As a 67-year-old stroke survivor and registered nurse, I’ve experienced caregiving from both perspectives. In 2020, I had a medullary stroke that altered my communication, not by impairing my speech, but by causing me to pause mid-sentence to gather my thoughts. These pauses stem from the stroke’s impact on neural pathways connecting the medulla to higher brain areas involved in language processing, subtly slowing my ability to organize and express ideas. At 67, age-related changes, like reduced cognitive processing speed and working memory, amplify this effect, making it harder to quickly retrieve words or structure complex thoughts. Though brief, these pauses have reshaped my social world—not because of the pauses themselves, but because others often finish my sentences, assuming they know my intent. Sometimes they’re right, but more often, their words miss my meaning, leaving me frustrated and unheard. This has driven me to prefer writing, where pauses don’t invite interruption, allowing me to express thoughts on my terms. I’m pursuing a bachelor’s degree in nursing, and it being online, I thankfully don’t have to speak. It’s all writing, which suits me much better. My experience might provide some guidance for caregivers: letting clients speak at their own pace is essential for their dignity and connection.
A Nurse’s Perspective, A Survivor’s Reality
As an RN, I’ve cared for many clients, often those with communication challenges. Though I no longer practice hands-on nursing, my years in the field shape how I view care. I used to finish clients’ sentences, thinking I was helping them express themselves. I now see those moments differently. After my stroke, I pause to organize my thoughts, not because I’m confused, but because my brain needs a moment to process. When someone jumps in to “help” by completing my sentence, it feels like my voice is stolen. When their words don’t match my meaning, I’m left correcting them or abandoning my thought, which is exhausting. Over time, this frustration has pushed me toward silence, leading to social isolation.
Writing has become my refuge. Unlike speaking, where pauses invite others to interrupt, writing lets me take as long as I need to express myself clearly. In my studies, I rely on written assignments, which avoid the pressures of real-time conversation. But not everyone has this option, and many stroke survivors or clients with neurological conditions face similar challenges in daily interactions. A pause doesn’t mean we’re stuck—it might mean we’re processing, choosing words, or managing fatigue. For me, the medullary stroke subtly slowed cognitive pathways, and at 67, age may amplify this. The real barrier, though, is others’ haste, not my pauses.
The Cost of Being Interrupted
When someone finishes my sentence incorrectly, it’s more than a miscommunication—it feels like I’m not trusted to speak for myself. Each interruption erodes my confidence, making me question whether it’s worth speaking at all. Social settings, once enjoyable, now feel daunting. I’ve withdrawn from conversations, not because I can’t talk, but because I dread being misheard. This isolation isn’t just emotional—it’s a health concern. Research shows social connection aids recovery and mental health for stroke survivors, yet communication barriers can trap us in silence.
As a nurse, I didn’t realize my actions might have made clients feel this way. I recall clients who spoke slowly or paused, and I’d step in, thinking I was easing their effort. Now I wonder if they felt as I do—silenced or dismissed. Caregivers have immense power to shape how clients see themselves. A moment of patience can affirm their autonomy; a moment of haste can undermine it.
A Call to Caregivers: Pause and Listen
Caregivers, your instinct to help is vital, but sometimes the best help is giving space. Here are ways to support clients who pause or speak slowly, drawn from my experience:
- Wait Before Speaking: Resist finishing a client’s sentence, even if their pause feels long. Count to five silently if needed. This gives them time to find their words and feel in control.
- Check, Don’t Assume: If you think you know their meaning, ask gently instead of stating it. Try, “Are you saying…?” or “Take your time, I’m here.” This respects their intent.
- Watch for Frustration: A sigh or frown might mean their words were misinterpreted. Ask, “Did I get that right?” to clarify without escalating tension.
- Foster Safety: Show you value their thoughts with nods, eye contact, and minimal distractions. A calm setting reduces pressure and builds trust.
- Guide Others: In group settings, model patience and redirect interruptions from family or friends. Explain that pausing is part of their process, not a flaw.
These tips apply beyond stroke survivors to anyone with communication challenges, from Parkinson’s to dementia. Patience preserves their dignity and encourages connection.
A Lesson for Caregivers
I wish I’d known as a practicing nurse what I know now as a survivor. My pauses don’t define my ability to think or feel—they’re a small part of my communication. When caregivers and loved ones give me time to speak, I feel valued. When they don’t, I retreat, and my world shrinks. Writing and studying have given me outlets, but conversation remains a challenge.
Caregivers, you can make your clients’ world bigger. By letting them speak at their own pace, you affirm their worth and help them stay connected. It’s a simple act with profound impact—one I’m grateful for every time I’m given the space to say what I mean.