AAC can be new to Medical professionals
Successful conversation with Augmentative and Alternative Communication (AAC) users is a skill that takes practice and is rarely taught in the course of medical training. However, doctors, nurses and many other medical professionals will have occasion to meet AAC users in their workplace. This guidance is written for them.
A communication aid is a system or device used by people who have difficulties with speech. It is one element in the broad field of AAC.
AAC is the term used to describe various alternative methods of communication when people have no speech or speech which is difficult to understand. Some AAC tools “add on” to verbal communication – simple methods such as pictures, gestures and pointing.
What to do if a person is admitted to hospital with a communication aid.
First, remember that the communication aid is a vital piece of equipment and it belongs to the person – it is not a toy.
They need to be able to access it. Hospital staff must not lock it away for “safe keeping”. You don’t need to know how the aid works, but you do need to listen to what the person is saying via the aid.
Some communication aids speak with an electronic, computerised voice. Don’t be afraid to say that you can’t understand the electronic voice as it can take a bit of time to “tune in” to it. Sometimes it can be difficult to hear an electronic voice in a noisy environment. It is okay to:
- Ask the person to repeat what they said
- Ask them if you can read the text on the screen
Security - what can you do?
You don’t have to lock communication aids away to keep them secure. What you can do is;
- Check any equipment is clearly named in case it gets misplaced.
- Inform the person in charge of the ward about the aid.
- If an aid is being charged overnight, check who is responsible for it.
Acknowledge Problems
If the communication aid doesn’t work or if you have difficulties with it, contact the family/carer or the Speech and Language Therapy Department.
Conversation can be challenging
In any medical or nursing setting, you may come across someone whose speech is difficult for you to understand.
There might be times when you wonder whether the person is able to fully understand what you are saying.
This section is about people who have speech, language or communication difficulties due to a condition. This could be MND, MS, brain injury, stroke, cerebral palsy, learning disability, etc. Here are some tips and guidelines to make communication easier – for the person and for you.
Conversation can take longer
If possible allocate a double appointment to someone with communication difficulties; they will be more relaxed, you won’t feel rushed and you are more likely to gain a fuller case history, etc.
Speak in short, clear sentences and avoid jargon
If the person is able to read, write down key words on a piece of paper as you are speaking. Use gestures, pictures and props to demonstrate what you are saying, if appropriate. If you are talking about specific procedures, they may find photographs of the procedures easier to understand. It may be time-consuming to create the photographs, but they could be useful for others. Similarly, a simple diagram may explain a procedure much clearer than speech. You could also add specific gestures to what you are saying, such as pointing with your thumb to the upper arm to indicate an injection.
Conversation with people with little or no speech
If the person has no speech, or speech that you find virtually impossible to understand, you might find these techniques helpful:
- Ask questions where the person only has to answer “yes” or “no”
- If this is too hard for them, ask how they usually indicate “yes” and “no”
- Ask them: “Show me how you say YES. Show me how you say NO.”
- Some techniques might be blinking once for ‘yes’ and twice for ‘no’, looking up for ‘yes’ and down for ‘no’, head nod/shake, thumbs up/down, pointing to ‘yes’/’no’ symbols, etc.
Ask the person if they have any alternative method to support their speech:
- Can the person write? If so, offer them a pen and paper to support their speech.
- Can the person spell? If the person is unable to write, write the letters of the alphabet on a piece of paper and ask them to spell out what they are saying by pointing to the letters. If they can’t manage this, you can point to letters in sequence, asking them to indicate when you reach the desired letter. It helps to have a pen and paper handy to write down the letters as they are dictated.
- Do they have a communication aid? Encourage them to use it.
When the conversation breaks down
If the person appears to be trying to communicate something to you and you simply don’t understand, then try the following three questions:
Who are we talking about?
List the main people involved in the person’s care, slowly so that they can indicate when you have said the correct person.
Where are we talking about?
List the key events and places that the person has gone through, slowly so that they can indicate when you have said the correct place.
