Good communication
Effective communication is of key importance at the end of life. Many people with learning disabilities have significant difficulties in communication; with both expressing themselves and understanding what others say. Strategies to support optimum communication currently are crucial.
Good practice
- Ensure the person has the option of being accompanied to appointments by someone who knows them, and their communication needs well.
- Try and avoid multiple appointments if possible — one stop shop is best.
- Make sure glasses and hearing aids are worn.
- Prepare someone before a meeting or doctor’s visit so they know what is going to happen and what to expect.
- Use the person’s preferred methods of communication and follow any existing communication guidelines (e.g., in a communication profile or speech and language therapy recommendations)
- Follow the Accessible Information Standard
- If possible, have a preliminary discussion with carers/speech and language therapist before an important meeting so that relevant resources can be prepared in advance.
- Remember that anxiety, fatigue, recent epileptic seizures, medication, and the environment can all influence a person’s communication.
Helping someone to understand
- Ensure you have the individual’s attention before talking to them — a quiet environment helps.
- Wherever possible show someone something as well as telling them.
- Back up speech with non-verbal communication — signs, gestures, and facial expression.
- Pay attention to rapport development and quality interaction e.g., by listening to the person and using your facial expressions, body language and tone of voice.
- Support speech and written information with ‘visuals’ such as objects, photographs, pictures, and symbols.
- If an individual has established augmentative and alternative communication methods/systems — please use them (e.g., a communication book, Talking Mats, objects of reference system, eye-gaze device, social stories).
- Do not speak too quickly.
- Use short, simple sentences.
- Avoid complex or abstract vocabulary and explain new information words.
- Check an individual understands by asking them to recap what you have said in their own words — NOT by simply asking ‘Do you understand?’ or asking them to repeat exactly what has been said
- Allow plenty of time for an individual to process information.
- Simple summaries of discussions and information should be given to the person. They can then go through this several times with someone — to ensure it has been properly understood.
- Be prepared to build understanding of topics over time e.g., by breaking down into chunks
- In the late stages of an illness touch can be very important — and reassures someone that they are not alone.
- Helping someone to express themselves
- Allow plenty of time.
- Reduce background noise.
- Sit face to face with the individual and in a good light.
- Notice any non-verbal communication, e.g. eye contact and facial expression.
- Be aware that being able to speak does not necessarily mean an individual has good understanding.
- If you don’t understand what someone says, ask them to say it again more slowly or to try and say it another way.
- If an individual has augmentative and alternative communication methods (e.g., a communication book or communication aid), please encourage them to use them.
- Similarly, if an individual uses signs ensure there is someone available to sign with them.
- Involve a ‘communication partner’ who knows the individual well and can help ‘mend’ any communication breakdowns that may occur.
- Consider a referral to Speech and Language Therapy (Contact us HPFT.NHS ) if more in-depth / bespoke support is required to facilitate communication.