© 2020 MJH Life Sciences™ and Physician's Practice. When the family member/caregiver attends appointments, three-way conversations are more time-consuming. Treat adults with intellectual, cognitive or developmental disabilities as adults. – Deirdre Wilson. However, don’t be afraid to use the standard phrases like “I’ve got to run”, since they are not hurtful, they are simply considered common phrases. Managing patients with disabilities requires a more thorough preparation as you need to be very aware of their needs, without making them feel uncomfortable.
Also, although this applies to regular patients as well, you should always remember not to talk loud to a patient with special needs. • When talking with a person in a wheelchair for more than a few minutes, place yourself at the person’s eye level to spare both of you a stiff neck. Patients with disabilities afford us the chance for immense professional growth if we welcome the opportunity to remain clinically teachable and emotionally compassionate to those with special needs. The job of a nurse is always difficult, with all sorts of challenges along the way. As a certified physician assistant (PA) specializing in neurosurgery, I work regularly with other medical providers and special needs patients. The reason the behavior mentioned above shouldn’t be used is that the patient with a special need will assume that you are treating them as a child. That is why you must ask them whether or not they want your help in certain situations. You can achieve that through many ways, such as asking them what terminology they prefer regarding their disability and use that. Speak in a normal tone of voice, indicate when you move from one place to another and when the conversation is ending. Children with special needs have not only physical limitations that challenge their opportunity for communication, they also have environmental barriers. Since then, I have been fortunate to work with those with special needs, volunteering locally every week and with Special Olympics. If you have friends with disabilities, invite them to visit you and think of ways to include them in the things you do. The complex challenges of those with special needs requires extra preparation and a thorough review of their history. Many clinicians assume that if the patients cannot see or speak, they may not comprehend what is being said. • When greeting a person with severe vision loss, always identify yourself and others who may be with you. But, it would help to have more knowledge. However, if the person is hard of hearing or has a cognitive disability, then it is necessary that you slow your speech down a bit and also use a higher voice if the patient suffers from hearing loss. • Give whole, unhurried attention when talking to a person who has difficulty speaking. When I would escort my brother to a medical appointment, physicians would ask complicated questions directly to him, aware that he could not fully understand the question. Specifically, under no circumstances should you use a voice that is louder than usual, child-like vocabulary, or pet names. Be patient; try not to speak for the person. That’s what most of us strive to be. Another important thing to remember is to be respectful. Patients with a cognitive disability require more detailed or simplified instructions and explanations. Even if your patient has a translator or an assistant present with them, you should refrain yourself from addressing that person instead of the patient. Even if you don’t exactly understand what they are saying, the best thing is to ask questions that help you grasp the meaning of their words. I would wait until Guy finished commenting, and then sensitively offer additional clarification to the questions. Also, although the person may not display the regular listening body language, that does not mean that they cannot hear you. They may also need extra time dressing and undressing or require more time for clinicians to position and examine them. I have witnessed firsthand peoples’ struggle to communicate with those with special needs. Patients with disabilities may also be economically vulnerable, age prematurely, or be at increased risk of physical, sexual or verbal abuse. All rights reserved. When conversing in a group, give vocal cues, such as identifying the person to whom you are speaking. • Don’t be embarrassed if you happen to use accepted, common expressions, such as “See you later” or “Got to be running along” that seem to inappropriately relate to the person’s disability. Being prepared is paramount to a successful encounter for both clinicians and patients.

Patients with disabilities need more of clinicians’ time than nondisabled patients because of their physical, communication, and cognitive barriers. Instead, the voice and the vocabulary should be normal, just like you are using when talking with any other patients. When necessary, ask short questions that require short answers or a nod or shake of the head. Shouting won’t help. Wherever patients reside, it is imperative that they be accompanied by a reliable caregiver who is familiar with their activities of daily living and physical, social, and intellectual norms versus a driver who transports patients to the clinic. • Be considerate of the extra time it might take for a person with a disability to get things done or said. In a perfect world, physicians could schedule a phone consult before a visit with a caregiver/family member to better understand how they can make the visit most comfortable for patients.
These situations are best handled by asking the patient how he/she would prefer that you talk to them. It is common for clinicians to be uncertain about how to communicate to the patients for fear they may not understand questions or comments. Adjust your method of communication as necessary depending on the individual's responses to you. Remember a disability is different than an illness. In this case, the same rule as above applies – ask the person about their language needs. While illness and disability can coexist, it is important to separate the disability from the acute care treatment plan. Also consider in advance who will chaperone the patients. At the end of the day, you might even notice that it’s not more difficult than handling a regular patient. Also, although this applies to regular patients as well, you should always remember not to talk loud to a patient with special needs. Being prepared is paramount to a successful encounter for both clinicians and patients. Never interrupt the patient, even if they expresses words slower. Treating the disability as an illness inappropriately perpetuates the “sick” role and is ultimately disempowering for people who struggle with challenging conditions. • To get the attention of a person with a hearing disability, tap the person gently on the shoulder or wave your hand. You know what you have to do and why. Recommendations for Communicating with Patients with Intellectual, Cognitive or Developmental Disabilities. Assume patients with disabilities understand what is being said to them. Remember to consider their needs ahead of time, and let them know if a barrier exists at an event you’re inviting them to. Prepare for the encounter in advance by reviewing patients’ histories.

As a nurse, it is quite important that the patient feels that you are genuinely helping them. For example, if the patient has a central nervous system deficit, flaccid paralysis, or spasticity is consistent with their baseline, we … However, you must not make them feel like they are unable to look after themselves, so the line is quite thin here. © 2020 MJH Life Sciences and Physician's Practice. Looking at it from a medical perspective, if the conversation is rather long, then your patient might end up with a neck strain. In most circumstances, speak to patients with disabilities first, even if patients are nonverbal, visually impaired, and/or have a blunt affect. Interacting with special needs patients will become much easier if you would try to imagine how you would like people to treat you if you were suffering from a disability. The complex challenges of those with special needs requires extra preparation and a thorough review of their history. Therefore, when dealing with that patient, you must not focus on their disability or act any differently than you would do with a regular patient. But, it would help to have more knowledge. Let the person set the pace in walking and talking.

Speak in a normal tone of voice, indicate when you move from one place to another and when the conversation is ending. Scrubs Magazine uses cookies to help serve you better content.

From my personal and professional experiences, I can offer five suggestions that may help clinicians provide the best quality care to those with disabilities. Patients with disabilities may need more time to express themselves, or they might use technological aids that delay the process. Like us on Facebook and join the Scrubs Family. Some also require written material to support verbal directives. Yet many people admit to feeling uncomfortable around a person with special needs because they’re afraid they may say or do the wrong thing. When giving directions to a person in a wheelchair, consider distance, weather conditions and physical obstacles, such as stairs, curbs and steep hills. Here are three important tips that can help you when working with special needs patients. This can help you find out valuable information, such as if they prefer to take the stairs with you or the elevator. Guy would try to answer the questions as best he could.