Phone conversation with a stroke patient?
January 23, 2012 9:29 AM Subscribe
Any tips for talking on the phone to someone with cognitive damage?
A family member in another city has had a stroke and is now in rehab for physical and cognitive issues. It will be a while before we can visit him in person, and this could be a fairly long haul from what we hear. So while he is in rehab, I want to keep in touch with him by phone.
The thing is, when I've called, I've felt like he was happy to get the call but struggling so hard to find words that it may have been stressful for him. And I find it much harder to judge/conduct the conversation without being able to see his face. (I don't see him getting set up to skype or anything while he is in there.) When I Google things like "talking to stroke patients" I get a lot of advice that assumes you are face to face.
For anyone who has been in similar situations: have you found any ideas or tricks for having some sort of conversation on the phone without putting the other person under pressure or wearing them out? Bonus points for any other ideas for brightening the day of someone who's in rehab for this kind of issue. Thanks!
(Making this anonymous because I'm not all that comfortable discussing someone else's health issues publicly.)
A family member in another city has had a stroke and is now in rehab for physical and cognitive issues. It will be a while before we can visit him in person, and this could be a fairly long haul from what we hear. So while he is in rehab, I want to keep in touch with him by phone.
The thing is, when I've called, I've felt like he was happy to get the call but struggling so hard to find words that it may have been stressful for him. And I find it much harder to judge/conduct the conversation without being able to see his face. (I don't see him getting set up to skype or anything while he is in there.) When I Google things like "talking to stroke patients" I get a lot of advice that assumes you are face to face.
For anyone who has been in similar situations: have you found any ideas or tricks for having some sort of conversation on the phone without putting the other person under pressure or wearing them out? Bonus points for any other ideas for brightening the day of someone who's in rehab for this kind of issue. Thanks!
(Making this anonymous because I'm not all that comfortable discussing someone else's health issues publicly.)
It's really difficult. You're right that most of the methods to support conversation only work face to face. I often phone people to set up appointments and then end up phoning their next of kin to confirm arrangements, even when I can talk to the person no problem face to face.
You've said cognitive problems - do you mean problems with attention and memory or do you mean he mainly has language problems? The ways to deal with these would be different. From what you've said it sounds like language mainly.
So some suggestions:
- Find out if he's having problems understanding language or whether it's just getting words out. If he is then you should be doing things like speaking in short simple sentences (not baby talk), getting rid of as much background noise as possible, repeating information and rephrasing things.
- Slow everything right down - you being slower will make it easier for him to slow down and give his brain time to catch up
- Don't try to finish his sentences until he's had a good go, or he asks you.
- On the other hand, sometimes you will have a good idea what he's trying to say. I usually give the person a little time and then say 'Do you mean X?' I think it's generally important not to just keep jumping in with wrong guesses as this is really frustrating. Put it in as a suggestion and if you're wrong then you shut up.
- Ask one question at a time. We often ask lots in a row, especially when a little nervous.
- He may have advice from his speech therapist about how to help with finding the right words. Follow this if he has it.
- If he has no specific advice, you could try asking questions about the word he is trying to think of, e.g., 'are you talking about someone in the family? Yes? Someone you see regularly? Is it cousin Jane?'
- Similarly, in conversation you have a lot of control over how much speech you require from him. You can ask questions that require yes/no, questions that require him to choose from two or more options you have given him, questions that require a one-word answer or more open questions. Easier questions are a useful tool for reducing frustration but can lead to a rather unsatisfying conversation. I would start with open ended questions and followup with closed or multiple choice questions.
- Don't ask 'test' questions designed to help him use his speech - if he's doing rehab all day then don't assume he wants to work hard to talk to you. You can tell him that if he wants to practice something specific then he can ask, of course!
- Accept any communication that gets his point across. Doesn't matter if the grammar isn't good or if he mispronounces, unless he asks you to correct him every time he makes an error.
Also you might want to remember that strokes tend to make people really really tired for quite a long time so be sensitive that in both your conversations and what you send him! I think booked on tape/CD might be good, but short stories or other books in chunks might work better than something where you have to keep track of a complex story.
That's a lot of advice, but really it's something you'll work out between you in much more detail than someone else could ever give you. Be patient and be relaxed and he will get there.
posted by kadia_a at 9:58 AM on January 23, 2012 [3 favorites]
You've said cognitive problems - do you mean problems with attention and memory or do you mean he mainly has language problems? The ways to deal with these would be different. From what you've said it sounds like language mainly.
So some suggestions:
- Find out if he's having problems understanding language or whether it's just getting words out. If he is then you should be doing things like speaking in short simple sentences (not baby talk), getting rid of as much background noise as possible, repeating information and rephrasing things.
- Slow everything right down - you being slower will make it easier for him to slow down and give his brain time to catch up
- Don't try to finish his sentences until he's had a good go, or he asks you.
- On the other hand, sometimes you will have a good idea what he's trying to say. I usually give the person a little time and then say 'Do you mean X?' I think it's generally important not to just keep jumping in with wrong guesses as this is really frustrating. Put it in as a suggestion and if you're wrong then you shut up.
- Ask one question at a time. We often ask lots in a row, especially when a little nervous.
- He may have advice from his speech therapist about how to help with finding the right words. Follow this if he has it.
- If he has no specific advice, you could try asking questions about the word he is trying to think of, e.g., 'are you talking about someone in the family? Yes? Someone you see regularly? Is it cousin Jane?'
- Similarly, in conversation you have a lot of control over how much speech you require from him. You can ask questions that require yes/no, questions that require him to choose from two or more options you have given him, questions that require a one-word answer or more open questions. Easier questions are a useful tool for reducing frustration but can lead to a rather unsatisfying conversation. I would start with open ended questions and followup with closed or multiple choice questions.
- Don't ask 'test' questions designed to help him use his speech - if he's doing rehab all day then don't assume he wants to work hard to talk to you. You can tell him that if he wants to practice something specific then he can ask, of course!
- Accept any communication that gets his point across. Doesn't matter if the grammar isn't good or if he mispronounces, unless he asks you to correct him every time he makes an error.
Also you might want to remember that strokes tend to make people really really tired for quite a long time so be sensitive that in both your conversations and what you send him! I think booked on tape/CD might be good, but short stories or other books in chunks might work better than something where you have to keep track of a complex story.
That's a lot of advice, but really it's something you'll work out between you in much more detail than someone else could ever give you. Be patient and be relaxed and he will get there.
posted by kadia_a at 9:58 AM on January 23, 2012 [3 favorites]
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Comedy and books on CD/tape/MP3.
Write letters.
Send cards.
posted by cooker girl at 9:34 AM on January 23, 2012 [2 favorites]