RULE 43

About the design of a customized system of forty-two icons to help AM, my stepfather— who suffers from aphasia because of a stroke—to communicate. It is also about a personal experience and it is about the creation of possibilities. The system of icons was designed according to the individual’s needs, and taking into consideration his level of education, age, background, personal interests, personal objects, and preferences for styles, among other considerations. It was also designed according to the needs of the caregiver.
To understand the project, it is necessary to understand the individual and the family situation. AM was seventy-two years old when he suffered the stroke. He used to be a lawyer, specializing in legislation, and in the history of the Constitution. Although retired, AM was still working as a consultant. One of his hobbies was reading,’and the subjects of the books that he read were usually related to his profession. His professional life, however, ended after the stroke.
As a result of the stroke, AM suffers from Broca’s aphasia, a nonfluent aphasia. Individuals with this kind of aphasia have their speech reduced to a few words, which are produced with effort, When trying to articulate a sentence, the effort is such and the result is so poor, usually just one or two words, that the individual becomes tired and frustrated. Auditory comprehension in AM is good, and he can “participate” in a conversation by just listening, but he is not able to respond to questions or to make comments. It is not that he doesn’t want to, he can’t. He is able to talk on the phone, answering with brief sentences (for example, “hello,”“I feel fine”).
In the case of AM, the right side of the body is also affected. Even though the arm is not paralyzed, it has become weak. Writing is also affected, and he is not able to sign a form, but he is able to do a mark. His reading comprehension is generally good, and he is able to read the titles in the newspaper, but not a complete article. In general, “ . . . individuals rarely read for recreation because of the slowness and the effort required” (Goodglass, 210), His ability to gesture is lost, To survive the stroke, AM had to have surgery in a main neck artery, and after the surgery he needed to avoid moving his head and neck for a brief period.
The whole family situation is altered because the individual should not be left alone. If he needs something, he is not able to communicate his needs by phone or to explain his situation. Someone has to be at home to care for him. Because of the weakness in his right arm, for example, AM is not able to prepare his own lunch.