Communication Breakdown: A Snowball set in Motion
As my dad got older, he lost his hearing. Even with a hearing aid, he still missed a lot of words.
Almost every exchange went like this:
Mom: Would you like something to drink?
Dad: What?
Mom: Would you like something to drink?
Dad: One more time?
Mom: Would you like something to drink?
Dad: I can't hear you!
Mom: Never mind!
But what I really noticed wasn’t the hearing part. It was the frustration and distance it created.
Challenges with word finding after a brain injury can have the same impact as hearing loss on personal and professional relationships.
People who have word-finding issues are sensitive about it. And they go to great lengths to avoid drawing attention to it.
People with aphasia (you’ll see why I used this medical term for word-finding in a moment) tend to "dumb-down" their speech. It helps to reduce uncomfortable pauses.
But words that aren't used are forgotten. And it’s easy for vocabulary—particularly at the edges—to erode.
People with post-concussive issues also tend to steer around the use of proper nouns. Proper nouns can be tough to access. And that’s embarrassing.
Sidebar: Anomia is a species of aphasia that makes it difficult to find words or name objects, even when the person can describe them.
Regular speech starts resembling speech to text where everything is simplified and non-specific. The word “thing” is used as a substitute for more descriptive words.
But even with adaptations, problems arise.
Sometimes the inability to find a word is mistaken for failure to complete a thought. Being misunderstood is frustrating. And people with brain injuries are self-conscious.
Small pauses can escalate into big issues. People withdraw and become isolated. Not physically isolated, but no longer part of the conversation. As the culture at home, work, or in friend groups evolves, people are left behind. They’re on the outside looking in.
Loneliness is an epidemic in the United States. The Surgeon General released a General Advisory calling attention to the public health crisis of loneliness, isolation, and lack of connection in our country.
This represents a dangerous convergence of factors for a community of people who already have a higher risk of dementia due to mTBI.
And all of this needs to be considered when calculating someone’s loss. Word finding is part of it. But I think isolation is a much bigger-ticket item.