Information for Healthcare Providers

Adapted from an article by Kelsey Mandak, April 8, 2020

Read Kelsey Mandak’s full article on the RERC website

• Always stand where the patient can see you. Be sure the patient can hear you. Speak clearly and more loudly if you are wearing a mask.
• If the patient had a pre-existing disability, check to see if they have:
  • A health passport with critical medical information.
  • A description of how they communicate (e.g., do they have an alphabet board, picture board, or iPad that they use to express themselves).
  • Instructions for how they want you to communicate with them. 
  • A contact person who can help if communication breaks down.
• If the patient is temporarily unable to speak due to intubation or other medical treatment or if you are unable to locate the patient’s communication supports,
  • Establish yes /no signals
    • Yes /no responses might include a head nod or shake, thumbs up or down, looking up or looking down
    • Ask “How do you communicate ‘no’?” and observe carefully. Repeat for ‘yes’ signal
    • Once these signals are established, record them in the patient’s medical chart and post them bedside or over the bed for other healthcare providers
  • Ask one question at a time and wait for the patient to respond. Provide choices one at a time.
    • For example, ask the patient “Are you in pain?”
    • If the patient communicates “yes”, then ask questions one at a time to identify the location of the pain. Wait after each question.
      • For example, ask “Does your head hurt?” and wait for a response. “Does your chest hurt?” and wait for a response.
  • Confirm with the patient that you understood their response correctly
  • Explain to the patient what is happening. Use gestures and demonstrations or show pictures to support understanding as needed. Confirm that they have understood.
  • Give the patient other ways to communicate. Ask the patient to write, spell messages or to point to written words or pictures to communicate needs. Click here for free communication boards.

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