1.1. Explain the importance of meeting an individual’s communication’s needs. Communication is an essential part of all relationships, and as a support worker, the ability to communicate well with the service users is a basic requirement for doing my job. Every individual has the right to communicate and as a support worker, I have a moral obligation as well as adhering to the standards, codes of practice, guidelines, morals and law to make sure that everyone’s communication needs are met.Every person has the right to “freedom of expression” as stated in The Human Rights Act 1998. If an individual’s communication needs are not met then all aspects of their daily life can be affected such as not being able to communicate when they are ill or feel sick or hungry or when they need help with different aspects of their life such as what they want to wear,what they would like to do socially or in the worst case if they were being abused. It would also affect all the other rights covered by the risks, safety and security.
| 1.2. Explain how own role and practice can impact on communication with an individual who has specific communication needs. As a support worker I need to be alert at all times and to be prepared to analyse and adapt to everyone’s needs for communication. The way I work and relate to the individuals I support can help or hinder them to have the proper care or needs attended. There are so many ways of communicating and almost every person is able to communicate in some way. It is vital that i act in a way that shows i am interested in them and that they have my undivided attention. I should always let them speak and not interupt them or try and finish their sentances, i should respond with single questions so as not to bombard and confuse them, and i must always allow them time to think and to give their response and never try and answer for them. I should use closed questions at times when limited communication is the case, for example; would you like a cup of tea? a simple yes or no can be given. If you are able to encourage more in depth communication then ask an open question such as; would you like a drink? they can answer yes or no but then you can ask; what would you like to drink? that way the person will have to make their own decision and give you an answer.
1.3. Analyse features of the environment that may help or hinder communication It is difficult and frustrating to communicate effectively when there is background noise, therefore arranging the environment to aid communication is a very important step to achieve effective communication. Some factors that can hinder communication are; * Poor lighting, individuals with poor sight may be unable to see you properly and a person with a hearing impairment may also rely on reading facial expressions or lip reading. * Background noise from televisions, radio, traffic or other individuals. It can be almost impossible for an individual without communication problems to concentrate when there is background noise, this is of course magnified for a person with hearing difficulties or someone that needs to concentrate on what is being asked or told to them.
* Obstacles in-between the persons communicating. Desks or windows can create a barrier between the two people trying to communicate. It can seem for the person the other side to create a sense of superiority or hierarchy, this can cause unease. * Insufficient distance. Everyone needs space and by getting too close to someone you can be invading their space. If a person was talking to you and you walked up and put your face next to theirs or got close and stared into their eyes this could or almost always would make a person feel intimidated or uncomfortable.
1.4. Analyse reasons why an individual may use a form of communication that is not based on a formal language system. The communication of someone who does not use formal language is usually around individual body language, vocalisations, facial expressions etc. You have to get to know the individual to find out what their ‘signs’ mean. Learning disabilities. Up to 90 percent of people with profound and multiple learning disabilities (PMLD) do not communicate using formal communication like speech, symbols or signs. But this does not mean that they can’t communicate. Instead they tend to rely on facial expressions, vocal sounds, body language and behaviour to communicate.
1. Using objects of reference
These are objects that have special meanings attached to them. They are useful for people who are unable to understand pictures or symbols. They can help someone to understand what is being discussed or to anticipate an event or activity. To help make an object meaningful to the person you support it can be useful to present the object and follow it straightaway with the activity it represents – for example presenting a cup and then following it by giving the person a drink. Once a link has been made between the object and an event or activity, the object can start to represent that activity. If objects of reference are developed for different activities then they might provide a way for someone to get involved in choosing what they want to do.
2. Use of appropriate communication aids
Many communication aids are not appropriate for people with PMLD, for example, voice recognition software. However, a Big Mack, which allows sounds to be recorded and activated at the push of a button, is an example of a communication aid which can help someone with PMLD communicate. You can record a noise on a Big Mack and stick pictures on it or attach an object to it to help prompt the person to use it. The person can then communicate and get involved by pressing the Big Mack and activating the message or sound.
3. Use of multimedia
Using video and digital photography to develop computer-based personal profiles has helped people with PMLD to have ‘a voice’ and put across their preferences in a really powerful way. To start using multimedia, you could take some film of the person you support doing an activity they enjoy. See how they respond to being filmed and to watching film of themselves. Do you think the film is useful in showing how the person communicates and what they enjoy doing? It is always important to think about issues around consent when you are filming someone or showing people’s images as per your company policies and procedures.
4. Communication passports
A communication passport presents the person positively as an individual. It draws together information from past and present, and from different contexts, to help staff and conversation partners understand the person, and have successful interactions. It is a place where the person’s preferences can be recorded. The person’s preferred means of communicating is also recorded – some innovative practice uses digital film. A communication passport is very useful way to help others understand how someone communicates. Physical disabilities such as hearing problems or speech difficulties. Get their attention. Because they’re deaf, you’ll need to tap them on the arm gently or wave your arm (not too close to their face). Show your emotion to let them know how you feel (smile etc.)
Introduce yourself. Some deaf people can lipread, so make sure to face them. Speak clearly, and don’t talk very fast, because slurred speech/fast speech makes lip-reading more difficult than it already is. Use your hands to communicate if possible. That is, learn sign language. For example, the sign for car looks like you’re holding a steering wheel. Bring pictures or a book to show them if they don’t understand. Be patient if they don’t understand you at first. Try again. Deaf people can usually read and write, just as much as anyone else. A pad and pen will come in handy to aid communication, especially if you do not sign and they do not speak.
In society people do not always understand mental health and in the most severe cases such as Schizophrenia. Popular media fuel stereotypes about mental illness and dangerousness, because that is how they generally are portrayed on the screen. Newspapers sensationalize crimes committed by people with mental illness. Our fear of mentally ill people also stems from our own inability to communicate with them and our lack of knowledge about mental illness. Just because they may be behaving in ways that don’t make sense to us, doesn’t mean that we can’t provide them with service that is part of our jobs to provide. So how do we communicate with a person with mental health issues? Be respectful to the person. When someone feels respected and heard, they are more likely to return respect and consider what you have to say. If they are experiencing events like hallucinations, be aware that the hallucinations or the delusions they experience are their reality.
You will not be able to talk them out of their reality. They experience the hallucinations or delusional thoughts as real and are motivated by them. Communicate that you understand that they experience those events. Do not pretend that you experience them. Some people with paranoia may be frightened, so be aware that they may need more body space than you. Do not assume that they are not smart and will believe anything you tell them. Mental illness has nothing to do with the person’s intelligence level. Do not lie to them, as it will usually break any rapport you might want to establish. Do not just pass them on to another person like a “hot potato” just to get rid of them. This may save you time in the short run, but may come back to haunt you later, or cause problems for someone else.
Anyone who is passed unnecessarily from one person to another can become angry or violent. Refer them to someone else only if it is an appropriate referral. Listen to the person and try to understand what he/she is communicating. Often, if you do not turn off your communicating skills, you will be able to understand. Find out what reality based needs you can meet. If needed, set limits with the person as you would others. For example, “I only have five minutes to talk to you” or “If you scream, I will not be able to talk to you.” Keep a current list of community resources, like shelters, food programs, and mental health services that you can suggest to them (if they need it). Some people will not accept the suggestion, but some will. Call for help (police, security, or colleagues) if you feel physically threatened or need help de-escalating the person.
An early sign that someone’s language is being affected by dementia is that they can’t find the right words – particularly the names of people. The person may substitute an incorrect word, or may not find any word at all. There may come a time when the person can hardly communicate accurately or successfully through language. This may be distressing for their loved ones, but it’s a normal aspect of their memory loss. Other factors may also affect the ability of a person with dementia to communicate – including pain, discomfort, illness or the side-effects of medication. If you suspect this might be happening, talk to the person’s GP. Difficulties with communication can be upsetting and frustrating for the person with dementia and for those around them, but there are lots of ways to help make sure that you understand each other. Before you speak, Consider what you are going to talk about. It may be useful to have an idea for a particular topic ready, or to ask yourself what you want to achieve from the conversation. Make sure you have the person’s full attention. Make sure that the person can see you clearly. Try to make eye contact. This will help the person focus on you. Minimise competing noises, such as the radio, TV, or other people’s conversations.
When speaking to soeone with dementia speak calmly, slowly and clearly and give the person time to take in what you have just said. Speak at a slightly slower pace, allowing time between sentences for the person to process the information and to respond. This might seem like an uncomfortable pause to you but it is important for supporting the person to communicate. Avoid speaking sharply or raising your voice, as this may distress the person. Use short, simple sentences. Don’t talk about people with dementia as if they are not there or talk to them as you would to a young child – show respect and patience. Humour can help to bring you closer together, and may relieve the pressure. Try to laugh together about misunderstandings and mistakes – it can help. Try to include the person in conversations with others. Try to be positive. Avoid asking too many direct questions. People with dementia can become frustrated if they can’t find the answer.
Try not to ask the person to make complicated decisions. Giving someone a choice is important where they can cope with it, but too many options can be confusing and frustrating. If the person doesn’t understand what you are saying, try to get the message across in a different way rather than simply repeating the same thing. Listen carefully to what the person is saying, and give them plenty of encouragement. When you haven’t understood fully, tell the person what you have understood and check with them to see if you are right. If the person has difficulty finding the right word or finishing a sentence, ask them to explain it in a different way. Listen out for clues. Also pay attention to their body language. The expression on their face and the way they hold themselves and move about can give you clear signals about how they are feeling. If the person is feeling sad, let them express their feelings without trying to ‘jolly them along’. Sometimes the best thing to do is to just listen, and show that you care.
Due to memory loss, some people won’t remember things such as their medical history, family and friends. You will need to use your judgement and act appropriately around what they’ve said. For example, they might say that they have just eaten when you know they haven’t. A person with dementia will read your body language. Sudden movements or a tense facial expression may cause upset or distress, and can make communication more difficult. Make sure that your body language and facial expression match what you are saying. Never stand too close or stand over someone to communicate: it can feel intimidating. Instead, respect the person’s personal space and drop below their eye level. This will help the person to feel more in control of the situation.
Sensory impairment is when one of your senses; sight, hearing, smell, touch, taste and spatial awareness, is no longer normal. Examples – If you wear glasses you have a sight impairment , if you find it hard to hear or have a hearing aid then you have a hearing impairment. A person does not have to have full loss of a sense to be sensory impaired. . Deafblind people may use symbols, objects of reference, sign language, braille and other communication systems. 1.5.Identify a range of communication methods and aids to support individuals to communicate. Communication charts, books etc – Effective communication for the non-speaker can often be achieved by pointing with a finger or the eyes to words, photos and symbols contained in communication books, charts and boards. These may include PECS. Words and symbols – It’s not essential for the user to be able to read text in order to use a communication aid. Many aids present the user with symbols which can relate a full range of spoken vocabulary.
Communication aids that speak – These aids use two types of ‘voice’ – artificial or pre-recorded – to speak letters, words or phrases that the user has chosen. By artificial, we mean computer-generated speech. Nearly all speaking communication aids can play back pre-recorded speech which, as it’s name suggests, consists of single words or phrases that have been recorded by a human speaking into a microphone (usually on the aid itself). Human aids – Interpreters, translators for those who speak a different language for example and advocates who will help an individual to understand and to make a decision that is in their best interest. Sign Language – this is especially helpful with deaf people. Makaton is a language programme using signs and symbols to help people to communicate. It is designed to support spoken language and the signs and symbols are used with speech, in spoken word order. Touch- touch is a very powerful means of communication.
Lightly touching a person’s hand can convey your concern and affection for them, the touch has to be appropriate, and there are important cultural issues around touch that need to be understood. It’s also important that patient/clients give permission for you to touch them. You could ask them to touch you once for yes and twice for no as an example. Braille – The Braille method is a system which is commonly used by blind people to read and write. Each Braille character is made up using six dot positions which are arranged in a rectangle. Dots can be raised at any of the six positions and can be used to form up to 64 permutations. 1.6. Describe the potential effects on an individual of having unmet communication needs. An individual with unmet communication needs may feel isolated as if no one is listening to them or understands them. This may then result in them getting very frustrated and angry, they may also begin to get depressed and withdraw from usual daily activities.
2.3. Explain how and when to access information and support about identifying and addressing specific communication needs . I would try and access support information if i was struggling to communicate with an individual and had concerns that there were other issues. I would firstly discuss with senior members of staff, other carers involved including family and of course my manager. Headway have two full time occupational therapists whom i could contact immediately for advice or for them to come out and assess the individual. If i was concerned about strange behaviour or had concerns that an individual was potentially putting themself at risk of harm then as a duty of care i would contact a psychiatrist. I have had to do this before and have had to monitor behaviour, record and communicate to other staff members. I have done this through doctors appointments asking for psychiatrist referral and also directly by contacting an emergency number for 24 hour psychiatrist support.
I am also lucky that we have a full time psychologist at Headway so i am able to do a referral immediately for an assessment and possible further psycologist input to discuss behavioural issues perhaps made worse by depression or anxiety. I can alsso use the internet to access support for behavioural issues and speech problems. I have always found google excellent for this and at Headway we have a full list of numbers to contact for specialist support if and when required. 5.1. Identify specialist services relating to communication technology and aids. The internet aswell as other therapists including speech therapists, occupational therapists and doctors and hospitaals can all give you information regarding communication technology. Below is a list of communication aids. (a) Talking photo albums.
These have varied minutes of recording time for each message and are a really useful product to help you stay independent. The Albums have a variety of uses for people with a visual impairment, Alzheimer’s or Dementia. They can be applied to activities for children or adults with special needs or for anyone who just wishes to have audible information readily available as a quick reference. You can store and access; Emergency Contacts, Remember Important Information, Stimulating memories,Medication Management,Photographs of family, friends, holidays and special events, Organize Appointments, Create Audio/Visual Procedures, Diary Event Schedules and Create a Talking CD or DVD Holder. (b) Listen to Me. Below is an example of a listen to me device. It can be carried in a case or over the shoulder so is very portable. It has 12 buttons where pictures or memory aids are stored and when pressed will play a short message which you would produce yourself.
(c) Lightwriter. Lightwriters are text-to-speech devices – the person who cannot speak types a message on the keyboard, and this message is displayed on two displays, one facing the user and a second outfacing display for the communication partner(s). A speech synthesiser is also used to provide speech output. For people who are unable to use a keyboard, some models of Lightwriter offer the option of an on-screen keyboard with selection made by a switch using a scanning technique. Below is a picture of a lightwriter.
(d) Go Talk. This is very similar to the other products. Sentances such as “i would like”, “thank you very much” etc can be stored as a picture or phrase and pressed to speak the sentance. It can have up to 32 different pictures or phrases stored and as many as you can like can be instantly pressed to produce a full flowing sentance such as; “i would like chcicken and chips for tea thank you very much”. I have again listed an example picture below.
It is important that all relevent staff and the user is fully trained to use either of the chosen products to ensure good communication is produced.
5.3. Explain the importance of ensuring that communication equipment is correctly set up and working properly. Firstly it may need setting up by a qualified engineer or specialist person. The individual and staff may need training on how to use it,also you need to know, does it need servicing? does it need a maintenance check, how often & by whom? What could be the impact on individual if the equipment wasn’t working e.g. health and safety – not working in an emergency – frustration, stress, isolation. I would need to think about the equipment and what i would do if the equipment wasn’t working and whom i would contact to get it repaired. It would need a thorough risk assessment and contingency plan put in place in case of not working. I would after training and finding it was providing to be a good communication tool try and get a spare for in the case of not working.
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