I'm currently on my neuro placement and I've been treating a pt who is quite receptively and expressively dysphasic. Initially when I assessed the pt I thought his lack of comprehension and speech would severly hinder our communication and thus affect treatment outcomes and compliance. There were a number of assessments I was unable to conduct due to his inconsistent yes/no and unreliable responces, especially concerning sensation and proprioception tests. With some initial ideas from my curtin supervisor concerning assessment techniques and communication strategies, I started to utilise certain techniques which have helped convey basic instructions to the pt. Some strategies I have employed include using short concise commands rather than speaking in sentences which I usually do, using touch (esp on their affected side to promote sensory input) to get the patients attention, demonstrating on myself and the pts unaffected side, imitation, gestures, repetitive verbal cues and consistent treatment sequence, facilitatory manual handling and using the pts own language to establish important pt feedback like assessment/treatment induced pain and discomfort.
These basic techniques have all worked well with my pt and I have obtained good compliance and treatment progress. Also, as I have got to know the patient and his family, I have developed a better understanding of his objectives and goals. I have found it much easier to read the pt's body language, facial expression and recognise fatigue and occasionally vasovagals. I have also been able to use his gestures, body language and vocal expression to understand what he is actually discussing when his speech is not logical or structured. In the past when I have not had any clue as to what the pt is attempting to say I have asked him simple questions to try to understand him. For example asking "Are you talking about your leg/arm?" and then either continue questioning if I'm on the right track or else simply ask if what he wants to tell me is important or if he can let me know later.
I think in a similar future situation, working with neurological pts I will remember these strategies as well as utilising new ones I will hopefully learn along the way.
Does anyone have any useful communication strategies they have employed with dysphasic pts?
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1 comment:
Unfortunatley I haven't treated any dysphasic patients, but have seen fellow students treat very simillar patients to yours. Your communication techniques sound very useful. I will definatley be using them if I come across a dysphasic patient in the future.
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