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?"

Can she move her hands ?

[thornomad]

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.

you could try these

[EricMB20]

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]

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.

Re:Signalling yes and no

[QuickFox]

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

Dasher for text entry-

[Anonymous Coward]

While I'd agree that simple pencil and paper is often easiest, I thought I'd post this link to Dasher, which is a pretty cool little program for alternative methods of text entry... it can be eye controlled, breath controlled, finger controlled, pretty much anything, and apparently has a fairly quick learning curve, after which you can enter text over 30 words per minute-

http://www.inference.phy.cam.ac.uk/dasher/ [cam.ac.uk]

Re:Old Topic, new answers

[0123456789]

An alternative to OS X (or, at least, an OS independent solution) for text to speech is to use Emacs.

Seriously.

Take a look at EmacsSpeak [cornell.edu], which handles text to speech (as well as speech to text).

Having said that, if nodding and shaking her head are too much; I doubt typing will be an option either. I think one of the lower tech solutions are more likely to be useful. Good luck!

Re:Paper and pencil?

[mrbooze]

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.

Augmentative and alternative communication

[arb phd slp]

This is exactly what I do for a living.

Consider how long her recovery is expected to last. If she will be off the vent and speaking soon, you probably can make do with some low-tech solution or a stock laptop. A whiteboard and/or a cardboard alphabet and some immediately useful messages.

If it is going to be a while (more than a couple weeks) insist that the speech therapist at the hospital see her. Insurance will pay for speech therapy if you go the "Communication allows for active participation in care and treatment which has been demonstrated to improve recovery time and outcomes" route. A MEDLINE search will find plenty of clinical proof of this if you need it.

There are several manufacturers that make computers for this express purpose. Some have been mentioned already. Here's a list of a bunch of them: http://www.augcominc.com/links.html#dv [augcominc.com]

If you are in the U.S., your state has a lending program where you may borrow such a device for a trial before you commit to buying one. (And if she recovers speech, you might just use the loaner and not have to buy one at all). Most countries with national health programs have something similar. The hospital's speech therapist probably knows how to contact them.

If you don't get a satisfactory response from the hospital speech staff, see if your closest university has a Speech-Language Pathology of Communication Sciences and Disorders department. You might be able to get some good advice there.

Good luck.

Re:Paper and pencil?

[maxwells_deamon]

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.

Re:Really only TWO options available

[wing03]

"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.