Observe patient closely for cues to personal needs and desires, such as gestures, pointing to objects, looking at items, and pantomime to enhance understanding. Don't continually respond to gestures if the potential exists to improve speech to avoid discouraging improvement. - Monitor and record changes in patient's speech pattern or level of orientation. Changes may indicate improvement or deterioration of condition.
- Speak slowly and distinctly in a normal tone when addressing patient, and stand where patient can see and hear you. These actions promote comprehension and active participation.
- Reorient patient to reality:
- Call patient by name.
- Tell patient your name.
- Give patient background information (place, date, and time).
- Use television or radio to augment orientation.
- Use large calendars and reality orientation boards.
Use short, simple phrases and yes-or-no questions when patient is frustrated to reduce frustration.- Obtain communication aids for patient's use, such as an alphabet board, slate, pen, paper, and picture board, to provide alternative communication methods.
- Encourage attempts at communication and provide positive reinforcement to aid comprehension.
- Allow ample time for a response. Don't answer questions yourself if patient has the ability to respond. This improves patient's self-concept and reduces frustration.
- Encourage family members and colleagues to use speech appropriate for adults when talking to patient and not to talk about patient within range of hearing to convey respect.
Consult with a speech therapist to suggest such communication aids as an artificial larynx. Assist with its use. Appropriate early referral encourages the use of communication aids.- Demonstrate communication techniques, such as gestures, sign language, and eye blinking, to patient and family members to develop alternative communication skills.
- Assist patient in energy-conserving techniques to allow maximum breath for speech or use of communication aids.
- Repeat or rephrase questions if necessary to improve communication. Don't pretend to understand if you don't to avoid misunderstanding.
- Remove distractions from the environment during attempts at communication. Reduced distractions improve comprehension. Use communication boards (including alphabet and some common words and pictures) if appropriate to aid comprehension.
Provide patient with emergency call system (bell or call light), and respond to all calls immediately and in person. Place a sign over the intercom to alert all staff members of the need to respond quickly. Prompt responses reduce patient's fear and anxiety.- Review diagnostic test results to determine improvement or deterioration of the disease process. Adjust the care plan accordingly.
Suggested NIC Interventions
Active Listening; Anxiety Reduction; Communication Enhancement: Hearing Deficit; Communication Enhancement: Speech Deficit; Energy Management; Learning Facilitation; Touch |