Aids For Communicating With Hospitalized People?

charliezcc writes "My grandmother recently fell and broke two vertebrae (among other things) and is in the hospital while she recovers. Thankfully, she was not paralyzed and retains the use of her limbs. However, they have placed her on a respirator and she is virtually unable to communicate with us, so while we try to keep her company during her recovery, our company is reduced to mainly one-sided conversations. Asking her questions, even yes/no questions, is hard because of the neck brace — it turns into a guessing game and very quickly becomes frustrating for both parties. I'm a firm believer in the power of positive mental attitudes and to make her recovery a little better and I'd like to be able to facilitate two-sided conversations with her so she can keep positive. Keeping in mind that she does not have much technology experience, what would you suggest I utilize to ease the communication barrier? I remember seeing devices with a number of buttons that say whatever you program it to say, but I can't find these anymore. What other kind of devices are available?"

A Low tech solution

[janrinok (846318)]

I sympathise with your problem and wish your grandmother well. But try to get her to blink rather than nod her head. It is used quite frequently in cases such as this. I'm not trying to be rude, nor to sidetrack your question, but while you are doing your research it will enable limited 2 way conversation.

Re:A Low tech solution

[maxume (22995)]

Grandma, two fingers for yes, one finger for no. And so on.

Re:A Low tech solution

[HalifaxRage (640242)]

"She keeps telling me 'no', and always with the same finger"

Can she move her hands ?

[thornomad (1095985)]

If she can move her hands you can setup a type of "communication board" -- the simplest of these can be words written on a piece of paper/cardboard. If she is able to point to them then she can communicate in a limited way. You can have one for basic needs and another for spelling words. That is the less technological version of what some people use (and I can't remember what it is called) that let's someone touch a screen that, in turn, speaks for them. A quick search and I find stuff like this [bindependent.com]. I'm sure there is more -- better -- out there. Good luck. That isn't easy.

Dasher - 1 finger text entry

[StCredZero (169093)]

A tablet PC with Dasher might be the thing. Dasher is designed to enable 1 finger text entry at reasonable speed. My girlfriend uses it because of her repetitive stress injury.

http://en.wikipedia.org/wiki/Dasher [wikipedia.org]

http://video.google.com/videoplay?docid=5078334075 080674416&q=dasher+google+tech+talk&total=2&start= 0&num=10&so=0&type=search&plindex=0 [google.com]

But if she can still write, that will be even better and faster.

Bed Time

[Knunov (158076)]

Time to go to sleep. When I read the headline I thought, "Yeesh, that's a pretty harsh punishment for commuting with hospitalized people. And why do people in the hospital need to be sharing a car, anyway?"

you could try these

[EricMB20 (1144673)]

i've used these products in the past with children with special needs - they're great communication tools - a bit expensive - but good - you can rent them weekly as well so that might be a plus - good luck! http://www.dynavoxtech.com/ [dynavoxtech.com]

eLocutor

[uss_valiant (760602)]

For the extreme case there's eLocutor [holisticit.com]. It was designed for Stephen Hawking who can only push a single button. But it also has a mode for users that can control arrow keys in addition to a single button.
I don't know the field at all and I don't know eLocutor but from an article. Maybe it has a huge learning curve and is thus inappropriate as a short-term solution.

Signalling yes and no

[QuickFox (311231)]

She probably shouldn't nod and shake her head to signal yes and no, as that may strain her spine. Propose some other signal. The easiest of all is probably that she make the same movements with her fist that she would otherwise make with her head, imitating nod and head-shake with her fist.

Or better, give her a chart of the Sign Language Alphabet [wikipedia.org]. With that she can say anything, if she and her listener both have enough patience. With that she could sign "Y" for yes and "N" for no, and in many cases choose among alternatives with just an initial letter.

Re:

[QuickFox (311231)]

A better chart [indiana.edu], a little clearer.

Old Topic, new answers

[fishdan (569872)]

I used to be a Sp.Ed teacher working with severe autistics (which has really made me a great member of a dev team). I had many students who could communicate, but did not have the fine motor skills to speak. High tech is sometimes more than you need. I know you're willing to spend whatever it takes for your grandmother, but in this case, a little time investment may be wiser than a cash investment.

My first suggestion is American Sign Language [wikipedia.org] With a minimal amount of effort you can be communicating simply, and there's no reason to not spend more time learning more and stepping up to high end communication. I find ASL so useful that I've taught it to my friends for communication in loud bars, silent communication in meetings, secret messages we wish to pass in a room full of people, etc.

In terms of full fledged speakers, since you are not looking for a permanent solution, I'd recommend just using a OSX notebook. Open up the terminal, and type 'say hello world' You get the hang of it really quickly. On the windows side, Read Please [readplease.com] is quite competent, and has a 30 day free trial period. Plus there is probably wifi in the hospital...

If you don't have a laptop that she can use, I would suggested printed boards. The 800 lbs gorilla in the field is Mayer-Johnson [mayer-johnson.com]. Look around their products and see if maybe you can get away with something like their Picture Exchange Communication System [mayer-johnson.com]. Essentially they are cards with pictures on them that can be used for communication. It's not a great system for an adult, but if you need something temporary it's only $179.

I wish your Grandmother a speedy recovery.

Read to her?

[beadfulthings (975812)]

If your grandmother is stuck on her back, and it sounds like she is, she might enjoy an occasional reading session--not too lengthy, though. Check at home. Does she subscribe to any particular magazines or to the newspaper? Chances are she's missing those. Any particular authors she enjoys? Something lightweight in her favorite genre (mystery, sci-fi, thriller, classics whatever) might be enjoyable. Religious? Bible or other scripture might be wanted. Of course you can get audiobooks of all sorts, but the actual presence of somebody she loves, who cares enough to take time with her, is a good medicine in and of itself. Check with the occupational therapy folks regarding the boards they have for communicating needs/wants.

Think low-tech, not high

[Tsu Dho Nimh (663417)]

A small whiteboard and marker pen
Pen and paper

There's no need to go any higher-tech than that, because you would have to teach her how to use the device instead of using her existing knowledge of how to write.

Low Tech

[sakusha (441986)]

This problem requires a low tech solution. And fortunately, this is a problem that has a lot of practical solutions, derived from years of experience dealing with hospitalized, incapacitated patients. I used these to help take care of my mom, she was unable to talk.

Consult your hospital, they often have little message boards. There are some that have a little flip chart at the top, divided into functional categories like "I feel.. (sleepy, nauseous, good, thirsty etc.)" I want (water, pain meds, bedpan, etc.)" and then it has an alphabet at the bottom to spell out words that aren't on the chart, along with a list of common words so she doesn't have to spell them out (it, and, the, etc.).

If she can write, I recommend a "Magna-Doodle" pad. Very easy to use, clears with a push of the lever, designed for little kids so it's easy to use even for someone weak and incapacitated. Get a big Magna-doodle pad, that makes it easier to write long messages, or write big if you have poor motor control.

Paper and pencil?

[kbahey (102895)]

First, hope she gets well soon.

Why must hi-tech be the answer?

Why not use paper and pencil?

Are her hands free? She can gesture yes and no in a way that you can tell her to.

Re:Paper and pencil?

[Jah-Wren Ryel (80510)]

Why must hi-tech be the answer?

Because this is slashdot.org.

Low tech is handled by luddite.org.

What are you thinking? Have some common sense.

[dircha (893383)]

This is sort of like when some technology guys decides that if we can just get computers running Linux into sub-Saharan Africa, we'll save the world.

If your grandmother is on a respirator, the last thing she needs is for someone to interrogate her. She's your grandmother, not a dying secret agent.

Listen, just be with her where she can see you. Read a book. Hold her hand. Talk gently to her. Tell her that you're there. Tell her who is in the room with her. Tell her who is coming to see her. Tell her about news in the family. Tell her what your children have been up to.

You know, things people have done for thousands of years to comfort their loved ones who have fallen ill?

Turn off your ipod and your blackberry and think a little, man. Technology may not cause cancer, but apparently it has an affect on common sense.

Re:if she can move her hands, mouse+ screen keyboa

[scottv67 (731709)]

have a TV or large monitor brought in with a mouse...

Um...no. Don't bring a pickup truck-full of electronics into the hospital room. The nurses have enough to do without stumbling over cords from devices you brought from home. The original poster said that the patient was on a ventilator. There are probably already quite a few electronic medical devices in the patient's room. If you are thinking of bringing in something bigger than a laptop, check with the nurses on that unit first.

Yes, I work in

Re:Paper and pencil?

[mrbooze (49713)]

The hospital I worked in something like 15+ years ago had a supply of Magna Doodles. (I think that's what they were called, basically a toy that you could write on with a magnetic "pencil" and easily wipe off anything you wrote by sliding a level.)

They kept a few around the ICU/CCU for patients that needed them to communicate. At the time I sort of assumed that most hospitals kept some sort of tools around for that purpose.

Re:Paper and pencil?

[maxwells_deamon (221474)]

A magna doodle is the way to go if possible. Paper piles up very quickly.

I had jaw surgery many years ago and went to the toy stores beforehand to get a couple of magic slates and they had just come out with the magna doodle so I bought one.

After the surgery, at the start of each of the first 4 shifts a nurse would come into my room and see it and say "OMG where did you get this?" "Could I borrow it for the floor meeting, Please" It would go away for a half hour and then come back. They did lots of jaw surgeries on that floor and were very tired of papers laying everywhere.

As I was wired shut for 7 weeks I even took it with me afterwards to shop and such.

Just make sure you write her name on the frame so she gets it back.

Really only TWO options available

[spineboy (22918)]

Pencil and paper, or some type of pointing board with common phrases/questions/answers on it. Most hospitals will have both.

As far as having his GRANDMOTHER learn any new technological choices, while in a hospital, sedated, on a ventilator, in a neck brace - FORGET IT. She's not gonna learn sign language easily, except yes/no. If she can't even write, because of medication/delirium/whatever, then she's not going to be able to learn new ways of communicating.

Sounds like she's an old lady, and somewhat frail like many older people. Becoming intubated for a vertebrae fracture is not normal, so I think she probably has multiple medical problems (I'm a doctor).

Stick to what she knows, and is comfortable - and she will do better with it.

Re:

[networkBoy (774728)]

I realize it's likely cost prohibitive, but from what I've seen of Mr (Dr, Sir?) Hawkings kit, the UI is very intuitive, especially for the portions where you're not trying to build a sentence (or a speech for that matter). You look at what you want to say and if you either blink or hover long enough the computer says it. It'd make yes/no I hurt, etc. questions a cakewalk.

@ spineboy
Assuming these are *not* cheap, how much is too much (IYHO) before a hospital would not buy them to have on hand in cases li

Re:Really only TWO options available

[wing03 (654457)]

"I realize it's likely cost prohibitive, but from what I've seen of Mr (Dr, Sir?) Hawkings kit, the UI is very intuitive, especially for the portions where you're not trying to build a sentence (or a speech for that matter). You look at what you want to say and if you either blink or hover long enough the computer says it. It'd make yes/no I hurt, etc. questions a cakewalk."

It's called a Dynavox. http://www.dynavoxtech.com/ [dynavoxtech.com]

IIRC, my wife who's in the field of speach therapy and augmentative communications, mentioned he uses a switch that measures muscle tension and a scanning keyboard/UI to pick and choose his words.

Yes, they are expensive. They also need training to use as well as it needing training, setup and/or direction from a speach therapist to a caregiver in order to setup.

For someone in a hospital, a communication board (8x10, 11x17 or whatever grid of organized pictures and letters) is more effective and simple. Most hospitals should have these to communicate basic needs like itchiness, pain, sensory answers a nurse of doctor would ask.

LOL - that has to be the worst solution so far

[spineboy (22918)]

Kudos for an original idea, but do you really expect some old grandmother, sedated, on a respirator, from a minor vertebral break, to learn Morse code? For a young person, it's a better idea, although limited, because not everyone knows Morse code. With pencil and paper, she can communicate with everyone.

Sign language

[Migraineman (632203)]

Learning morse takes a buttload of time. It's extremely abstract, and probably isn't going to be easily memorized by someone who's sedated. If she already knows morse, then I'd say it's more of an option.

Alternatively, teach her a handful of ASL signs. "Yes" is a fist you nod. "No" is two fingers pinched against the thumb. Finger spelling resembles the written characters in many cases, so it shouldn't be a big burden to learn. Don't be afraid to invent signs - that's perfectly valid, especially wh