By: Caryn Deskines, MS, CCC-SLP
Hi, my name is Caryn Deskines and I’m one of the Speech Language Pathologists on the Acute Care service at Seattle Children’s Hospital. I’ve been asked to give some tips for parents and outpatient therapists for preparation for inpatient admissions for children who use augmentative systems to communicate.
As you well know, each child is unique and each child’s method of communication is unique. What follows are some very general suggestions to consider when preparing for an inpatient stay. It is assumed that many of these things parents will be able to do on their own, with help from their outpatient treating therapist as needed.
If your child uses pictures to communicate, preparation with anticipated vocabulary in advance can be very useful. What pictures are needed (if any) is very dependent on your particular child. Sometimes children benefit from pictures of routine hospital occurrences such as basic vital signs (thermometer, blood pressure cuff, oxygen monitor, etc.). There may be other things that are expected as a part of a specific patient’s care during his/her admission; parents can ask at appointments prior to the admission (for example, a pre-operative appointment for a planned upcoming surgery) for anything else they might anticipate being a regular part of the nursing care. However, this is not a must-- if your particular child is just fine with nurses taking vital signs, etc., you may not need to prepare this. Decisions about what to prepare should be based on the anticipated needs of the child in an unfamiliar setting.
Additional suggestions we would offer:
Bring your child’s communication system and any power cords that come with it.
Know the positioning needs of your child with relation to accessing his/her communication device. If your child will spend the majority of his/her time in bed rather than wheelchair, can he/she still access the device? If not, is there a lower tech way to meet immediate hospital needs? Might eye gaze be an option for the short term?
Remember that nurses and doctors will not know how to use the communication system (especially high tech devices), so you will likely be providing a lot of education.
If your child has preferred activities that can be fun or self-soothing, bring some. That way, when your child uses his/her communication device, caregivers can provide the item being requested.
Know that adaptive call light switches are available if you request them. These are tent switches for easier options for access. It can sometimes take some time to have these adaptive call lights delivered and set up.
Another question frequently asked is if we can do anything to prepare the nursing staff in advance. Unfortunately, there is not much we can do to prepare specific nursing staff in advance beyond the preparation of what the family brings. One thing that is often very helpful is a sign with details explaining how the patient communicates and what the patient needs to be most successful (described as simply as possible). Please note for patient privacy reasons we are not able to post this on the outside of the door to the room, but a basic sign can be posted on the door saying “Please see the information posted in the room for how to communicate with me”, to trigger anyone walking into the room to read the details posted within the room.
There are several benefits to the family creating this in advance and bringing several copies to post on the door and in the room. 1) it is immediately available, 2) it is specific to the child, 3) it is written by the people who know the child best, and 4) it can be created in advance versus parents trying to create this during a potentially stressful time. Having a designated spot for an AAC system (e.g., on the bedside table) is also very helpful. In addition to a sign posted in the room, we often recommend that families review how to best communicate with their child with each RN coming on for a shift.
A “Speech consult” can be requested during admission, at which point one of our speech-language pathologists will then meet the patient and do our best to trouble-shoot maximizing functional communication in the hospital setting and add any pictures needed, etc. It should be noted that we are a consultative service for the entire hospital, and we do not have extensive or specific training in AAC devices, etc., but we will do our best to help with maximizing communication if the above recommendations are not sufficient in meeting the child’s needs.
We hope this helps in preparing for an inpatient stay here at the hospital!
Thank you, Caryn, for taking the time to share this helpful information with our readers!
You might also be interested in the following guest post written by a parent sharing about a hospital experience with her non-verbal child: