Living without Language

By Etelka Froymovich, RN, BSN, MHA

July 14, 2010

“I did not have the ability to think about the future, to worry, to anticipate, or to perceive it. . . I simply existed.” These are the words of clinical psychologist Scott Moss, describing being temporarily struck without the power of language after suffering a stroke. According to Moss, being without the power of speech effectively destroyed his power to think in abstract terms. Essentially, he was unable to communicate not only with others, but also with himself.

Scott Moss was suffering global aphasia. Aphasia, which afflicts one million people nationwide, according to the National Aphasia Association, is an impairment of language skills, usually caused by a stroke or head trauma. Receptive aphasia is an inability to comprehend language, whereas expressive aphasia is an inability to use language to communicate. Global aphasia is a combination of receptive and expressive aphasia. The conventional wisdom is that severe aphasia destroys a person’s sense of self, often requiring that the person be institutionalized for the rest of his or her life.

Case studies show, however, that aphasia is not necessarily the end to an individual’s personality or social life. Nor do all people suffering from even severe global aphasia need to be institutionalized. In fact, a long-term care facility may be counterproductive to making progress. Dr. Oliver Sacks writes, in The New Yorker, of aphasics in nursing homes and long-term hospitals: “A vital social dimension of their lives is missing, and aphasics frequently feel intensely isolated and cut off.” He further describes the feeling of entering a hospital for the chronically ill, full of “incurable” people and how demoralizing that must be for a new “inmate.”

Instead of placing a loved one with aphasia into a longterm care facility, a more appropriate alternative may be home health care. The good news is that in a proper setting like the home, many aphasics have been able to regain their former, fulfilling lives. Though recent studies show that the brain can repair itself better than previously thought and that different areas of the brain can take over some functions lost by other areas, improvement is mostly through learned compensation for lost language skills. With intensive speech therapy and, in some situations, physical and occupational therapy, many can get around aphasia by learning new ways to communicate.

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