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Accelerated aphasia
Posted: Monday, October 7, 2019 11:33 PM
Joined: 6/11/2019
Posts: 391

Mom's been having word trouble (aphasia) since her ministroke in January. (The initially severe language deficit was my first immediate clue that something new beyond the dementia had happened.)

After the first 24 hours, it began to improve. By spring, it was nearly gone, due in part to being in geri-psych and then daycare where she was forced to talk with others all day. By early August it was becoming more obvious again. But it was simple things like saying "spoon" when she wanted a pair of snips (for arranging flowers) or "flier" when she wanted a piece of foil. Depending on what was happening, I could guess what she wanted most of the time.

When she came home from the hospital last month, it really started going downhill. So much so that lately, I can't guess what she means. She has no details for most things. Tonight's mystery: "the name of the lady she had the party with and what happened to the stuff she got." She can't provide a single specific. Even more frustrating, I know it's not real. She hasn't had a "party" in more than 15 years and it wasn't a product party; it was Halloween! Besides which I don't think she has ever had a product party. Maybe a Tupperware party in the 60s, but none before or since.

The problem: Severe agitation ensues when I can't figure out what she is after. And tonight, just saying I'd check on it almost caused a meltdown. Only a quick, 'Hey, you want some pie?" managed to get her off topic.

She speaks clearly and relatively normally though a slight stutter has emerged. Anyone got ideas on how to figure out what she's saying and stave off meltdowns?

This makes handling all the repetition look simple!

Posted: Tuesday, October 8, 2019 10:08 AM
Joined: 10/24/2018
Posts: 681

Hi MbyM-- the specific "party/stuff" incident you describe sounds more like memory than language loss to (TOTALLY NON EXPERT) me. If she had remembered the name, she would have been able to speak it? Or is that not how it would go? If she remembered whatever "stuff" it was, perhaps she'd call it cabbage and bicycle rather than cake-safe and Bundt pan, but in her head she would know what she meant? It seems like you could elaborate on this possible Tupperware party (or maybe there were parties before you were born even)? For my mom, saying to her, "I was just a baby then, I really don't remember that" has worked more than once. I can also say, you know what? I bet I wasn't even born yet, but I remember a lady next door who....and wasn't she the lady who lent you her car and watched me when Sis fell out of the tree and sprained her ankle?(true story, I was 3+, Sis 2 at most) That kind of thing also works for me. 

Mom has what I call "severe expressive aphasia of her inmost thoughts and feelings". She does fine with hostess mode responses and generic questions ("how is your family?"), but when she wants to pour out her heart, it gets awful very quickly. She'll search for a word, give up and search for an alternate (you can see this all in her expression), forget the whole thought, become desperate, and give up. At that point I can do nothing but watch very attentively and keep calm while trying to figure out what we were talking about that might have prompted whatever she now cannot get past her lips. Those are the good days. The terrifying days have started recently-- she will be completely in command of her intellect, reason,  and words, and will speak of deep thoughts in sentences and paragraphs. I don't know if these days are final rallies, or what! Every time I see her, she wants (justifiably) to "get out of this awful place". Bro and I have pretty much decided she is subconsciously contemplating death. 

Posted: Thursday, October 10, 2019 1:43 PM
Joined: 4/24/2019
Posts: 2

I experienced the beginning and then rapid progression of aphasia with my father about a month ago. It was one of the most difficult parts of this entire process, losing most of the ability to communicate(as if it wasn't hard enough to begin with). This disease ebbs and flows, they will always have good days and bad days, moments of clarity. I have found (and I am sure each person is very different) that telling him "I'm not sure but I'll look into it!" or "I'm working on it, it will be taken care of soon" tends to ease his concern. When that didn't work a simple redirection usually solved it. Any sort of change of topic or distraction. You will probably need to start relying a lot more on physical communication and hand gestures as well. Words become near to impossible to articulate, but in my experience responses to hand gestures and body language have still somewhat stuck around. "They may not remember what you said, but they will remember how you made them feel." I try not to ever let my frustrations or feeling of defeat show, always focus on smiling and being cheerful and positive.
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