Bruce Willis, the Emmy-winning actor and star of the “Die Hard” movies and blockbuster hits “The Sixth Sense” and “Pulp Fiction,” just announced he has been diagnosed with aphasia. His family members announced the diagnosis on March 30, writing that they vow to make the most of every day.
“We are moving through this as a strong family unit, and wanted to bring his fans in because we know how much he means to you, as you do to him,” ex-wife Demi Moore wrote in her Instagram post. “As Bruce always says, ‘Live it up,’ and together, we plan to do just that.”
Other actors, directors and producers expressed their love and concern for Willis, a popular and well-liked member of the entertainment community. In a tweet, Gabrielle Giffords, the former congresswoman and gun control advocate who suffered a brain injury in a mass shooting in 2011, said, “I’m thinking of Bruce Willis and his family today. Aphasia makes it hard for me to find the right words. It can be lonely and isolating. To everyone living with aphasia, I’m here for you. You’ve got this.”
What is aphasia?
As a condition that affects your ability to communicate verbally and in writing, aphasia makes it difficult to express yourself and understand those talking to you.
Aphasia comes in three types:
- Expressive aphasia: Known as Broca’s or nonfluent aphasia, this type of aphasia is when comprehension is more manageable than speaking. This type affects how people talk in order to be understood by others. For example, a person might say, “Take shower,” or “Go store today.” Because those with this form of aphasia are aware of their inability to speak in complete sentences, they can become frustrated when trying to communicate. This type is also sometimes associated with paralysis or weakness.
- Comprehensive aphasia: Also known as fluent or Wernicke’s aphasia, those with this kind can speak in full sentences—but what they say doesn’t make sense to the listener. They may misuse words or make up words that don’t mean anything, and they often don’t understand others or realize others can’t understand them.
- Global aphasia: Resulting from extensive damage to the brain’s language centers, global aphasia is the most severe form of the disease. People with this type have very poor comprehension or speaking skills.
What causes aphasia?
Most often, aphasia occurs after a one-time event such as a stroke or severe head injury that affects the blood flow to the brain, but it can also be the result of a brain tumor or neurodegenerative disease. Sometimes people will experience temporary aphasia because of severe migraines or a transient ischemic attack (TIA).
Brenda Rapp, a cognitive scientist at Johns Hopkins University, told Barron’s, “The brain system governing language is a ’very complex machine’ that involves selecting the right words, moving the mouth appropriately to vocalize them, and on the other end hearing and decoding their meaning.”
Symptoms of aphasia
Brain episodes such as TIAs and strokes – known as “silent strokes” – can happen without visible signs, and aphasia may be the first sign of a stroke or other brain injury. Take your older adult to a doctor immediately if any of these behaviors develop:
- Speaking in incomplete sentences that are short and hard to understand
- Putting words together that don’t make sense
- Confusing words or sounds of letters when speaking
- Using nonsense words
- Difficulty understanding what others are saying
- Writing incomprehensibly
Diagnosis and treatment of aphasia
After a general checkup (and often an MRI as well), the doctor will do a test to evaluate how the patient’s brain is working. The Mayo Clinic lists a number of tests involved in an evaluation of aphasia, which will challenge the individual to complete a number of tasks:
- Name common objects
- Engage in a conversation
- Understand and use words correctly
- Answer questions about something read or heard
- Repeat words and sentences
- Follow instructions
- Answer yes-and-no questions and respond to open-ended questions about common subjects
- Read and write
Treatment is categorized in two ways: Impairment-based treatments focus on fixing what isn’t working through physical therapy and behavioral therapy to restore the patient’s abilities to understand and speak successfully. This type of in-office therapy is supplemented with at-home exercises that are often computer-based and focus on word-finding and reading comprehension.
Communication-based therapy employs compensatory strategies for interacting with others, including accessing remaining language skills and building on those to develop communication skills for expressing wants and needs.
Tips for communicating with family members with aphasia
When communicating with someone with aphasia, the most important thing you can do as a caregiver or family member is to be patient with them. You’ll need to give them your full attention when they’re speaking and resist the urge to correct their grammar, the words they use, or other ways they misspeak. The goal is not perfection; it’s comprehension.
Here are some ways you can help those with aphasia communicate more easily:
- Repeat back to them what you believe they’re saying. For example, if your loved one says “cup coffee,” you can say back, “Do you want a cup of coffee?”
- Communicate directly and succinctly in short and easily understandable sentences.
- Use facial gestures and touch to inform and reinforce what you’re saying, and let them know you understand what they’re saying.
- Ask yes-or-no questions and keep them simple. Instead of asking, “Do you want a ham and cheese sandwich or tuna salad for lunch,” say, “I’m making you a ham and cheese sandwich for lunch. Does that sound good?”
Aphasia, as with any brain injury or disorder, changes a lot about how a person lives and how those around them live. For Bruce Willis, the support of his extended family will likely make it easier for him to enjoy his life, even while he deals with this condition. If you’re dealing with a loved one with aphasia, the Willis family is an excellent example of how to face the challenges positively and honestly.
For more information about aphasia, visit the National Aphasia Association online.