The Art of Conversation with Aphasia Research
What is the problem?
Stroke rehabilitation should enable people to live the best lives they can. Significant predictors of living well with aphasia in the first 12 months post-stroke include the size of a person’s social network and the absence of low mood. In the longer term, living successfully is promoted by independent participation in the community. People with aphasia report long-term needs around communication outside the home, creating a personally meaningful role and maintaining support networks. The need for social connection and meaningful activity are common threads across stakeholder consultations.
What do we know already?
Current WHO, NHS and public health agendas promote the use of art and creativity in healthcare. There is a recognised need for multiple approaches to health and wellbeing including evidence-based community-centred approaches harnessing local assets and resources to reduce health inequalities (Public Health England, 2015). This links to NHS agendas in patient partnership, patient-centred care and social prescribing. Organisations such as the Arts Council England are working to support the NHS move towards Integrated Care Systems, where voluntary and community partnerships support the delivery of local healthcare.
Current Project
The Art of Conversation with Aphasia (ACA) is a group intervention blending two established and evidenced approaches, communication partner training and community arts engagement. A proof of concept project was funded by UCL Innovation and Enterprise from 2020-2021 as part of an initiative targeting health and wellbeing disparities on the south coast of England. ACA involved UCL, Say Aphasia (a charity run by and for people with aphasia) and the De La Warr Pavilion, an East Sussex arts centre. We coproduced all aspects of the project with people with aphasia and family members, speech and language therapists and a community artist.
We explored the promise of the ACA intervention, carrying out a before and after study with five communication dyads (a person with aphasia and a family member/friend) using self-report measures of conversation, the Aphasia Impact Questionnaire, and qualitative interviewing. As this was during the Covid-19 pandemic, ACA was delivered over Zoom, presenting an opportunity to reflect on delivery methods. After ACA, participants reported more enjoyable conversations where they used their targeted communication strategies weekly whilst feeling less isolated. ACA promoted conversations about new and wide-ranging topics, people enjoyed the creative activities, group delivery promoted social bonding and confidence, and art made people forget about their aphasia. Participants reported “art…different things to talk about than stroke” and “we used art to explore how we work together”.
ACA shows promise as a community-based intervention with wellbeing benefits that enables PWA and family/friends to develop communication strategies to navigate conversations, while engaging in meaningful activity and forging social connections. Speech and language therapist Dr Firle Beckley and artist Nikki Hafter continue this work through Lemonade from Lemons, a Community Interest Company.