COMMUNICATION

Speech Pathology Department

COMMUNICATION

We will discuss the different modes of communication and the important role WE ALL play with assisting our patients with communication and our responsiveness to their needs.

Language Access Plan

Modes of Communication

Expressive communication Verbal speech Writing Signs, gestures Body language

Receptive communication Listening Processing

ESTABLISH

Establish some type of communication system – speech dept. plays a key role in this

Have them blink, squeeze your hand, etc. Always have one consistent response Generally best to have them respond to any

“yes” question For example: “Blink your eyes if you are in pain.”

If they do not blink then you know they are not in pain, if they do then you know they are in pain.

SIMPLIFY

Simplify when needed (e.g. dx of CVA, cognitive impaired)

Discuss one topic/idea at a time Do not speak to the patient as if they are a child If the patient is hard of hearing, do not

shout/yell at them Decrease the noise level with permission Speak more slowly, but naturally Offer amplification system

CONFIRM

Repeat what you think they said to clarify If they say yes to a question, ask the

opposite to ensure they have consistent yes/no response If they say yes to both questions then you

know they are not answering consistently

Keep in Mind….

The patient may need extra time to understand & respond to your questions

Be patient, unhurried, and accepting of their speech attempts – don’t leave abruptly

Do not stress if you are having difficulty communicating with a patient – ask another co-worker for assistance if needed.

Convey a calm reassuring and encouraging attitude at all times with your patient and their family

Non-Clinical folks

Can a non-clinical employee assist our patients……YES

We actually expect you to If you notice a call light on, walk into that patients room

and provide assistance Obviously you are limited in what you can do for them,

but even if you simply let them know you will inform their nurse/RT of what they need that makes a huge difference

You are being RESPONSIVE to their request *never give them food/drink unless you check with

their nurse first

RESPECT

Respect your patients and their family Always knock on their door before you enter and greet

your patient Do not talk as though they are not there – even if they

have a diagnosis of comatose Do not call them nicknames such as “Granny” or “Honey” Avoid responding to sensitive questions from the family in

front of the patient Always tell the patient that you are talking to their family

member and ask for permission “Is it OK if I tell your daughter how you slept last night?”

Types of communication we may use here: Verbal speech Low tech systems

Letter boards Picture boards

Speaking valves High tech systems

Computers/eye gaze Sign language, gestures Writing

EMPOWERMENT

Empower your patients by allowing them to communicate

If they have a special device to communicate allow them to use it when communicating For example: if they have a speaking

valve, have it placed so they can communicate their needs with you more effectively

If they have a letter board – USE IT

LANGUAGE ACCESS PLANRockcastle Regional Hospital and RCC Inc., complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. A maroon binder containing our Language Access Plan and interpreter resources is located in all nursing stations, ED and in the Medical Arts BuildingYou can also view the Language Access Plan in the web based policy managerWe subscribe to the Language Line Services (over the phone) for individuals who speak a different languageWe have qualified interpreters available for individuals who are deaf or hearing impaired (Sign language) or Limited English Proficient LEP (Spanish) that will come to the facility face-to-face A TTY phone is located in ED

ORAL CARE

Why is Oral Care Important?

Other than the obvious it: Provides a clean oral cavity Decreases risk of aspiration

pneumonia Prepares the patient for the

meal/increases oral awareness Decreases dry mouth Increases the desire to eat/talk Decreases risk of gum disease Helps prevent heart disease Improves overall quality of life

Materials Needed – Kits:

Toothbrush (soft, small head) Toothbrush cover/cap Toothpaste Mouthwash (alcohol free) Toothette (to be used to assist – not to replace a toothbrush) Denture care/materials if needed (encourage patient to remove dentures

at least 3 hours daily) Oral care kit/container for storage Water Emesis basin Suction catheter available for residents unable to rinse their mouth

independently Familiarize yourself with the location of the kits and materials on each

wing*All kits should be placed in patient’s room within 24 hours of Admit

Oral Care Schedule – per our policy

Oral Care should be completed At least 2 times every day

i.e. before/after each shift change i.e. For residents with swallowing difficulties, it is beneficial to

perform oral care before each meal. This will decrease the amount of bacteria in mouth prior to eating in case the patient were to aspirate any food during the meal.

Including dentures and care for them as you would natural teeth AND as needed throughout the day

i.e. visible signs of oral care needed between brushing

*ALL staff are responsible for providing oral care when needed*

The Oral Care policy can be found in our facility policy manager

Always assess the condition of the patient’s:

Lips Tongue Gums Saliva Natural teeth Dentures Oral cleanliness Pain level

Dry, cracked lips Yeast on tongue

Poor oral hygiene Dry tongue

Keep in mind…

We must also consider our patients oral care beliefs and respect their decision to refuse oral care.

We should provide the patient with information regarding the benefits of oral care and good oral hygiene.