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It is difficult to imagine proper care for a sick person without proper and satisfactory communication between the patient and the person caring for him. Information provided by the patient (needs, fears, desires) must be understood and properly interpreted by the caregiver.
Likewise, information provided by the caregiver should be received by the sick person. It often happens that a sick person, apart from the underlying disease, has problems with speech or hearing. How to communicate with a sick person who cannot hear or speak?
Ways of communicating
The basic method of interpersonal communication is verbal communication, the means of which is the spoken or written word. It is used to express thoughts, feelings, needs and information. Verbal communication is also usually subconsciously supported by non-verbal communication: gestures, facial expressions and body language. Non-verbal communication includes physical appearance, facial expressions, eye expressions, body movement, hand gestures, and touch.
Non-verbal communication, although it does not express words, as is the case in sign language, also transmits information. Sometimes it is enough to just look at someone to know that they are angry, happy or sad. Many other emotional states can be read from facial expressions: fear, suffering, anger, disgust or rage. Likewise, many states, emotions and actions can be expressed with gestures. In interpersonal communication, non-verbal signals have a much greater impact on the interlocutor than the spoken words and their content.
It is worth remembering about this, especially if the mentee is a separate hearing impaired person. For if he does not receive our non-verbal message, he will focus only on our body language, which may tell him something completely different. That is why, along with verbal communication, properly adjusted non-verbal communication should always go hand in hand.
Methods of communication with the deaf or hard of hearing patient
Patients who cannot hear from birth use Polish Sign Language. It is very difficult for people who are deaf from birth to read meanings of words with the movement of the lips. The ideal situation would be for such a patient to be cared for by a person using PJM.
However, for the vast majority of adult hearing-impaired patients, their hearing loss occurs relatively late. It is estimated that about 30 percent. people over 65 are hard of hearing and their hearing systematically deteriorates with age. These patients usually cannot use sign language, so communication with them can be supported in writing.
Before starting a conversation with a deaf person, we must somehow signal him / her to want to talk. It may be a touch of the arm or a vigorous wave of the hand, but we never approach the patient from behind so as not to scare him. You should be sure that the sick person is looking at us and sees well. We stand in front of the patient approximately one meter away, facing the patient. You need to pay attention to the light source: lamp or window. If it is directly behind us, the glow of the beam blurs the visibility of the face. In order for the patient to be able to read the words from the movement of our lips, we speak slowly and clearly (smoking or chewing gum is not allowed during this time). Sentences should be short and unambiguous. At the same time, we avoid difficult words. We consciously support the statements with gestures and facial expressions. If the patient has problems understanding a certain sentence or word, we repeat it patiently. When he still does not understand, we write the statement on a piece of paper in large block letters. It is practical to have a blackboard with chalk on hand. We always make sure that the patient has understood us.
We communicate in a similar way with a hearing impaired person. Often one of the ears is better. Then, when speaking to the sick person, we stand on the side of the better hearing ear. But always remember that for people who are hard of hearing, sounds may be perceived in a limited and distorted way. Therefore, we patiently repeat the message if we feel that the patient has not understood it.
If the patient has a hearing aid, we check its proper functionality. When talking to deaf or hard of hearing people, one must take into account that understanding the information conveyed to them requires a lot of attention and concentration, which makes long conversations tiring for them.
Communication with a sick person with speech difficulties
Caring for a sick person with speech disorders is extremely difficult. Slurred speech or inarticulate sounds are often incomprehensible to the environment. A sick person, seeing that he is misunderstood, becomes nervous and can even be aggressive. The guardian of such a person must be especially understanding and patient.
While communication with each other is very limited, it is not impossible. The caregiver must first of all develop alternative methods of communicating with the patient. Assess the patient’s ability to understand, read and write, and to transmit non-verbal signals: head nodding, hand movement, and eyelid blinking. When talking to a sick person, we come face to face with him, maintaining eye contact. Before that, eliminate any noise sources: turn off the radio, close the window. We speak slowly and clearly, maintaining the correct intonation. In the conversation, we use simple and short sentences without difficult words. We formulate the questions in such a way that the patient can answer with one word (yes / no) or with one gesture of the head.
If the oral form fails, the written form may be used. Cards with the words “yes” and “no” or possible answers should also be prepared and the patient should be encouraged to choose the right one.
One should patiently wait for the patient’s response. Do not urge him to do so, and do not be responsible for him. We start the questions by identifying key issues. You can also reach for simple speech therapy aids in the form of picture boards, blackboard and chalk or cards with the most frequently used words. By observing the facial expressions of the patient, it is possible to determine his condition: is he satisfied, nervous or maybe he is already tired and a break should be taken.