This week, the focus of my blog entry is on the impact HIV/AIDS has on language and speech. Since the start of my time volunteering at the Dr. Peter Centre, one of the biggest learning curves for me is learn how to communicate with the residents. To this day, one of the things I still struggle with is being able to fully understand what some of them are speaking about. There is a huge amount of variability in the ways people speak. Some people talk “normally”, while many talk very slowly or quickly. Often, spoken thoughts would resemble a “word salad”, as they appear to be random and very jumbled. At many times, I effortfully partake in the conversation by asking questions based on what I think they are trying to say. I would also ask them to repeat what they have just said. Sometimes, I fall into the trap of nodding my head, replying with “okay” or “yeah”, even though I had no idea what they just said. I realize it’s not the greatest thing to do, but I want to make the person I’m speaking to feel listened to and valued. The nursing staff sure don’t seem to have much difficulty comprehending everyone’s speech, as it appears that they have accustomed to everyone’s quirkiness.
After a quick Google and UBC Library search, I have found several articles that raise some points I have never considered. Quoting directly from an article by Krikorian and Wrobel, “the cognitive deterioration served in patients with HIV infection and AIDS represents one of the most debilitating manifestations of HIV-related disease” (1991). More recent research supports the authors’ claims. According to Lin et al. (2011), HIV has been linked to cognitive impairment. Since HIV can spread to brain cells, it can result in damage to the central and peripheral nervous systems (Matthew and Bhat, 2007). Consequently, it has been shown to cause significant impairment in high order brain functions (Lin et al., 2011).Through structural and functional brain imaging, the effects HIV include the loss of white and gray matter volumes (Lin et. al, 2011). Additionally, decline starts in the early stages of infection. Matthew and Bhat note that people living with HIV may have difficulties with speech, language, cognition, and swallowing (2007). Other observations of other functional changes include generalized mental slowing and intellectual deterioration (Krikorian and Wrobel, 1991). Personally, I don’t think many people consider the effects HIV/AIDS can have on the brain. Speaking for myself, I always associate HIV/AIDS with topics such as physiological deterioration, motor impairment, transmission, and the immune system.
The effects of not being able to communicate at a level previously available to some of the residents can take a toll on their overall wellbeing. A couple weeks ago, one of the residents had a high ankle sprain in which he had to wear a cast for. When I was speaking to him, he expressed his frustration over the cast and how it was digging into his leg. However, the message didn’t get across without difficulty on my part trying to comprehend what he was trying to say. Because of the communication difficulties, there was a delay in having the nursing staff adjust his cast in order to alleviate his discomfort. It’s the little things that really make a difference, as stress associated with communication difficulties can really pile up. Because of this, I think it’s even more important for me to be a good listener. In some sense, this relates back to last week’s post; specifically, regarding one of Maslow’s hierarchy of needs- esteem.
References
Krikorian, R., & Wrobel, A. J. (1991). Cognitive Impairment in HIV Infection. AIDS (London, England), 5(12), 1501-07. doi:10.1097/00002030-199112000-00013
Lin, K., McArthur, J., Morgello, S., Simpson, D., Collier, A. C., Marra, C., . . . CHARTER Group. (2011). Effects of Traumatic Brain Injury on Cognitive Functioning and Cerebral Metabolites in HIV-Infected Individuals. Journal of Clinical and Experimental Neuropsychology, 33(3), 326-34. doi:10.1080/13803395.2010.518140
Matthew, M., & Bhat J. (2007). Voice Disorders in HIV-Infected Individuals. International Journal of STD & AIDS, 18(11), 732-35. doi: 10.1258/095646207782212306
