Your healthcare team
Treating a patient with aphasia takes several team members who are all medical professionals. Your treatment plan and healthcare team will depend on what type of aphasia you have, underlying conditions, and other factors.
Learn more about some of the healthcare providers that may be part of your team.
Speech-language pathologist
What is a speech-language pathologist?
A speech-language pathologist, or SLP, is a licensed health professional who works with patients with communication challenges. Your SLP will be the person who diagnoses the type of aphasia you have through a series of tests.
SLPs focus on prevention, assessment, diagnosis, and treating issues related to speech, language, social communication, cognitive communication, and swallowing. They treat both adults and children.
What issues do SLPs treat?
An SLP’s main goal is to establish achievable communication goals for you. He or she will do this by evaluating, diagnosing, and treating the issue.
Common disorders that an SLP may evaluate and treat include speech disorders, language disorders, swallowing disorders, and some cognitive issues. These may include:
- Non-verbal and limited verbal skills: People with severe aphasia, apraxia of speech, dysarthria, expressive language, and voice disorders struggle with communicating their needs, wants, thoughts, and feelings. These individuals typically benefit from augmentative and alternative communication systems.
- Receptive Language Disorder: Difficulty comprehending communication. For example: The inability to follow directions.
- Expressive Language Disorder: Trouble using language to express one’s thoughts and feelings. For example: Making a request, asking a question, labeling an object, or giving simple directions.
- Pragmatic Language Disorder: Struggling to effectively and appropriately use language in social communication. For example, responding appropriately in social situations.
- Cognitive and Memory Difficulties: Difficulty remembering important information, completing steps in a task, or how to solve problems.
- Swallowing Difficulties: Difficulty chewing and swallowing food, liquids, and pills. Swallowing disorders are often caused by stroke, head and neck cancer, surgical complications, or other disorders that impact the brain and muscles of the mouth and throat.
What role does an SLP play in treating aphasia?
Speech-language pathologists (SLPs) play a central role in screening, assessing, diagnosing, and treating people with aphasia. SLPs working with clients often help with all of the following:
- Teaching other professionals about the needs of people with aphasia and the role of SLPs in diagnosing and managing aphasia
- Screening individuals who present with language and communication difficulties and determining the need for further assessment and/or referral for other services
- Conducting culturally and linguistically relevant, comprehensive assessments of language and communication
- Diagnsing the presence or absence of aphasia
- Referring clients to other professionals to rule out other conditions and to facilitate access to comprehensive services
- Designing and implementing person-centered treatment plans
- Working collaboratively with the patient and treatment team
- Counseling people with aphasia and their families regarding communication-related issues
- Consulting with other professionals to facilitate program development and to provide supervision, evaluation, and/or expert testimony, as appropriate
- Advocating for individuals with aphasia and their families
Occupational and physical therapist
What is an occupational therapist?
An occupational therapist (OT) is a licensed healthcare professional who works to help you do everyday activities (called “activities of daily living,” or “ADLs”). They focus on physical, developmental, social, and mental challenges.
What is an OT’s role in treating aphasia?
OTs do not treat aphasia, but may treat the other physical effects that come from what caused the aphasia, such as a stroke or brain injury. Many stroke survivors experience changes in their physical, cognitive, and emotional abilities that make daily activities related to work, school, parenting, or leisure difficult. OTs collaborate with patients, families, and caregivers to determine which activities are necessary, meaningful, and/or relevant to them.
This can include:
- Helping patients reacquire self-care skills
- Teaching adaptive tasks that help the person to safely perform activities of daily living (ADLs)
- Addressing ongoing deficits such as weakness, sensory loss, and cognitive or visual impairments
- Community reintegration and modifying tasks or environments
- Training in the use of assistive technology, to maximize independent ADLs
- Performing work-related task analysis and work site evaluations, and recommending modifications as needed
- Evaluating and treating swallowing difficulties
- Developing coping strategies to support psychosocial health, well-being, and self-care
- Teaching and promoting healthy lifestyle habits and routines to minimize the risk of a subsequent stroke
- Developing strategies to overcome barriers to sexual intimacy
- Providing driving readiness evaluations and any necessary equipment recommendations
What is a physical therapist?
A physical therapist (PT) is a licensed healthcare professional who focuses on how your body moves. They will examine, diagnose, and treat your physical symptoms with exercise programs and hands-on therapy (like massage) to help reduce pain and restore your ability to use your body.
Physical therapists (PTs) are an important part of a stroke rehabilitation team. They are specially trained in treating disabilities related to motor and sensory impairments.
PTs help with problems with movement and balance. They teach their clients exercises to strengthen muscles for walking, standing, and other activities. PTs employ a wide range of tools and techniques that help build muscle mass, improve range of motion, and increase endurance.
What is a PT’s role in treating aphasia?
PTs do not treat aphasia, however they may treat other side-effects from what caused the aphasia, like a stroke or brain injury. Strokes and brain injuries often cause weakness or loss of function on one side of the body. This is called hemiparesis. PTs use strategies to encourage the use of impaired limbs. When evaluating a stroke survivor, PTs will assess:
- Strength
- Endurance
- Range of motion
- Gait abnormalities
- Sensory deficits
From their assessment, PTs will create an individualized rehabilitation program aimed at targeting the stroke survivor’s impairments. Rehabilitation plans may focus on:
- Regaining the use of impaired limbs
- Teaching compensatory strategies to reduce effects of deficits
- Establishing ongoing exercise programs to retain learned skills
Case managers and social work
What are case managers and social workers?
A case manager is like a coordinator for someone with health concerns. They cannot provide medical treatment, but they can keep track of the patient’s medical needs and who should be providing services. They work to ensure that the treatment plan is met. They can help link you with medical services and other related needs. Case managers often work for a hospital or clinic, though they can also be employed by the insurance company.
A medical social worker provides social services to someone who is receiving medical treatment. This can include planning for discharge from the hospital, arranging for in-home help, and counseling. A social worker can help connect you with resources you need to move forward. Medical social workers have degrees in social work and complete internships in medical settings.
What roles do caseworkers and social workers play in aphasia recovery?
Case managers and social workers can provide services like:
- Communicating with doctors and therapists about the treatment plan
- Finding transportation
- Connecting you to support groups
- Advocating for the patient’s needs
- Coordinating with insurance
- Getting necessary medical and adaptive equipment for the home
Even if you have a large, supportive family, case managers and social workers are still important. They can keep various needs organized and are often aware of potential challenges that your family might not have thought of yet.
If you have less support from your family, case managers and social workers are even more important. They are like a safety net to ensure that all patients are connected with the resources they need. If you have any concerns about how you will meet your needs once you leave the hospital, talk to your social worker.
Neurologist and cardiologist
What is a neurologist?
A neurologist is a physician (doctor) that is specially trained in the brain and nervous system. Because a stroke causes injury to the brain, neurologists often work with people who have had strokes. Neurologists can do brain testing, manage symptoms, and recommend treatments to reduce the risk of a future stroke.
What is a cardiologist?
A cardiologist is a physician (doctor) that is specially trained in the heart and cardiac system. This includes all the veins, arteries, and blood vessels that carry blood around the body. Because a stroke involves the blood flow to the brain, a cardiologist is likely to be involved in your healthcare team.
What roles do cardiologists and neurologists play in treating aphasia?
Neurologists and cardiologists do not treat aphasia. However, they do treat the underlying conditions that may have caused the stroke that caused the aphasia. Your neurologist might take scans, or pictures, of your brain to see where there is damage. A neurologist might also test things such as your coordination, sensation, vision and reflexes. This helps to determine how your brain works.
Neurologists do not do brain surgery. If you need brain surgery, you will be referred to a neurosurgeon. Neurologists also work with a variety of other conditions, such as Parkinson’s, multiple sclerosis (MS) and brain infections.
If you meet with a cardiologist, they will likely start with a physical examination. The doctor might order additional testing like blood work, an X-ray, or more advanced testing to look at your heart’s function. A cardiologist will not perform heart surgery. If you need heart surgery, you will work with a cardiac surgeon.
Both of these doctors are very important members of your healthcare team because of their specialized training. They can do testing, manage symptoms, and perform procedures that your family doctor cannot do. With their help, you can learn more about your health and how to stay as healthy as possible in the future.
Dietitians and Nutritionists
What are dietitians and nutritionists?
Dietitians and nutritionists are healthcare professionals who focus on helping you balance your eating preferences with a diet that’s healthy for you.
They both have education and training in the same areas. However, dietitians usually have additional licenses that allow them to be called a dietitian. Because of this, they often have more formal training and education requirements.
If your doctor has referred you to work with someone on your diet, it will likely be a registered dietitian (RD).
What roles do dietitians and nutritionists play in treating aphasia?
Depending on your health history and medical conditions, a special diet might be recommended for you. These diets can help regulate your blood pressure, blood sugar, and cholesterol, among other things. Some common diets include low sodium, low fat, and low sugar.
You might have a special diet that doesn’t fit exactly into a label. Either way, your dietitian can teach you what foods to eat and how much of them to eat. They can help you to know when it’s okay to have a treat and when it’s most important to cut back. They can teach you about specific foods and provide recipes that will fit into your diet.
Dietitians make recommendations about what you should eat based on nutrition and your medical needs. However, you might also see a speech-language pathologist (SLP) about what food consistencies are safest to eat. This recommendation will be based on any swallowing difficulties you have. For instance, an SLP might recommend that you eat foods that have been pureed or drink liquids that have been thickened. Your SLP and your dietician can work together to identify foods that meet all your needs.
Nurse practitioners
What is a nurse practitioner?
Nurse practitioners are nurses who have additional advanced training. There are general nurse practitioners, similar to a family doctor or general practitioner. Nurse practitioners can also specialize in a certain area, like adult health or women’s health. Nurse practitioners are trained to promote overall health, disease prevention, and lifestyle choices.
Although nurse practitioners are not physicians, they are able to perform many of the same roles. In many states, nurse practitioners can serve as a patient’s primary caregiver. They can provide referrals and prescribe medication as needed. However, some states limit what a nurse practitioner can do.
What role do nurse practitioners play in aphasia recovery?
In some cases, you may choose to see a nurse practitioner instead of a doctor. Nurse practitioners can fill the gap when doctors are in high demand. This is especially true in rural areas where there is a shortage of doctors. They can help reduce the cost of healthcare and are often more available than doctors. If you need a last-minute appointment, your doctor might ask if you will see a nurse practitioner instead. Nurse practitioners do not treat aphasia, but they do treat the underlying conditions that may have caused the stroke.
Research shows that nurse practitioners are highly trained and qualified. If your healthcare team includes a nurse practitioner, you can feel confident you will receive high quality care from them. Just like a doctor, they will also refer you to someone else if they do not have the expertise to meet your needs.
What to ask your provider
Often the first time we speak to a provider about aphasia, it can be rushed, overwhelming, or intimidating. It’s a good idea to prepare a list of questions for you or your loved one’s provider.
Here is a list of helpful questions that a group of care partners for adults with aphasia created:
- How long will my loved one have aphasia?
- Is there a cure for aphasia?
- Will my loved one talk again?
- Will my loved one regain his/her physical functions?
- What is the difference between aphasia and apraxia?
- What are the next steps for my loved one?
- Can I leave my loved one alone?
- What does each professional on his/her healthcare team do?
- What treatments are available for aphasia and which do you recommend?
- What services are available for my loved one (therapy, home health assistance, etc.)?
- Are there ways to help my loved one understand others or communicate more effectively?
- What resources do you have for support groups in the area?
