Using Family Members or Close Friends as Informants About Participation Goals for Older Adults With and Without Aphasia

Client-centered care is a stated focus for many rehabilitation programs, but personalized goal-setting presents unique challenges for people with aphasia (PWA). A potential solution for clinicians is to enlist the help of family members or close friends to determine what life activities should be addressed. In this article, we review two main reasons this solution is not ideal. First, we discuss how negative effects on autonomy and motivation may be instigated unintentionally. Next, we consider to what extent accurate input can be assumed by proxy responders. We conclude by reporting the results of a small study showing that congruence about activity choices among family members or friends not affected by aphasia is similar to previously reported congruence in families with a history of aphasia. These results suggest that ability to predict life activity preferences in others is limited, regardless of the presence of aphasia. We contend that although the input and participation of significant others is of...