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Helpful Resources

Advance Directives

What kind of medical care would you want if you were too ill or hurt to express your wishes? Advance directives are legal documents that allow you to spell out your decisions about end-of-life care ahead of time. They give you a way to tell your wishes to family, friends, and health care professionals and to avoid confusion later on.

A living will tells which treatments you want if you are dying or permanently unconscious. You can accept or refuse medical care. You might want to include instructions on:

  • The use of dialysis and breathing machines
  • If you want to be resuscitated if your breathing or heartbeat stops
  • Tube feeding
  • Organ or tissue donation

A durable power of attorney for health care is a document that names your health care proxy. Your proxy is someone you trust to make health decisions for you if you are unable to do so.

NIH: National Cancer Institute

Aphasia

What is aphasia?

Aphasia is a language disorder that makes it hard for you to read, write, and say what you mean to say. Sometimes it makes it hard to understand what other people are saying, too. Aphasia is not a disease. It's a symptom of damage to the parts of the brain that control language.

The signs of aphasia depend on which part of the brain is damaged. There are four main types of aphasia:

  • Expressive aphasia is when you know what you want to say, but you have trouble saying or writing your thoughts.
  • Receptive aphasia affects your ability to read and understand speech. You can hear what people say or see words on a page, but you have trouble making sense of what they mean.
  • Global aphasia is the loss of almost all language ability. You can't speak, understand speech, read, or write.
  • Anomic or amnesia aphasia is when you have trouble using the right words for certain things, people, places or events.

In some cases, aphasia may get better on its own. But it can be a long-term condition. There's no cure, but treatment may help improve language skills.

What causes aphasia?

Aphasia happens from damage to one or more parts of the brain involved with language. The damage may be from:

  • Stroke, which is the most common cause of aphasia
  • Brain tumor
  • Brain infection or inflammation
  • Brain injury
  • Other brain disorders or neurologic diseases that affect the brain and get worse over time, such as dementia
Who is more likely to develop aphasia?

Anyone can have aphasia at any age, but most people with aphasia are middle-aged or older. Most aphasia happens suddenly from a stroke or brain injury. Aphasia from a brain tumor or other brain disorder may develop slowly over time.

How is aphasia diagnosed?

If a health care provider sees signs of aphasia, the provider will usually:

  • Test the person's ability to understand language and speech. This includes asking questions and checking to see if the person can follow simple commands.
  • Order an imaging scan to see if there's a brain injury and what part of the brain is damaged. Possible tests include:
    • MRI
    • CT scan

If imaging shows signs of aphasia, more tests may be needed. These tests measure how much the brain damage has affected the ability to talk, read, write, and understand. In most cases, the tests are done by a speech-language pathologist or speech therapist (a specialist who treats speech and communication disorders).

What are the treatments for aphasia?

Some people fully recover from aphasia without treatment. But most people should begin speech-language therapy to treat aphasia as soon as possible.

Treatment may be one-on-one with a speech therapist or in a group. Therapy using a computer may also be helpful.

The specific therapy depends on the type of language loss that a person has. It may include exercises in reading, writing, following directions, and repeating what the therapist says. Therapy may also include learning how to communicate with gestures, pictures, smartphones, or other electronic devices.

Family participation may be an important part of speech therapy. Family members can learn to help with recovery in many ways, such as:

  • Using simpler language
  • Including the person with aphasia in conversations
  • Repeating or writing down key words to help communicate more clearly

How much a person recovers depends on many things, including:

  • What caused the brain injury
  • What part of the brain was hurt
  • How badly and how much of the brain was hurt
  • The age and health of the person
Can aphasia be prevented?

You can help prevent aphasia by:

  • Making heart-healthy lifestyle changes to lower your chance of having:
    • A stroke
    • Heart disease
    • Vascular disease (problems with your blood vessels)
  • Protecting your brain from injury:
    • Wearing the right helmet for sports safety, such as when riding a bike
    • Taking action to prevent falls
    • Always wearing your seatbelt and driving safely

NIH: National Institute on Deafness and Other Communication Disorders

Assisted Living

Assisted living is housing and services for people who need some help with daily care. They may need help with things like dressing, bathing, taking their medicines, and cleaning. But they do not need the medical care that a nursing home provides. Assisted living allows the residents to live more independently.

Assisted living facilities sometimes have other names, such as adult care facilities or residential care facilities. They vary in size, with as few as 25 residents up to 120 residents or more. The residents usually live in their own apartments or rooms and share common areas.

The facilities usually offer a few different levels of care. Residents pay more for the higher levels of care. The types of services they offer may be different from state to state. The services may include:

  • Up to three meals a day
  • Assistance with personal care, such as bathing, dressing, eating, getting in and out of bed or chairs, moving around, and using the bathroom
  • Help with medicines
  • Housekeeping
  • Laundry
  • 24-hour supervision, security, and on-site staff
  • Social and recreational activities
  • Transportation

The residents are usually older adults, including those with Alzheimer's or other types of dementia. But in some cases, residents may be younger and have mental illnesses, developmental disabilities, or certain medical conditions.

NIH: National Institute on Aging

Brain Diseases

The brain is the control center of the body. It controls thoughts, memory, speech, and movement. It regulates the function of many organs. When the brain is healthy, it works quickly and automatically. However, when problems occur, the results can be devastating.

Inflammation in the brain can lead to problems such as vision loss, weakness and paralysis. Loss of brain cells, which happens if you suffer a stroke, can affect your ability to think clearly. Brain tumors can also press on nerves and affect brain function. Some brain diseases are genetic. And we do not know what causes some brain diseases, such as Alzheimer's disease.

The symptoms of brain diseases vary widely depending on the specific problem. In some cases, damage is permanent. In other cases, treatments such as surgery, medicines, or physical therapy can correct the source of the problem or improve symptoms.

Caregivers

A caregiver gives care to someone who needs help taking care of themselves. The person who needs help may be a child, an adult, or an older adult. They may need help because of an injury or disability. Or they may have a chronic illness such as Alzheimer's disease or cancer.

Some caregivers are informal caregivers. They are usually family members or friends. Other caregivers are paid professionals. Caregivers may give care at home or in a hospital or other health care setting. Sometimes they are caregiving from a distance. The types of tasks that caregivers do may include:

  • Helping with daily tasks like bathing, eating, or taking medicine
  • Doing housework and cooking
  • Running errands such as shopping for food and clothes
  • Driving the person to appointments
  • Providing company and emotional support
  • Arranging activities and medical care
  • Making health and financial decisions

Caregiving can be rewarding. It may help to strengthen connections to a loved one. You may feel fulfillment from helping someone else. But caregiving may also be stressful and sometimes even overwhelming. You may be "on call" for 24 hours a day. You may also be working outside the home and taking care of children. So you need to make sure that you are not ignoring your own needs. You have to take care of your own physical and mental health as well. Because when you feel better, you can take better care of your loved one. It will also be easier to focus on the rewards of caregiving.

Dept. of Health and Human Services Office on Women's Health