Health and Social Care

Facilitating Understanding

• Background noise should be kept to a minimum e.g. turn televisions and music off. A quiet environment is best.
  
  
• Keep good face to face contact at the same level as the aphasic person (NB people in wheelchairs).
  
  
• Speak slowly and clearly in an adult manner. DO NOT revert to Adult-Child communication patterns.
  
  
• Use your normal volume – do not shout.
  
  
• Ensure only one person is speaking at any one time.
  
  
• Use short, simple sentences.
  
  
• If necessary it can help to rephrase sentences and emphasise important words.
  
  
• Write down key words and especially if giving information to be remembered.
  
  
• If necessary use gestures, mime or drawings to help aid understanding.
  
  
• Pause between sentences or when changing the topic of conversation.
  
  
• Give plenty of time for the person to speak. Communication is not 'automatic'. Time is needed to find the words and formulate sentences. Do not be embarrassed by short silences.
  
  
• Encourage all types of communication e.g. gestures, drawing, writing, pointing. Have a pen and paper at hand.
  
  
• Do not interrupt.
  
  
• Do not pretend to understand. Try to ask questions to assist the aphasic person get their message across.
  
  
• If the person appears to be getting frustrated encourage them to try again.

When asking questions:

Try not to ask 'open-ended' questions. Make your questions specific e.g.

“Would you like fish?”
“Would you like chicken?”

Rather than

“What would you like to eat?”

This makes it easier to answer.

Lack of understanding of Aphasia

• A lack of awareness and understanding of the disability of aphasia results in inequality of treatment in the planning and delivery of health and social services
  
  
• High percentages of staff receive insufficient training and are unskilled in the facilitation of communication responses
  
  
• This leads to inappropriate assumptions and discriminatory treatment

People with aphasia report many incidents of:

• Being patronised/talked down to
  
  
• Environmental barriers to communication e.g. noisy backgrounds
  
  
• Staff talking too quickly
  
  
• Insufficient time to communicate
  
  
• Being ignored
  
  
• Lack of skills to support communication 
  
  
• Interactions with untrained staff result in people with aphasia being unable to make best use of their remaining language abilities.

Access to information

• Individuals with aphasia are often presented with information in formats inaccessible to them.
  
  
• A lack of awareness of their specific needs results in people with aphasia being asked to access/respond to written information. Verbal information is often presented at an inappropriate linguistic level to which they are unable to respond.
  
  
• People with aphasia also complain of a lack of information at discharge from hospital relating to where they can go to get support and advice. Traditional information networks are often inaccessible to these people.

Participation and empowerment

• People with Aphasia are, because of the very nature of their disability, at risk from exclusion in decision-making processes at every level – from how services are planned and delivered to personal decision making processes.
  
  
• People with Aphasia are often dependent on carers or family members to put forward their point of view. Whilst this is a lifeline for many it is not always appropriate in terms of personal privacy or voicing personal viewpoints.
  
  
• Also, individuals may live alone or wish to speak with an independent voice.
  
  
• People with Aphasia must be afforded the choice of having their views put across accurately by others that speak on their behalf or an independent, trained advocate who can facilitate self-advocacy.

(Source: Speechmatters.Speechmatters Response to First Stage of Equality Scheme Consultation Process. Key Themes – Barriers to Inclusion & Equality)