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Tip of the Month – August 2014 – working with communication aids

This month’s Tip of the Month comes from Community Speech Language Therapist Robyn Gibson from North Shore Hospital in Auckland.  She created a fantastic information sheet to be included in generic nurse training around disability awareness within the hospital.  It provides a lovely overview of what AAC communication aids are and how to use them.  She also created a resource providing general tips and strategies for working with individuals with communication difficulties.  These resources can be printed out for nurses, rest home, private hospital staff and anyone else working with adults with communication difficulties. We think this is a fantastic resource to share with anyone working with individuals who have communication difficulties as a result of stroke, traumatic brain injury, intellectual disability, cerebral palsy, motor neurone disease or dementia.  Thanks Robyn!


Working with communication aids

Some people use augmentative or alternative communication (AAC) aids. There are lots of types of communication aids.

Some involve a computer or other machine that someone uses to communicate:

totm aug pic

How to work with someone who uses a communication aid

  •  Firstly, make sure that the communication aid is within easy reach of the person who uses it! If it is kept in a cupboard or out of reach, the person may not be able to communicate with you at all.
  • Establish a way that they can indicate to you that they want their aid/want to say something.
  • If it is an electronic device, make sure that it is switched on and plugged in/well charged.
  • Make sure you know how the person indicates yes and no – with or without the aid. If they can do this without the aid, it might be nodding/shaking their head, a different gesture, using their eyes etc.

If the person uses the aid to help them understand what you say, then use it as you say each sentence, for example:

  • Write key words on the piece of paper
  • Show the picture/image of what you’re talking about
  • Write or show the options to answer a question, for example, If the person uses the aid to help them to tell you something,

totm aug2

  • Give them plenty of time to use the communication aid to show you their answer/type or write an answer.
  • Try not to anticipate what they are going to say or finish the sentence for them.
  • Be honest if you don’t understand what they are telling you.
  • If you are providing options for them to choose, include ‘something else’ as an option in case they think of something that you haven’t thought of!\
  • Only give options that are available – for example don’t offer coca cola to drink if you don’t have any.

Please write down any key information about how that person communicates and have this clearly displayed at their bedside so all staff and visitors can see.

Supporting patients with communication difficulties

Communication difficulties happen for lots of different reasons. Someone may have had a communication difficulty for a long time or it may be very new to them. Some communication difficulties affect the way people process their thoughts, find words and understand what is said to them e.g. as a result of a stroke, traumatic brain injury, intellectual disability, dementia or delirium. Some communication difficulties mean that the person knows exactly what they want to say but the muscles for voice or speech don’t work effectively, e.g. as a result of cerebral palsy, motor neurone disease  or stroke. Some communication difficulties can be a combination of both of these and can be exacerbated by hearing or vision changes. If the communication difficulty has been present for a long time, the person or their family/whanau may be able to show you the best way of communicating with them.

When you are working with someone with a communication difficulty, the most important question is:                               How do they usually communicate?

  •  Can they tell me what they need?
  • Do they need me to ask the right question?
  • Do they use pictures/writing/drawing to communicate?
  • Do they use a computer or other aid to communicate?
  • Can they show me using facial expression or gesture?
  • Can I express what they need by their behaviour?

Asking questions

  1.  First, ask open questions e.g. ‘What would you like to drink?’
  2. If they find it difficult to answer, ask a closed question or give choices, e.g. ‘Would you like a hot drink or a cold drink?’ ‘Would you like tea or coffee?’
  3. If they find it difficult to answer from choices, ask questions that need a ‘yes’ or ‘no’ answer, e.g. ‘Would you like tea?’ ‘Would you like water?’
  4. You could also hold up the options e.g. holding up the box of tea bags and the jar of coffee so they can show you which one they want.

General communication tips

  •  Keep what you say straightforward. If you use idioms/metaphors/sarcasm, be aware that not everyone will understand this.
  • Use common words and phrases – if you need to use a medical term, explain what it means.
  • Use a good speaking pace (slower, but not patronising).
  • Make sure the person can see your face – if possible, sit at eye-level and in front of them/on their good side if they have a visual impairment.
  • Have important conversations in a quiet place.
  • Be patient! Give people lots of time to process the question and think of their answer.
  • Be honest if you don’t understand.
  • Check that they have understood what you have said.
  • Repeat and/or rephrase what you have said if they haven’t understood.

It is important to include people with communication difficulties in conversations and decisions, even if this is difficult for them.

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Jessamy Amm
I am passionate about providing the right communication solution for clients and their families, whether it is giving advice on strategies or making recommendations about low or high tech communication systems. Another area of interest is helping to provide students with access to a comprehensive communication system in order to support development of their literacy skills.
Jessamy Amm

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