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Raising the Bar in Rehab


Published April 2, 2009 7:32 AM by Lisa Catenacci
Alright, let's talk about how you handle non-verbal patients. 

I have twice experienced working with patients with expressive aphasia.  The first patient, at my last clinical experience, was a recent CVA (within three weeks from the time he was admitted to the rehab department).  During his rehab stay, he increased his verbalizations greatly- saying fragmented sentences and increasing his vocabulary daily.  The first few days of therapy he would nod or shake his head appropriately, and towards the end of my clinical he would say "I used to work with trucks," or "I'd like to walk."  It was very interesting to see such drastic improvement in a considerably short period of time. 

Fast forward to my current clinical...I had an evaluation yesterday with a woman who was 8 years post-stroke, and essentially nonverbal.  She makes a "Choo-choo" sound, similar to a train, when she is trying to express herself, but otherwise can make no understandable sounds.  She nods and shakes her head appropriately to questions, and does a fairly good job of using gestures throughout the session. 

So, what can you do? For the lady, is there any chance she will talk again?  You look in her eyes and can see such a warm heart, desperately trying to communicate with others.  I think that's the hardest part for me, that there is virtually nothing I can do for her, except put my arm around her and say, "I know this is hard, but I will do everything I can to understand what you are trying to say."  And after I say that, she cries.  

If you have any tips, ideas or past experiences you would like to on the little "comment" link below and leave a message.  I'd love to hear what you have to say!



Thank you for your kind message.  I will utilize the strategies you mentioned to help connect with my patients.  

Lisa Catenacci April 3, 2009 2:01 PM
Chandler AZ

Hey Liser,

I have had TONS of patient's who are non-verbal.  A lot of people my patient's are on vents and whatnot.  Anyway, we try our hardest to develop ways to communicate.  I had a kid with an SCI on my last rotation who we used blinking (once for yes, twice for no).  With some lower SCI patients who are on vents, you can have them write stuff down.  You can try having patient's squeeze your hand.  I guess it really comes down to what kind of aphasia they have or what is causing them to be non-verbal.

Call me.  (Is that inappropriate for blogging?)


Mike Kelley April 2, 2009 9:04 PM
Greenville NC

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