Nurse Kristine is trying to communicate with a client with brain attack (stroke) and aphasia. Which of the following actions by the nurse would be least helpful to the client?
A. Speaking to the client at a slower rate.
B. Allowing plenty of time for the client to respond.
C. Completing the sentences that the client cannot finish.
D. Looking directly at the client during attempts at speech.
Correct Answer: C. Completing the sentences that the client cannot finish.
Clients with aphasia after brain attack (stroke) often fatigue easily and have a short attention span. The nurse would avoid shouting (because the client is not deaf), appearing rushed for a response, and letting family members provide all the responses for the client.
Option A: Talk directly to the patient, speaking slowly and distinctly. Phrase questions to be answered simply by yes or no. Progress in complexity as the patient responds. Reduces confusion and allays anxiety at having to process and respond to large amounts of information at one time. As retraining progresses, advancing complexity of communication stimulates memory and further enhances word and idea association.
Option B: Speak in normal tones and avoid talking too fast. Give the patient ample time to respond. Avoid pressing for a response. Patient is not necessarily hearing impaired, and raising their voice may irritate or anger the patient. Forcing responses can result in frustration and may cause the patient to resort to “automatic” speech (garbled speech, obscenities).
Option D: General guidelines when trying to communicate with the aphasic client include speaking more slowly and allowing adequate response time, listening to and watching attempts to communicate, and trying to put the client at ease with a caring and understanding manner.
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