Hope for people with communication disorders

"Despite my heavy schedule, I’m happy to share; I realize that that’s also another important aspect of our work.”

Close up of a man using mobile smart phone (photo credit: INGIMAGE)
Close up of a man using mobile smart phone
(photo credit: INGIMAGE)
Victims of strokes, accidents and debilitating illnesses often suffer from an inability to express themselves, converse with others and make themselves understood. Imagine the frustration and aggravation when you’re trying to tell a family member or a caretaker that you’re cold or that you want a drink of water, and this person can’t fathom what you want.
The inability to express oneself is called aphasia, and there is now a special center in Jerusalem called the Mike and Elaine Adler Center for Communication Disorders, located on the Hadassah College campus, where aphasia patients and their families learn alternative ways of communicating.
The able founder and director, Daphna Olnick, and her devoted staff established the center nine years ago.
Olnick and her assistant, Meirav Revah, are speech pathologists. They are assisted by students in that field and by volunteers who often are from different professions entirely.
“We want to establish a community among our clients here,” explains Olnick. “We have discussion groups, outings, interest groups – like photography, Bible classes, art, technology – and many parties.”
The underlying philosophy at the center is to accent the strengths of the participants, not their handicaps.
“We don’t deal just with language rehabilitation, but take into consideration the entire person and his family; it’s a holistic, social approach,” Olnick calls it.
How do they achieve their goal? Members of the staff use a range of methods to help the patients deliver their message and understand spoken language: white boards, on which the patients or their therapists can write out what they want to communicate, and iPads and tablets, on which they learn how to cut and paste sentences if their writing is also impaired.
There are posters and cards with pictures to aid in expression. No doubt the social interaction among peers who find themselves in the same situation is an especially effective tool.
WHEN A patient with aphasia leaves a rehabilitation ward or clinic, the health services usually provide up to 12 sessions of speech therapy a year.
“That’s never enough,” says Olnick, who adds that at the Adler Center, clients can be treated for an indefinite time.
Spouses and, sometimes, adult children are also roped into the rehabilitation and social network. There are lectures and group discussions for family members, where they not only learn about aphasia, but pick up tricks of the trade on how to continue the communication improvement process at home.
“It’s been a real life-saver for me,” says Hedva, the wife of a 45-year-old mechanic who had a stroke three years ago and still has difficulties talking.
“I’ve learned how to understand him without using words,” she says. “I’ve become much more patient, and I get so much support from the other women in our group.”
The discussion groups are generally composed of patients with the same degree of impairment, but members come from every walk of life.
Behind a one-way mirror, I observe one such group of five men with severe aphasia, ranging in age from 45 to 80. Most have been coming to the center for three or more years. Olnick is leading the group, with two speech therapy students serving as volunteer facilitators.
The participants shuffle into the room, several using a walker or a cane. They are all smiling and are greeted warmly by Olnick and the volunteers. Each has his personal communication tool (e.g., a white board, a tablet or an iPad).
Olnick explains to the group that she won’t be with them for the next two weeks, as she is going abroad. The two facilitators write this out on a white board for those who can’t understand what she is saying, and they nod.
She explains that she will be meeting with donors, and again the message is related to some of them by white board.
A discussion then begins as to whether the newest member of the group might benefit from an iPad.
Chaim disagrees by shaking his finger, but Moshe expresses the view that it would be very helpful, although he needs help from the staff members, who make his monotone sentences understandable.
“What do you do with your iPad?” Olnick asks a man with a mustache. He can’t really answer, but through the process of elimination and with the white board, they go through the options – games, e-mail, YouTube – and he nods emphatically when they get to YouTube.
Olnick asks the others for their opinion.
Ephraim is able to talk haltingly.
“[I use the iPad] to talk here in the group,” he says.
“Do you use it to explain things at home, too?” asks the volunteer.
Ephraim says no.
“You’re really improving,” Avery tells him. Moshe agrees, with an emphatic shake of his head.
“We’re all improving,” he says.
They laugh freely and in comradeship. Ephraim looks pleased, “For 10 years I was zero, nothing, but now I’m improving,” he states.
Joel, an English speaker, says very slowly and haltingly: “I do use the iPad at home. The iPad helps me remember the names of the children.”
He repeats three names slowly and carefully.
“What use do you make of the iPad at home?” Olnick asks.
Everyone gives the others time to answer at their own pace, and again there’s a long pause until, finally, Joel is able to respond, though with much effort.
“Old photos, mail, and here I use it instead of speech,” he says.
Ephraim indicates that he wants to say something, and points to Avery.
“You help me a lot. You all help me,” he says, as he wipes his eyes in an emotional moment.
Chaim is trying to say something, but no one is able to understand him except one of the volunteers. He’s very excited when she realizes that he wants to say that he uses the iPad to read the newspaper. He can’t say more than “yo, yo” for “no, no,” but when he spreads his arms as if holding a newspaper, he’s nodding his head and seems to feel great to be understood.
The group then discusses the newspapers they read.
Once again, it’s difficult to decipher Chaim’s choice, but because he is the only haredi member of the group, Olnick soon gets to his choice by process of elimination.
Once more, he is beaming. He’s been understood. He’s part of the discussion.
THE CENTER is a non-profit organization associated with Hadassah College. It receives referrals from all over the country, but for budgetary reasons is limited in the number of participants it can accept. Some of its budget comes from government agencies, foreign and local donations, and also membership fees. Those who can afford to do so pay NIS 75 for each session.
The unique program the Adler Center has developed for aphasia patients, and the obvious strides in quality of life for clients and their families, make it an ideal model to be duplicated elsewhere in Israel, and even abroad.
“The Adler family introduced us to a communication rehabilitation clinic that they used in New Jersey when a member of the family suffered from aphasia, and we’ve now modified and adapted it to Israeli society,” says Olnick.
“Now, we’re constantly being visited by clinicians and administrators who want to learn and emulate. Despite my heavy schedule, I’m happy to share; I realize that that’s also another important aspect of our work,” she says. 
The writer is a veteran geriatric social worker and co-founder of Melabev, an organization for Alzheimer’s care. She is now organizing courses on aging for professionals and support groups for family members coping with dementia.