Planning for AAC in medical settings

Unfortunately, we are seeing a rapid spread of the coronavirus. Often AAC users may be vulnerable and susceptible to infection. AAC users and their supporters need to make plans in the event that they must go to hospital or medical centers. AAC users will need access to their AAC in these settings. Research tells us that without access to AAC to communicate clearly in hospitals, people are at risk for negative outcomes (Bartlett et al, 2008).

6 tips to support you:

1. Document your need for AAC

You may need this to demonstrate that your iPad is essential for communication. This documentation could be as simple as a piece of paper that states your name and date of birth, along with a sentence that says you rely on AAC technology (e.g., an iPad with Proloquo2Go or Proloquo4Text) for communication. Better yet, get a medical ID bracelet that lists your need for AAC.

2. Disinfect your iOS device or laptop

Your iOS device or laptop can transmit viruses and bacteria. There are valid infection control issues for why a hospital may not let you bring an iPad into the ICU or other medical environment. However, the iPad can be effectively disinfected without damage to the device. Remove your iPad from any protective case and disinfect it separately from the iPad itself. Apple has released guidance on how to safely disinfect an iPad if you are in doubt.

Every hospital has an infection control officer or specialist. Ask for help from this practitioner if needed.

3. Ask for hospital AAC evaluation

You may still be denied the right to bring your AAC into the hospital. Ask for a hospital speech language pathologist to evaluate your need for AAC. Ensure that the hospital’s speech therapy department is notified that someone with complex communication needs has been admitted and will need support.

4. Prepare back-up AAC

If you don’t have access to your usual iPad-based AAC, then what can you use as an alternative? Most hospitals provide generic laminated communication boards. Using an unfamiliar, light-tech board is an acquired skill, for both you and your communication partner. If you communicate by selecting letters, your communication partner will need to be able to keep up with the speed with which you select them. Practice selecting letters while someone else writes down your selections.

If you communicate by pointing to symbols, then unfamiliar symbols in unfamiliar locations will be a challenge. If possible, take a screenshot of your current AAC and print it to bring with you. Even better, laminate it. The familiar display will be helpful. You can also download, print and practice using the Crescendo Core Word board.

5. If possible, bring familiar communication partners to support you

You can express your message using AAC, but it’s only effective if medical professionals take the time to hear your message. Friends and family can help alert medical professionals that you have a message and can ask for them to wait while you construct your message.

Unfortunately, some hospitals are restricting visitors at this time. If your familiar communication partner is not there, you might need a different plan. Consider making a video with your communication partner to explain your communication system. Print out some instructions or more information about your communication. Perhaps you can FaceTime with your supporter during discussions. They can help even if not in person.

Also, consider a button or sign that can be said or shown quickly. It could say "Please wait while I write my message". This may also allow you more time when talking with medical professionals.

6. Practice new access methods

You might usually type your message or select symbols on an iPad screen through direct touch. COVID-19 can result in respiratory failure for a small number of people who get the disease. You may need a ventilator to support breathing. If you cannot use your AAC in your usual way, you may need to communicate by answering questions. This is an acquired skill, especially for your communication partner! Your communication partner will need training and practice to ask you effective questions. Practice strategies like responding to partner-assisted scanning and eye pointing now, before you actually need it.

Now is the time to prepare in case you need AAC in hospital.

Prepare and plan

We want to be prepared for the coronavirus. Plan for how communication could look in medical situations. Wash your hands, make a plan, and be prepared !

References:

  • Howell, et al. (2014).Disinfecting the iPad: evaluating effective methods. J Hosp Infect. 2014 Jun;87(2):77-83
  • Bartlett, Blais, Tamblyn, Clermont & MacGibbon (2008). Impact of patient communication problems on the risk of preventable adverse events in acute care settings, Canadian Medical Association Journal