Mr and Mrs Singh come from a different culture and some of the issues will have been very sensitive or difficult to talk about. This could have made them anxious and because of the cultural differences Mrs Singh could have been depressed. The communications cycle should have been used throughout this meeting. At no point did any of the health professionals check with Mr and Mrs Singh if they understood what was being said to them. If they had checked, (and they should have done considering their use of non-verbal communication by their looks of bewilderment ) then they may have discovered that they did not understand and the health professionals could have modified their approach to the meeting perhaps with the use of an interpreter.
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Task 2 (Pass 4)
Identify how the communication needs of patients /service users may be assisted, including non-verbal communication.
Methods of communications
There any many different aids, help etc that can assist a service user to communicate. It all depends on the specific difficulty/disability a service user has. For example a hearing aid, picture cards etc can all help in the correct circumstances. Below is a list of some of the ways available.
∙ Advocates
∙ Interpreters and translators
∙ Speech therapists
∙ Mentors and befrienders
∙ Psychologist
∙ Technical aids and adaptations
∙ Makaton
∙ Signing
∙ Braille
Advocates
An advocate is somebody who can help you to put across/explain what it is you want to say. They can make sure that whoever it is you want to communicate with understands your views/feelings. An advocate does not necessarily need to do all your talking for you but can simply just offer assistance so your message gets across and is understood. This is especially good if the person wanting to communicate has a speech impediment for instance. Advocates are specially trained but you can also have a friend/family act as an advocate. The advocate must promise to keep what is said confidential unless the sevice user agrees to information being passed on. The advocate is however permitted to pass on information to social services in the interests of protecting the service user or anybody else who might be at risk. The service user also has the option of choosing their own advocate. They can choose to use an advocate of the same sex or the same ethnic background.
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Interpreters and translators
These are very similar in what they do only an interpreter interprets meaning/feelings as well as word. A translator can translate one language to another in both spoken and
written form. They both provide a service to somebody who speaks a different language to the one being spoken. An interpreter is probably more useful when the communication being done is of sensitive nature and especially a cultural difference.
Speech therapist
A speech therapist helps to rehabilitate or correct speech. Stroke victim might use a speech therapist as a stroke can often leave the victim with a speech problem such as slurring words or much worse. Speech therapists can also help people who have a speech impediment such as a stammer, or a cleft palate. Depending on the nature and severity of a speech disorder will depend on what a speech therapist will use. They may use vocal exercises to strengthen the voice, repetitive sounds and the use of audio and visual aids. A speech therapist might also use sign language.
Mentors and befrienders
A mentor or befriender does not have to be a professional such as a doctor or teacher but somebody who you trust and respect. They should have a good range of knowledge and experience. A carer can become a befriender to a service user because over a period of time the service user as come to trust and respect their carer. They can help with communication as often a person who uses or needs a mentor or befriender is unable to put across what they want because of speech impediments or stammer etc.
Psychologist
A psychologist is somebody who provides support to somebody with mental health problems. However there is more than one type of psychologist. There are clinical, forensic and criminal to name just a few. It is possibly the clinical one that most people know of. These tends to be based in hospitals or clinics and help to diagnose mental and emotional health issues. A person who is in need of a clinical psychologist will often be withdrawn and therefore not talkative. The psychologist can assist with communications
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as over a period of time they are able to bring the person out of themselves. As a psychologist is bound by the data protection act 1998 the person talking to one might feel more at ease and therefore more open to communications.
Technological aids and adaptations
There is an abundance of technology and aids available to assist with communication. Hearing aids, cochlear implants, flash cards, audio books etc but there is a relatively new one available
called type or touch speak. It was developed about 10 years ago and was designed to be
used with a computer. The type speak is used just like typing a letter only with the use of a computer and voice synthesizer it speaks what you have typed. The touch speak works in a similar way only it uses a screen that has an abundance of images and wide range of vocabulary that you touch and the computer speaks using a voice synthesizer. You can also pre type sentences into it. These help people to communicate who have a particular disability such as motor-neurons disease or people who have had throat cancer and no longer have a voice box because of it.
Makaton
Makaton is a form of signing. It uses both images and hand signing to convey a message. It was developed about 20 years ago and the symbols are as pictographic as possible. It is similar to what a person would do if they were in a foreign country and did not speak the spoken language. Makaton was developed from the British sign language and supports the written word in the way sign supports speech. It is commonly used with children but whoever is in the child’s life will also use it. Below is a couple of example of Makaton signs that are used.
There is also a children’s television programme on the BBC called something special which is a programme that uses Makaton. The programme was developed with children in mind who are deaf so that they too can enjoy children’s television.
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Signing
Sign language is a manual communication. It combines hand, arm, body and facial movement to express thoughts. It is not only used by the deaf but by people with a speech
Impediment. It has variations for geographical locations and is used in over 40 countries.
The first school for the deaf opened in Paris in 1755. Below is a chart that displays the alphabet in sign language.
Braille
A Frenchman called Louis Braille in 1821 developed Braille. It is widely used by the blind and can be both read and written. Each letter is made up using raised dots in 2x rows of 3 which are called cells the dots are raised at different points to represent a different letter. The presence or absence of dots is the code for each symbol. Below is the Braille alphabet.
Task 3 (Merit 2)
Explain the specific communication needs patients/service users may have that require support, including the use of technology.
Cerebral palsy case study
Britney is 22 years old and she has cerebral palsy. She lives with her mum, dad and two younger brothers. They live in a bungalow that has had some alterations/adaptations made to accommodate some of the equipment Britney needs to assist with her day-to-day life. Britney bedroom has a bathroom next door and has had the wall partially knocked down to accommodate double doors. There is a hoist attached to a runner on the ceiling and the hoist can be moved from above Britney’s bed straight over to the bathroom, it stops just above the bath. This is very useful as it is much easier getting Britney ready for a bath on the bed and drying afterwards. The bed that Britney sleeps on can be lowered, raised or tilted to suit what’s being done for example getting Britney into bed is easier when it is lower. Britney has a very full and active life thanks to her mum Gertrude and dad Harold. She attends a specialist day center three times a week and spends alternate weekends in respite. The respite gives Britney’s parents some quality time together and also gives Britney some space. Although Britney is unable to talk she is able to communicate with the use of a touch speak and also uses facial expressions such as frowning when annoyed or smiling when happy.
Facial expressions Touch speak (see page 6 & 7)
Everyday Britney has carers coming in to assist with bathing, getting up, going to bed and toileting etc, all the everyday tasks that the rest of us take for granted. Britney’s parents communicate with the carers every day both verbally in the form of morning updates on what kind of a night Britney has had and non verbally by writing in the care plan which as Britney‘s main carers they are entitled to do so. The communication is not only on a morning as there is carers going in at various times of the day so there is plenty of communication between carers and Britney’s parents. Britney also likes to make her presence known and will often interrupt conversations to let others know she is there too. There is a care plan that contains all the information that the carers need to know about Britney plus the extent of the care needed and what is required of the carers who go in. The care plan was very carefully thought out and is detailed enough so that if and when a
New carer needs to go they can look at the care plan and know exactly what care is needed and needed to be done at any given time. The care plan is also a way to communicate.
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Cerebral palsy is not a condition that is hereditary nor is it something you are born with but a condition that develops usually because of birth trauma or brain damage. There are 3 main forms of cerebral palsy that give various symptoms. Spastic; which has symptoms such as stiff and weak muscles, making movement difficult. Athetoid; which can give spontaneous and unwanted movement and also posture is affected. Ataxic; which gives problems with balance, speech, shaky hands and or feet. There is also mixed which gives some or all of the above symptoms. There is no cure for the condition but the symptoms can be treated.
There is no cure for cerebral palsy itself but there are quite a lot of treatments available to ease the symptoms of somebody with cerebral palsy the treatments available depends on the particular problem. For hearing difficulties technological aids such as an hearing aid or in severe cases cochlear implants. Flash cards can also be used. For speech difficulties again flash cards can be used but technological aids such as a computer and voice synthesizer (touch or type speak) can be good.
Hearing aid Cochlear implant Touch speak Flash cards
A speech therapist can also be useful as these not only help with speech but eating and drinking as cerebral palsy suffers suffer with jaw problems making eating and drinking difficult. There are drugs to help control seizures and pain. Physiotherapy can help with muscular difficulties and also botox is used as this relaxes muscles. Surgery is another option, probably one of the last ones. To assist with walking there are specially adapted frames or leg braces. There is also rolling walking frames that be of huge help to those with spasticity. A cochlear implant is a device that has small electrodes implanted under the skin and a transmitter that is worn behind the ear similar to an hearing aid. The implant is designed to stimulate the auditory nerve (what gives us hearing) and can help people who are profoundly deaf or totally deaf. It cannot make hearing completely normal but it can give a sensation of sound that does improve with time. It benefits those best who were born with hearing but lost it through an accident or illness.
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Downs syndrome case study
Madonna is 38 and has downs syndrome. She lives on her own in a sheltered accommodation flat that houses other down suffers. However not all the residents have downs some have other disabilities. She has a mum Ethel and dad Gerald but no siblings. Madonna has been living on her own for about 10 years. She has plenty of support from her parents and social worker. The accommodation block is run by wardens who are on 24 hour call. These also offer support to Madonna as well as the other residents. Madonna, her parents and social worker meet on a regular basis to keep up to date with Madonna‘s progress. The accommodation Madonna lives in was built about 20 years ago and was built specifically for people like Madonna. The wardens help the residents to live an independent life as possible. The staff run daily activities along with day drips and adventure holidays which all or any of the residents can take part in. Madonna along with some of the other residents attend college where they take part in special learning programmes that helps them to develop reading and writing skills. Madonna has a busy social life along with a boyfriend called Moses who she adores. She visits her parents on a regular basis and vice versa and loves to go shopping. When Madonna was a small child she attended speech therapy as she had a problem with eating and with speech due to her small jaw and enlarged tongue. She still attends speech therapy for her speech. Madonna also attends a heart clinic every 3 months as she has a heart defect. Madonna wears specially adapted glasses as she has a small nose bridge and uses an hearing aid.
Specially adapted glasses Hearing aid
Downs syndrome is a genetic condition that has no know cause but caries a higher risk of
having a baby with it over the age of 35. Having some or all of an extra chromosome called 21 causes the condition. Downs sufferers usually have a lower than average IQ that ranges from mild to moderate retardation. You can tell downs suffer just by sight as they have common physical and facial features such as small eyes and ears. They have a flat nose bridge and the back of their head is flat. They also tend to be shorter and have only 1 crease on their palm instead of 2. A downs sufferer has a high risk of being born with a heart defect and is at higher risk than normal of developing leukemia and testicular cancer.
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They are also prone to gastric problems and recurrent ear infections. Another common problems downs sufferers have is obstructive sleep apnea and thyroid problems.
The average age of a downs sufferer is 60 and most lead a relatively normal life with support however this is not always the case and some need 24 hr care.
There is no cure for downs syndrome but heart conditions and recurrent ear infections etc can be treated. A downs sufferer might benefit from a speech therapist because of their short jaw line, which makes them look like they have a long tongue. A speech therapist can also help with eating and drinking, as this is another common problem because of the tongue/jaw ratio. Because they have poor muscle tone they could also benefit from physiotherapy. Downs sufferers benefit from the use of advocates and technology such as the touch speak that uses a portable or hand held computer with built in voice synthesizer can communicate words, phrases or sentences at the touch of a screen or an hearing. Hearing aids and cochlear implants are also used to assist with deafness. A cochlear implant is a device that has small electrodes implanted under the skin and a transmitter that is worn behind the ear similar to an hearing aid. The implant is designed to stimulate the auditory nerve (what gives us hearing) and can help people who are profoundly deaf or totally deaf. It can not make hearing completely normal but it can give a sensation of sound that does improve with time. It benefits those best that were born with hearing but lost it through an accident or illness.
Cochlear implant Touch speak (see page 6 & 7) Advocate (see page 5)
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Bibliography
Newton, R. (2004). The Down’s Syndrome Handbook. UK: Vermilion
Portch, T. (1999). Communication and Interpersonal Skills. Great Britain: Hodder and Stoughton
Stanton, M. (1997). The Cerebral Palsy Handbook. UK: Vermilion
Stretch, B, Boak, A, Dunn, O, Haws, H, Herne D, Mason, L, Moonie, L, Webb, D (2006) BTEC National health studies. Oxford: Heinemann
Image 1 taken from Microsoft clipart
All other images taken from Google images
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