Functional therapy

The longer I provide therapy, the more I wonder: what is truly functional communication? Obviously, we all want to help people with aphasia communicate what they really want to talk about. But what is that?

I sometimes joke that workers in nursing homes and hospitals don't really want their patients to talk. It is much easier to just go in, "do for" the patient, and walk out. No arguing, no complaining, no negotiating!

Many people with aphasia don't have to ask to have their basic needs met. Someone will bring food and water, assist them to wash and dress, and provide for other essential needs, whether they ask or not. So what do they really need to communicate?

One family had a person with aphasia who went out and walked around the neighborhood. They didn't know where she was going or when she would be back. Of course, I didn't know exactly where she was going, either! To try to address the family's concern, I took some photos of destinations in the neighborhood and gave the pictures to the person and family.

Another gentleman eats whatever is put in front of him. He looks eager to talk when the subject of politics comes up.

The same man used a wheelchair and went out every day. His aide wanted some way that he could tell her where he wanted to go each day.

I do try to give some way of indicating family members, whether a picture or a written name, so that the person with aphasia can inquire about family members.


What do you find is truly functional communication?