Golden Opportunities

Imagine, just imagine, what your life would be like if you couldn’t tell someone you were hungry, or tired, or that you had to go to the bathroom. And what if you couldn’t hear or understand what a person was saying? Here to explain what caregivers can do if age or illness is making communication difficult is Cindy Satterfield, speech language pathologist for the Visiting Nurse Association of Cleveland.

Question: When we talk about communication deficits, what do we mean?

Answer: Decreased hearing, memory problems, impaired word-finding skills, difficulty swallowing, and more.
Many of these issues may stem from a stroke or neurological disease, and all interfere with a person’s ability to function on a daily basis.

Question: Can you give us some examples of how communication barriers impact our daily lives?

Answer: Those with hearing loss may not hear the doorbell or phone, and my misinterpret communication on the phone. For example, when I try to schedule a home care visit, a patient with hearing loss often has a hard time discerning who I am over the phone, when I am coming, etc. This difficulty can lead to a lot of anxiety.
Receptive or expressive deficits following a stroke can impede a person’s ability to comprehend directions or reading. They may have trouble speaking clearly. They may have trouble signing a check.
Cognitive problems are a huge thing. People may have trouble orienting themselves or remembering their phone number or address, when they have a doctor’s appointment, when they need to take medications, etc.
They may have judgment problems, so safety is an issue. Cooking, for example, may be a concern.
Those with swallowing difficulties may have issues eating orally safely, needing to have their food pureed to a thickness determined by a speech pathologist. If not, food can aspirate into the lungs. Also, the flavors in pureed foods are not as intense, and that can cause weight loss.

Question: What should we do if we are experiencing this ourselves, or if a loved one is having communication problems?

Answer: Seek an evaluation. A speech language pathologist like myself can help with language and cognitive problems, and can assist those with swallowing issues. You may want to have an audiologist do an evaluation as well. Many times a person may seem to be confused, but it’s really an issue of hearing. The problem goes away with a hearing aid!

Question: What are some steps caregivers can take in the home to make a person with communication deficits feel more comfortable and independent?

Answer: Amplifiers are available from the phone company, and that may help with telephone communication.
Purchase a large calendar, with large print. Crossing off each day can help the person stay oriented.
Wherever you — can simplify things! For example, sort out medication into a pillbox. Find one that has not only the days of the week but also morning/noon/night.
Set the person up with a daily schedule or routine—when to eat breakfast, when to take medication, when to test blood sugar, etc.
Put up plenty of photographs of family members and friends with their names printed on it. Also keep important phone numbers written clearly kept by the phone.
If someone loves to read is having problems with vision, consider audio books.
If verbal expression is difficult, caregivers should try their best to stick to yes or no questions.
And if writing is a weakness, it may be time to decide what trusted family member will be held responsible for signing at the bank, signing checks, etc.

Question: Are there organizations that can help?

Answer: Yes. Disease based organizations, like the ALS or Alzheimer’s groups, may offer help and support. And you may call The Visiting Nurses Association. We can send out a nurse, do an evaluation and help set up an appropriate plan to assist.

Keeping the lines of communication open is so important. For more information, call the Visiting Nurse Association of Cleveland. The number’s next. My thanks to Cindy Satterfield for giving voice to our communication concerns.