Right Hemisphere Stroke: Changes in Thinking & Response

Right hemisphere strokes change how survivors process conversations & respond. Learn why & get practical caregiver strategies for better communication

Right Hemisphere Stroke: How Thinking & Response Change

When a Simple Question Becomes Complicated

Sometimes, he seems like his pre-stroke self. He laughs at the right moments, carries on conversations, and everything feels normal. But then, there are times when you ask a question, and he just stares back. No response.

At first, you think he didn’t hear you. So you ask again. Still nothing. Or worse—his response doesn’t fit the conversation at all.

This is a common reality for families after a right hemisphere stroke. It’s not about hearing loss or memory—it’s about how the brain now processes and responds to information differently.

In this article, we’ll explore:

✅ How the right hemisphere processes information
✅ Why stroke changes communication, response, and personality
✅ How care partners can support understanding & reduce frustration

Let’s start by looking at why these changes happen in the first place.

Right vs. Left Hemisphere: How They Differ

Most people associate stroke with speech and language difficulties, which typically happen after a left hemisphere stroke. The left hemisphere is where language is usually processed, so when it’s damaged, it often leads to aphasia—making it difficult to find words, form sentences, or understand language.

However, a right hemisphere stroke affects a different set of cognitive functions, including:

Processing conversations beyond just words
Understanding humor, tone, and implied meaning
Recognizing emotions in facial expressions and voices
Spatial awareness, attention, and organization of thoughts

Because of this, someone with a right hemisphere stroke may still speak fluently but struggle with processing meaning, keeping up with conversations, and responding appropriately in social situations (Flint Rehab).

Why Right Hemisphere Stroke Changes Understanding & Response

Let’s go back to the dinner invitation example. You ask, “Do you think we should invite Betty and Jim to dinner?” and get no response—or a reaction that doesn’t make sense.

Here’s what might be happening inside the survivor’s brain:

🔹 Processing Delay – Their brain is working harder to make sense of what was said, causing a delay in response.

🔹 Focus on the Wrong Detail – Instead of understanding the question fully, they might latch onto one part—maybe “Sunday”—and get stuck trying to recall what’s happening that day.

🔹 Difficulty Switching Gears – If they were focused on something else, like watching TV, it may take longer to shift attention to the conversation.

🔹 Literal Thinking – The ability to interpret implied meaning, sarcasm, or humor may be impaired (MedBridge).

These challenges go beyond just understanding words—they affect the ability to follow social cues, interpret conversations, and respond naturally.

Personality & Emotional Changes After a Right Hemisphere Stroke

Right hemisphere strokes often come with shifts in personality and behavior, which can make conversations feel even more different than before. Some common changes include:

⚡ Impulsivity – Survivors may interrupt, blurt out thoughts, or struggle with turn-taking in conversations.

😐 Reduced Emotional Expression – Their voice may sound flat or emotionless, even when they care deeply about something.

🧩 Anosognosia (Lack of Self-Awareness) – Some survivors don’t realize they are responding differently or struggling to process conversations (Hopkins Medicine).

💬 Literal Thinking – They may miss humor or take figures of speech literally. If you say, “It’s raining cats and dogs,” they may look outside, expecting to see animals falling from the sky.

These changes can be confusing for care partners, but understanding why they happen is the first step to improving communication.

How Care Partners Can Help

If you’re a care partner, you might feel like you’re repeating yourself more often, or that your loved one isn’t responding the way they used to. Here’s how you can support them without frustration:

✅ Give More Time – If they don’t respond immediately, pause for a few seconds before repeating yourself. Their brain may need more time to process.

✅ Be Direct & Clear – Instead of saying, “Do you think we should invite Betty and Jim?”, try: “I’d like to invite Betty and Jim to dinner on Sunday. Does that sound good?”

✅ Reduce Distractions – If they’re focused on the TV or another task, pause or get their attention first.

✅ Use Visual Cues – Sometimes gesturing or writing things down can help with understanding.

✅ Check for Understanding – Instead of asking, “Did you get that?”, ask “Can you tell me in your own words?” This helps you know if they caught the full meaning.

✅ Be Patient with Emotional Differences – If they seem indifferent or blunt, remind yourself—it’s not personal. Their brain is processing emotions differently now.

By learning these strategies, care partners can reduce frustration, improve communication, and strengthen relationships.

To learn more about this topic, listen to episode #138 of the Listen for LIFE Aphasia Podcast.

📢 Final Takeaways & Free Resources

Right hemisphere strokes affect how people process and respond to information—changing the way they engage in conversations and social interactions.
These changes can impact understanding, emotional expression, and personality—often in ways that are hard to recognize at first.
Care partners can help by being direct, slowing down, and checking for understanding—while also learning how to navigate personality shifts with patience and support.

💡 Recovery is always possible! If you or a loved one are navigating stroke recovery, we have free resources to help:

📌 For Stroke Survivors: Get practical strategies to support ongoing recovery. Download 3 Key Reasons Aphasia Progress Never Stops today!

📌 For Care Partners: Caregiving is tough, but you don’t have to do it alone. Our free 5-day email course, From Chaos to Clarity, offers practical steps to help you find balance and connection.

💙 A Special Thanks to Our Sponsor – LIFE Aphasia Academy®
At LIFE Aphasia Academy®, we empower stroke survivors and care partners with tools for communication success.