Supporting Autonomy for People with Aphasia: Use of the Life Interests and Values (LIV) Cards

Abstract

Background: People with aphasia (PWA) are frequently disregarded as reliable respondents because their language problems may restrict their responses to oral and written questioning. Consequently, family members are often asked to speak on their behalf. The Life Interests and Values (LIV) Cards are a nonlinguistic, picture-based instrument designed for communicating directly with PWA about their current and desired life activities. Purpose: The goals of this study were to (1) explore utility of LIV Cards for interviewing PWA and (2) examine congruence between responses of PWA and proxies. Method: Study participants were 10 PWA with varying language and cognitive abilities and 10 family member proxies. Both groups participated in LIV Card interviews to identify current and preferred activities of the PWA. Core interview times for the PWA and percentage of selected activities for 4 activity categories were calculated, as was item-by-item response congruency between PWA and proxies. Results: All 10 PWA completed LIV Cards interviews in 45 minutes or less. There were individualized response patterns regarding activity participation and preferences. Mean point-to-point agreement between PWA and their proxies was 74% for current activities and 71% for activity preferences of the PWA. Conclusions: PWA were able to provide information about their current and preferred involvement in life activities through use of the LIV Cards. Family members did not predict activity choices and desires of PWA with full accuracy. The LIV Cards appear to be a viable tool for setting goals and discussing life priorities of PWA.

Keywords:

• aphasia
• communication
• life participation
• self-determination
• stroke