger Bargaining Depression Adaptation
Adapting, accepting and coping.
“Philosophical Shift”-
Accept limitations and look beyond what’s no longer possible
Not thinking of normal as the only acceptable outcome
Placing aphasia in context- not being defined by it
Planning and looking forward to future events.
Living and functioning to full extent possible, resuming relationships and forming new ones.
Family
Loss experienced by family too.
May undergo grief too :(
Depression
prevalence
Depression is common
70% of people with aphasia had some level of depression 3 months post stroke
Depression
influencing factors
Biological changes due to brain damage
Individual characteristics
Develops as a natural reaction to awareness of circumstances
How id depression treated?
Medication
Important to make an onward referral.
Assessing Mood
All should be screened for mood disturbance as early as appropriate .
If suspect issue make onward referral to GP.
Screening-
SAD-Q
Stroke Aphasic Depression Questionnaire
filled out by carer, based on observable behaviours e.g. crying, disturbed sleep.
Visual Analogue Mood Scale (VAMS)
specifically designed for people with communication difficulty for whom verbal measures would be unsuitable and unreliable.
