Every individual has the right to communication as the Human Rights Act (1998) lists the freedom of expression as well as other rights relating to communication. As a staff, I have a moral obligation as well as adhering to the standards, codes of practice, guidelines, morals and law that govern my practice to ensure that communication needs are met. For example, 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 properly and express their feelings and needs. This could be more severe in the case of abuse whereby the individual can’t communicate effectively to alert others if they are being abused and can be vulnerable to abuse or when the service user is unable to express that they are in pain .
The result could also put others in dangers for example if a person’s communication needs were not met and they discovered a fire they would not be able to report it quickly which would put others in danger. It would also impact other rights such as those covered by the GSCC’s codes of practice which include; diversity, equality, control, dignity, effective communication, risks, safety and security. These would be infringed because the individual would not be able to effectively communication their opinions or views in relation to these rights.
As a healthcare worker it is my duty to ensure that I support and encourage individuals in everyday activities and promote their independence. My organisation also works in a service user centred way whereby communication is very important key, so I must ensure the individual’s communication needs are met. If I do not follow the codes of practice set out by my employer and the GSCC then I will not be promoting and encouraging communication from the individual concerned. This bad practice can lead to the individual feeling de-valued, isolated and not being part of the group. As a healthcare worker, it is my role and responsibility to support individuals to express themselves.
The way in which I can do this is by assessing their needs, access information regarding their communication needs, providing the appropriate support, aids or equipment, encouraging and motivating communication, working with others and by monitoring the effectiveness of that support. Without the appropriate support the service user would be unable to express their needs or how they are feeling which can lead to both emotional and physical difficulties. By fully supporting individuals with specific communication needs I am supporting their rights, although at times it can be very tiring and demanding especially when working with service users with dementia.
It is difficult and frustrating to communicate effectively when there is background noise, therefore arranging the environment to aid communication is very. Features that may hinder communication may include, poor lighting, lack of privacy, distraction, noise from TV/radio, people all talking at the same time, seating arrangements, not facing individual when talking to them, covering mouth, eating or chewing, talking too fast or too low, poor ventilation, room too hot or cold. Features that may help communication could include, talking slowly, clearly and concisely, eliminating any background noise, coming down to the service user’s level, giving time to respond and so on.
An individual may use a form of communication that is not based on a formal language system because they might not have been taught the right way or not at all, might have found it hard so made their own way of communicating up. There could be several reasons for this, one could be; due to hearing difficulties, in which case they will use sign language, another could be because of learning problems, and these people use a form of body language, some might use their eyes, whilst others communicate by making facial expressions or sounds or even pointing. A further reason could be due to a severe medical condition, and in some of these cases the individual can learn to use electronic equipment to communicate. For example, if a person could not talk or write but could hear, and either you or they didn’t know sign language then you could ask a question and say “press once for yes and twice for no”, hence you are using a form of communication that is not based on a formal language system.
1.5 There are variety methods and aids to support individuals to communicate and these include; Objects: can be used for point of reference, example holding up a cup when ask somebody if they would like a drink. The object can help the person to understand what you are saying. Photographs: of people or items that can be pointed at. They are also more portable. British Sign Language: the main communication method used by people with hearing loss, it uses the hands body and face to make signs which represent words and phrases. Makaton: is a form of signing which is intended to support speech, not replace it. It is a simple form of signing which can be used with any people who have difficulty forming words. Deaf-blind manual alphabet: The person signs letters on to the hand of the recipient to spell out what they wish to communicate. Braille: It is raised dots on paper formed into set patterns. Talking, reading and writing could also help.
A communication disability can be a hidden disability. This lack of recognition can be a barrier to effective participation. Lack of understanding can result in people’s behaviour being misunderstood. A person may be described as having ‘challenging’ mood swings and so on. They may become withdrawn from other people. But their behaviour may be a result of an unmet communication support need. If an individual didn’t have the support they need to communicate, it can affect their communication skills severely and the service user is more likely feel isolated, withdrawn and frustrated due to the lack of ability to express their needs and feelings.
2.3 You need as much information as possible about the individual’s communication needs to ensure that their wishes and needs are met. In my work setting we get an ‘easy care’ plan before the individual arrives. This tells us of any specific needs the individual has on all aspects of their care. We then complete care plans, with the individual, to support them during their stay. Observing their interaction with others is a good way of finding out information also. Talk to the individual, their family/carers, other professionals involved in their care. If aids are needed (hearing aids, picture cards, pen and paper) make sure that these are available. If language is a barrier maybe learning a few words of their language would help. If their needs change you need to adapt to the changes.
I would prepare the environment for effective communication by ensuring that all areas are well lit, chairs are comfortable and facing each other, people were facing each other, there is no loud noises and all other needs are considered and working properly such as, computer screens, hearing aids and so on, in order for effective communication between the service users and anyone else involved.
I would always check and comply with the individual’s tailored care plan in order in order to use the agreed methods of communication to interact with the individual. For example, in my unit there is Mrs A, who is Asian and had stroke in the past which affected her speech severely. She does understand English, but unable to response. She uses her hand and eye contact to communicate, so by complying the care plan in place will allow me to understand her more and how to deal with her.
I would monitor the individual’s responses before and after the interaction to check the effectiveness of the communication by checking for any nods of heads, asking people if they had understood the question, making sure people were taking notes and so on. I would then take on board what worked and what has not worked on board in order to promote a better and stimulating way of communication.
I would adapt my own practice to improve communication support with the individual by allowing the individual time to think before expecting them to answer. I would also ask them if there was anything they wanted me to do in order for them to communicate more effectively with them. For Example Mrs D, who has dementia finds very difficult to interact most of times and when given one to one attention and time for her to respond she tends to say meaningful sentences.
I would support the individual to develop communication methods that will help them to understand others and be understood by them by advising others on the best way the service user communicates, and if necessary acting as an in between person for the individual to communicate with others, as well as advising the service users on the best way for them to communicate with others.
I would provide opportunities for the individual to communicate with others by taking time to provide all necessary equipment. I would also take them out into society so that they can communicate themselves with people, for example, in the park, shopping or when taking them out for coffee. This encourages them to be more interactive and will help to improve their social wellbeing.
I would support others to understand and interpret the individual’s communication by encouraging them to read and comply with the allocated care plan of the service users, as this would give the a more insight and more detailed information of the service user, such as the service user’s wishes and preferences.
I would support others to be understood by the individual, by using the agreed methods and advising them on the particular communication methods that the individual uses and prefers to use. I would take on board improvement or diminishment observed.
Some of the specialist services relating to communication technology and aids could be; Makaton, PECS book written communication, telecare, hearing aids, spectacles, picture card and also allowing time for the individual to process the information and to respond back and so on.
Types of support that an individual may need in order to use communication technology and aids could include; information being used in the individual’s preferred method of communication and language such as, DVDs, audio, braille, taking the individual to the shop to look at the equipment in order to get an idea of how it works, helpline, reviewing how the individual is getting on with the use of the equipment and whether it needs changing/adapting. All of these will reassure the service user and show that they are not alone in this and have support when needed.
It is very important to ensure that communication equipment is correctly set up and working properly in order to maintain the service user’s health and safety at all times. The equipment need to be set up by a qualified or specialist person who knows what need to be done. The staff and the service user may need training of how to use the equipment. Whether the equipment needs servicing, maintenance checks, how often and by whom. Putting all these into consideration will save the service users from stress and frustration if it happens not to work.
6.1, 6.2, 6.3
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