The impact of having a stroke with resulting aphasia on social relationships can be considerable. Studies have found that following a stroke, people take part in fewer social activities, contact with friends and the wider network is vulnerable, and increased strain is placed on the family unit. Those with aphasia may be particularly likely to experience negative social consequences. Analysis of blog posts written by those with aphasia may provide an ‘insider’ perspective on how these social changes are perceived and the consequences for everyday life.
Aphasia can affect all aspects of communication and can thus potentially have a profound impact on how a person experiences both family life and interaction within the wider network. There is evidence that those with aphasia experience a constriction of their social network, and have smaller networks than age-matched controls. There is also evidence that those with aphasia take part in fewer social activities than controls and see their friends, relatives and social acquaintances less frequently than prior to the stroke. Hilari and Northcott (2006) explored the social experiences of 83 people with chronic aphasia, and found that 64% reported that they saw their friends less than prior to the stroke and 30% reported having no close friends at all. In a study comparing the experiences of those with and without aphasia at around one year post stroke, it was documented that while all stroke survivors were at risk of losing contact with friends, aphasia posed specific challenges. In particular, those with aphasia experienced the most hurtful negative responses from others, and were more likely to report feeling abandoned or rejected by pre-stroke friends. The consequence of this reduction in the social network is that many describe feelings of loneliness and exclusion.
Contact with family members has been found to be more robust than contact with non-kin following stroke and aphasia. However, there is evidence that having a stroke can cause significant deterioration in family functioning in the months following discharge from hospital. The qualitative aphasia literature also describes the disruption to the 5 family unit, and new tensions in the marital relationship. Distress associated with lost roles and new dependence on family members, particularly the spouse, has been well-described. Language difficulties have been reported to make it harder to negotiate these shifts in family dynamics, and can take away a source of comfort.
There is evidence that poor social support, loss of friends and reduced social participation post stroke are associated with a number of adverse psychosocial outcomes. In a recent systematic review looking at factors predictive of health-related quality of life for people with aphasia, social factors such as poor support and reduced social network were found to contribute to poor health-related quality of life in 3/4 studies. A number of stroke studies have documented a significant association between depression and social factors such as loneliness and low satisfaction with social network; few social contacts outside the house; poor family functioning; and low perceived social support.
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Fotiadou D., Northcott S., Chatzidaki A., & Hilari K. (2014) Aphasia blog talk:
How does stroke and aphasia affect a person’s social relationships?
Aphasiology, 28, 1281-1300