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Madonna Rehabilitation Hospitals

During COVID-19, communication is key for those with complex needs

April 30, 2020

The ability to communicate has never been more necessary than now during the COVID-19 pandemic. Just as we are finding alternative ways to stay connected with family and friends, health care providers are turning to innovations that allow them to communicate with patients who face challenges with verbal communication due to breathing difficulties, sudden intubations and/or the inability of their loved ones to be present to assist. Communication experts at Madonna Rehabilitation Hospitals are continually adapting to patient needs and ensuring each individual has the effective tools they need to stay in contact with their care team and loved ones.

“This is where augmentative and alternative communication (AAC) comes in” said Dr. Susan Fager, AAC researcher and director of the Communication Center in the Institute for Rehabilitation Science and Engineering at Madonna Rehabilitation Hospitals. “There are many strategies, techniques and resources available to help our front-line health care providers communicate with patients suffering emergent events.”

Dr. Fager and her research team have been involved in the development of numerous AAC technologies and strategies. Madonna’s front-line workers regularly utilize these practices to communicate with individuals recovering from various acquired injuries and illnesses including stroke, spinal cord or brain injury, ALS and Guillain-Barre syndrome. But AAC methods are also useful for more temporary conditions, such as being unable to talk due to a tube being placed in the airway to assist with breathing during COVID-19 or other illnesses. Incorporating tools including simple eye gaze responses, partner-assisted scanning and communication boards help patients to express themselves and communicate with their health care providers.

“It is critical that we empower our health care providers to support these patients during this critical period in the recovery process,” Fager said.

Some important AAC strategies for health care providers to use with non-speaking patients include:

  • Yes/no responses- use simple/intuitive responses first (head nods). Other ways for patients to indicate yes/no include thumbs up/down or eye blinks.
  • Use eye gaze to communicate messages posted on clear/plexiglass boards
  • Communication boards with pictures/words/alphabet boards can be used to help patients communicate a wide range of messages from quick, urgent needs to detailed questions related to their treatment.
  • Keep questions simple/concrete and interactions short. Give the patient time to respond (pause) between questions.
  • Speak slowly and at appropriate volume. Use gestures and other cues in the environment to supplement the patient’s comprehension.
  • Explain all procedures. Repeat information as needed.

“It is important to be aware, educated, and prepared to promote effective communication in this unprecedented time,” said Erica Sandell, M.S. CCC-SLP, a speech language pathologist for Madonna’s outpatient Rehabilitation Day Program. “It is one of many roles of a Speech-Language Pathologist to identify a patient's communication needs and recommend the best low or high tech AAC device to sufficiently meet those needs.”

For those individuals experiencing aphasia or for those with language comprehension or expression disorders, it’s important to keep AAC strategies on hand even after leaving the hospital. Being prepared for an emergent medical event, for example, can ease the event and ensure the individual will be able to communicate with the health care team.

“Simple AAC strategies will allow individuals to have a voice in many situations ranging from medical decision making to engaging in conversation with family and friends,” Sandell said.

Here are some ways you can be prepared:

  • Identify one/more strategies for the individual to indicate a clear yes/no and to communicate with low tech methods (e.g., alphabet board, communication board)
  • Practice these communication methods
  • Prepare a communication passport for the individual to carry that has critical medical information
  • Prepare brief instructions for the individual to carry or a brief video on his or her phone that illustrates the best way to communicate with them.

The ability to communicate is more important now than ever before. Providing individuals with the tools they need to overcome communication barriers empowers them to communicate their needs, stay in touch with their loved ones and advocate for themselves. In a time where physical distancing is the new normal, it’s imperative that every individual has the means to socially connect with family, friends and their health care providers.

Madonna TherapyPlus has specially trained speech language pathologists available to help consult if you are having difficulty communicating or need some advice on the most appropriate AAC for yourself or a loved one. 

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