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The High Price of Aphasia

For stroke survivors coping with aphasia, the costs can be personal, professional, and financial.

Many stroke survivors are left with complicated communication problems,that make everyday interactions difficult. An estimated 30 percent of stroke survivors experience aphasia, a particular speech disorder, during the initials days after stroke. Individuals with aphasia frequently experience difficulty either expressing themselves (expressive aphasia) or understanding others (receptive aphasia). They often must also cope with difficulty reading, writing and finding the right words when speaking.

The Costs of Aphasia

A recent study of Medicare beneficiaries that experienced a stroke found that the cost of aphasia itself was approximately $1700 more than the cost of experiencing just a stroke. Healthcare costs paid by Medicare on behalf of stroke survivors with aphasia was for rehabilitation services received in hospitals, nursing homes, outpatient facilities, home health care agencies and from healthcare providers and for durable medical equipment. These costs represent only a fraction of the financial burden to stroke survivors with aphasia their families.

The cost of caring for stroke survivors with aphasia can be classified into two categories:

  • Direct costs (those that result from receiving healthcare services).  Examples are:
    • Hospital speech-language pathology services
    • Home health speech-language pathology services
    • Inpatient and outpatient speech-language pathology services
    • Medications
    • Durable medical equipment
  • Indirect costs (those that are harder to measure but related to loss from the condition). Examples are:
    • Lost income
    • Lost productivity (reductions in work load or underemployment)
    • Lost societal roles
    • Divorce
    • Caregiver burden

In addition to these direct and indirect expenses of stroke-related aphasia, many costs are not initially obvious. For example, stroke survivors who require speech-language pathology and other rehabilitation services are faced with co-payments and transportation to therapy expenses even when they have adequate insurance coverage for their therapy needs. Individuals with aphasia can also experience problems returning to work because of changes in their communication abilities.  Some stroke survivors with aphasia may only able to return to work on a part-time basis, while others are forced to change their type of job, which can result in large reductions in earnings.

Hidden Costs of Aphasia

There are also hidden costs that are very difficult to quantify. Indirect costs such as loss of societal roles (singing in a church choir, involvement in parent-teacher associations, community volunteering) can be substantial but hard to measure. Some stroke survivors with aphasia experience divorce and other family stressors.

The hidden cost of aphasia does not apply to just those with aphasia. Their spouses and other family members involved in the care of the individual with aphasia can also experience losses.  Spouses and other family members who serve as caregivers during stroke rehabilitation can experience significant strain and burden which is oftentimes not considered when measuring the indirect cost of aphasia.

To find financial assistance to help with the costs of recovery and rehabilitation in your area visit the Stroke-Network resource directory.

By: Charles Ellis, PhD CCC-SLP, Associate Professor at the Medical University of South Carolina

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"A recent study of Medicare beneficiaries that experienced a stroke found that the cost of aphasia itself was approximately $1700 more than the cost of experiencing just a stroke."

Aphasia has many costs associated with its treatment and recovery. Direct financial costs are only a part of the burden associated with aphasia. Stroke survivors and their families also face the indirect costs that occur over the course recovery.

Direct Costs

  • Hospital Costs
  • Speech-Language Pathology Costs
  • Medication Costs

Indirect Costs

  • Lost income
  • Lost productivity
  • Caregiver burden
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