Brain damage caused by an accident, stroke or disease that takes away someone’s ability to speak can be devastating for both the person and their family. You can feel like they’re a million miles away unable to speak or hear you.

If your loved one has experienced speech loss you may be reluctant to visit with them, not know what to do or say or question if they can hear you at all. Through brain scans, experts have discovered that even people with no signs of awareness are often able to understand and absorb what people are saying to them. You can and should communicate with your loved one but your methods will depend on the person and their level of responsiveness.

To help you better communicate with your non-verbal loved one make sure you:

• Act inclusive. Never assume that your loved one can’t understand what is being said. Don’t say anything that you wouldn’t want them to hear and always respect their privacy. Include them in your conversations, even if they can’t speak or appear to not understand. Don’t ignore your loved one in a group and, whenever possible, continue normal activities like dinner with family or visits from friends.
• Always introduce. Start your conversations by introducing who you are and why you’re there. If someone comes to visit or care for your loved one you should also introduce them by name and explain what they are here to do. Although this may be painful it can do wonders for recognition and shows your loved one a level of respect they deserve.
• Don’t be condescending. You should be using everyday words and simplifying your sentences, but make sure you speak to your loved one like an adult and not a child. Watch your tone of voice and try to sound natural instead of patronizing. Actively show your love one that you believe in their inner competence.
• Watch your mood. Your loved one may be very sensitive to nonverbal cues like facial expressions, mood and tension so consider how you’re presenting yourself. If you’re feeling angry, stressed or upset it may not be a good idea to visit with them that day. If you make a point of being relaxed and smiling, your positivity may even rub off on your loved one.
• Reduce distractions. During conversations try to minimize or get rid of background noise all together. Things like phones, television, radio, street traffic or other conversations will make your attempts to communicate less effective. Even moderately impaired people can ‘overload’ on background noise and wind up feeling overwhelmed and unresponsive.

Talking without Words

Try other, non-verbal ways of communicating with your loved one. Don’t rule out speech but experiment with writing, pictures, hand motions, eye contact and facial expressions. Try to look for clues on how your loved one is feeling based on body language so you can recognize if they’re tired, frustrated or experiencing other uncomfortable emotions. Use these alternatives:

• Communication boards. This tool displays the alphabet, common words or phrases and pictures to represent them. You can create your own communication board to customize it to specific needs or they can be purchased. Your loved one may be able to use the board to spell words or point to pictures to communicate a feeling or idea. A therapist may be able to help your loved one use the board more effectively if their movement is restricted, they can’t spell or have very limited communication skills.
• Yes or no questions. If your loved one can understand questions but can’t answer verbally, try asking ‘yes’ or ‘no’ questions. Choose a gesture for yes (head nod, eye blink etc.) and a gesture for no (shake of the head, hand squeeze etc.). Keep your sentences really simple so they only have to focus on one thought at a time. If you’re having a problem figuring out their answers, don’t get frustrated. Any response is a step forward.
• Use pictures, objects and writing. Draw pictures for your loved one to show them what you’re trying to say. Refer to maps, calendars and clocks when you’re explaining where or when and photographs when you’re talking about someone. Experiment with printing key words in large, clear letters as you’re having the conversation. Even if you’re loved one shows no sign of recognition or response, continue to communicate with them this way, showing familiar faces and places can trigger positive reactions.

Experiment with these different methods on top of their regular therapy to see which gives you the most response. You may find that a combination of several tactics is your best approach.

Other Ways to Connect

You don’t need to fill every single moment with your own words while with your loved one. There are lots of other ways to communicate and connect that don’t require words at all. Try these methods:

• Music: Listening to music can be very soothing, healing and comforting. Keep a CD or MP3 player in their room for when people aren’t around and experiment with singing and dancing when you are. Watch for reactions and see if it’s well received. You may feel like you’re reaching your loved one on some level.
• Reading: Reading with someone who can’t speak is a great way to be with him or her, regardless of whether they respond to you. Find out what they enjoyed reading before their speech loss. Get comfortable and read out loud at a good pace. Your loved one will likely know that you’re there with them and may even enjoy the story.
• Touch: Although it’s not for everyone, your loved one may respond well to touch. Start by gently holding their hand and watch for body language. Although they may not be able to squeeze you back, see if they seem relaxed or startled and withdrawn. If they respond well, a light massage may be a great way to connect.

You don’t have to do or say anything to bond with your loved one. Just sitting and looking out the window together can communicate a thousand words. The worst thing you can do is stay away because you don’t know what to do or say. A person who can’t speak is left extremely vulnerable. Be on the lookout for body language clues that tell you how they’re feeling or responding to your efforts. Figure out their likes and dislikes and offer the pleasure of your company in any way you can.