Hospitals are big and busy places. When people with specific needs or communication disabilities have to come to hospital, problems can arise. Research has repeatedly demonstrated poorer health outcomes for people with intellectual disabilities than for the general community.
Bendigo Health wanted to improve the way it provided services to this group and to others who faced barriers because of cognitive and/or communication barriers. The Victorian Department of Health and Human Services provided a grant to employ a project worker.
The Regional Communication Service was consulted as the project was getting off the ground. We provided information about the range of strategies and solutions in Augmentative and Alternative Communication, support, information access and way finding which have been used in other hospitals around the world.
It was decided that the first strategy to try was the Hospital Communication Passport. This is a template developed in the UK for use in the Hospital setting. It provides information about how the person being admitted communicates, how to best support them, and who this person is as a person. It means that staff who read it, especially if they do so before the person arrives, can make the admission much more successful.
Over a couple of years the project worker (who was a speech pathologist) adapted the template for local use, spoke to many forums, formed partnerships, visited workplaces where people with disabilities were supported, spoke to people with disabilities, trained hospital staff, and did all the work that was needed to get the template to be used effectively.
The Regional Communication Service was involved along the way, in particular, with feedback from disability service staff and people with disabilities in the community about how the implementation of the Hospital Passport was going.
Last month, the project worker finished her work. Use of the Hospital Passport is now embedded in the Hospital’s procedures.
Read more about the Hospital Passport used by Bendigo Health at https://www.bendigohealth.org.au/disability_or_special_needs/
Southern Loddon Mallee Regional Communication Service
Nineteen participants attended a morning of information and activities designed to raise awareness about communication difficulty. Kelsey and Meredith provided strategies that support people to communicate more successfully, including an introduction to Key Word Sign.
Participants included disability support workers, parents and family members of people with communication difficulty, and NDIS support coordinators.
Here’s what some participants said about the training:
“it is very important for all disability support workers/community services to attend this type of training; especially support workers”
“Good short course, great to have 2 presenters!”
“Very descriptive and covered areas interesting regarding my employment”
“ Very entertaining and informative…”
More workshops are planned in other LGA’s including Wodonga and Alpine
Hi, I’m Hannah Chalker, a Communication Coordinator supported by North West Regional Communication Service at Distinctive Options. I have interviewed several of our participants and they have given permission to share what they said.
They talk about their perspectives about challenges they face, what works well and ideas on how we can communicate better together. Let’s hear what one person (also called Hannah!) said.
Hi, my name is Hannah.
I am 20. I live with PKAN, which affects my ability to move my tongue and
means I can’t form words clearly.
Q: Do you struggle to communicate to others? Do people struggle to communicate with you?
Yes, people don’t always
understand me, even if they know me well. I often don’t have my tablet (which
has a speech app) accessible, as I don’t have anywhere handy to put it.
People who don’t know me don’t speak to me. They will speak to whoever I’m with, because they don’t understand what I’m saying.
Q What is your biggest barrier to getting your message across?
Not always having my tablet
handy to use my speech app.
Q What have you found to be the best way for you to communicate to people who don’t know you well?
My Verbally app, talking really slowly and gesturing.
Q What are some annoying things that people do when communicating with you?
Speak to me like I’m a baby; e.g. “Hello sweetie”
Speak to the person with me, instead of to me
Not giving me the opportunity to talk back because my phone is in my bag.
Q Do you have any advice for people who feel nervous to speak to you?
Just speak to me like you
would any other 20yr old.
Q What can people do so you feel included in conversations and activities?
Look at me if you’re talking
to me or ask me something and give me time to answer. Get my tablet out so I
can talk back.
Thank you Hannah!
(Since this interview, Hannah has new tags on her wheelchairs which say ‘Please get my tablet out of my bag for me’ . She gesture to them any time she needs to.)
As a new
member of the North West Regional Communication Service, I have been privileged
to be involved in and experience the positive impact that the Regional
Communication Service has on services/local communities and their members that
service individuals with complex communication needs.
experienced a stroke 2 years ago which left her unable to speak. Since this
event, she has been using her iPad, specifically the app Proloquo2Go, gestures,
photos, and writing to communicate with her friends, family and members of the
The North West Regional Communication Service has recently partnered with the Royal Melbourne Hospital – Royal Park Campus to present training regarding communication access to new staff members. The aim was to equip new staff members with the skills and knowledge to communicate with individuals with complex communication needs. This could not have been done without the help and courage of a communication access consultant, Donna.
Donna played a major role in delivering the training. She began by sharing her personal experiences after her stroke: frustration and isolation when people could not communicate with her successfully and sadness when people treat her differently. She also shared her new expertise: the importance of having strategies and alternative communication methods to foster successful communication and interactions.
Staff marveled at Donna’s proficiency in using the Proloquo2go app and also discussed ways in which they could improve the current communication boards to better suit people who have communication disabilities or difficulties.
Donna has a new-found confidence in sharing her story with a variety a people that interact with individuals who have complex communication needs. She continues to support these staff to enhance their skills in communicating with people who have communication difficulties.
Stephanie Popovich, North West Regional Communication Service
Stroke a Chord Choir is celebrating nine years of educating communities about stroke and aphasia – and of bringing joy to members and audiences.
This unique choir of stroke survivors with aphasia (loss of speech after stroke) began in 2010. The choir is supported by Maroondah’s Metroaccess worker and the Eastern Regional Communication Access Network speech pathologist. The choir began after Wendy Lyons, a stroke survivor herself, noticed that some people in her stroke group couldn’t speak, but could sing. The choir is conducted by a qualified music therapist and has had ongoing commitment from talented and passionate volunteer musicians.
Though remaining unfunded, the choir has hit many high notes, including a documentary film, several pieces of research, a book of members’ stories, as well as numerous performances including 8 large annual concerts. The latest achievement was a combined choir performance at Hamer Hall for an audience of 2000 people.
The choir has inspired several similar “aphasia” or “neurological” choirs to form in Victoria, Australia and even worldwide, with a Facebook page “Aphasia Choirs go global”, which is co – hosted with international specialists in music, speech and the brain.
Listen out as this small choir makes a big noise – singing its way towards a decade of inspiration!
The City of Greater Bendigo Service Desks Communication Access Symbol assessment is probably happening right now! Good luck everybody!
The City of Greater Bendigo has a population of more than 110,000 people. A few years ago, it identified communication access as an important part of its Community Access and Inclusion Plan. It requested support from the Southern Loddon Mallee Regional Communication Service.
Initial planning and training took place with the Manager of Customer Support and some selected “champions” working on the City of Greater Bendigo Service Desks.
Other Managers were informed and consulted about City of Greater Bendigo’s actions to achieve communication access.
The Mayor and Councillors and the Disability Inclusion Reference Committee were informed and reviewed the communication aids. The website was reviewed and changed.
By the start of 2019 City of Greater Bendigo service desks in three locations felt nearly ready for assessment.
In the first half of the year, the Regional Communication Service and City of Greater Bendigo staff worked hard to realise their goal to be awarded the Communication Access Symbol at the three main Service hubs in Bendigo and Heathcote.
Early in the year the Regional Communication Service observed and reported to City of Greater Bendigo managers on communication accessibility at the Service Desks. This led to some meetings with managers, to review results and plan responses.
The Regional Communication Service worked closely with the Customers Support Manager to make sure commercial picture communication symbols were properly acknowledged, to create explanatory material for the public and staff, and to organise staff training, including pre training questionnaires and tasks, pre and post training evaluations, scenarios for inclusion in training, and payment for the co trainer, who was a Communication Access Assessor and an Augmentative and Alternative Communication user.
The Regional Communication Service planned the training with the Communication Access Assessor. Four two hour trainings were delivered so that all staff at Bendigo and Heathcote Service Desks could attend.
Evaluations indicated that the training was highly valued overall. Participating in scenarios and roles plays, learning to use communication aids, learning how to interact with people with communication disabilities, and being able to ask a person with communication disability questions were all repeatedly commended. Everyone reported that they would recommend the training to others.
After City of Greater Bendigo receives its award, the Regional Communication Service will continue to support the sustainability of communication access. For example:
There is an identified champion who will review important elements of communication access provided by the Regional Communication Service regularly.
Links to CAN videos have been provided to enable new staff to understand communication access and old staff to refresh their knowledge.
There will be further liaison with City of Greater Bendigo Education staff who attended the training to ensure continued staff support.
The Regional Communication Service is involving other local organisations who can help resource the City of Greater Bendigo in communication access.
We hope more City of Greater Bendigo services will be developing their communication access.
Now another local government area has approached the Regional Communication Service for communication support, after seeing what the City of Greater Bendigo has done.
Meg Irwin, Southern Loddon Mallee Regional Communication Service
The Gippsland Regional Communication Service has been working with East Gippsland Shire Council’s Information Centres to increase communication accessibity. This is part of the council’s commitment to communication accessibility across all of its services.
Bairnsdale Information Centre has been the first Centre involved, with a view to roll out strategies across the Shire.
Bairnsdale Information Centre is an information hub in the centre of Bairnsdale. It is a resource for many international and Australian travellers. As well as providing information on local tourist activities, it helps travellers with logistical issues and with booking local accommodation. It also provide travellers with physical disabilities with information and links them to local resources to enable them to participate in tourism activities.
Information Centre staff had noticed some communication breakdowns in the centre. For example, travellers often made requests that indicated they were not aware of the Centre’s services. For example, it was not visually apparent that the Information Centre was able to book accommodation or that it offered free WIFI. All signage within the building was in written English words only, which was difficult to understand for people with low literacy or limited English. Staff also reported that several travellers daily asked for directions to public toilets (located outside of the building). This indicated that wayfinding signage could also be improved.
The Gippsland Regional Communication Service worked with staff to address these issues. Signage readability was increased by using visual symbols with written language. Symbols of services provided by the Centre where displayed in the centre. Improved signage and a simplified map to direct travellers to the toilets made wayfinding easier.
The project is ongoing, but communication accessibity has already improved at Bairnsdale Information Centre. Feedback from both staff and travellers has been positive. This is another example of how small changes in a service environment can increase communication accessibility for everyone in the community.
Mel Newcomen, Gippsland Regional Communication Service
The National Disability Insurance Scheme (NDIS) has been described as the biggest change in social services in 30 years and offers people who have received very little services in the past the opportunity to access life changing funding. But big changes can be disruptive and a bit scary, and the question on everyone’s mind is how to navigate the planning process to ensure that loved ones get the funding they need.
Planning for an NDIS planning meeting is one of the most important things people can do to ensure they get funding for communication supports that will make a difference in their lives. So, the North West Regional Communication Service has been offering information sessions to support people to do this. Two information sessions have been run, and included information and discussion about setting goals, the range of communication aids available and where to go for support. These sessions were attended by adults with disabilities, their families and support workers. Many of the people who attended had not accessed speech pathology services in a long time and were excited about the possibilities that are now available.
The information sessions generated a lot of discussion about how to navigate a new system that can seem quite alien and daunting. People who attended said that it was extremely beneficial to have the opportunity to exchange ideas with others going through the same process.
The groups recognised how very important it is to be prepared and organised well before your NDIS planning meeting to make sure you get the most out of your NDIS plan.
Here some of the tips suggested:
Be prepared and organised well before your planning meeting
recommended to start planning 3 months before your next review. There are lots
of different ways to get prepared including planning workbooks and group
recent assessment reports and recommendations from existing service providers
to bring to your planning meeting.
Think about your goals
Any services requested must directly link to your goals. Think about what
your long and short term goals are and what supports you need to achieve these.
talk to your current service providers for support in writing goals.
language of the NDIS
It is a good idea to link your goals to the buzzwords of the NDIS. This
will help your planner to understand that your goals are in line with the goals
of the NDIS. Think about how your goals fit in with the following areas: Daily Living, Home, Health and
Well-being, Lifelong Learning, Work, Social and Community Participation,
Relationships and Choice and Control. The NDIS price guide can be a good tool to learn the
Write a written justification if you didn’t use all the
funding in your plan
many reasons why a person might not use all the allocated funding in their
plan. There might be long wait lists for services, limited services available
in rural and regional areas or an illness in the family. It is a good idea to
write down why specific funding hasn’t been used and specify that it is still
needed for the next plan.
Know that Support Coordination is available
Support Coordinators are people who can help you make the most out of
your funds by linking you in with service providers and helping you understand your
plan. You can ask for this to be
included in your NDIS plan.
Seek support from others
It can be overwhelming to have to find services, manage
funding and navigate a whole new system. Talk to family and friends about your
experience and ask them to share theirs with you. Do they have a great speech
pathologist that they can pass on to you? Can they pass on pearls of wisdom for
preparing for planning meetings? It can make us feel supported to connect with
others who are going through similar experiences.
You can have more than one communication aid funded
Provide a quote where possible
Ask to see the plan before it is finalised
Bring someone with you to the planning meeting
Ask for a review if you are not happy with the plan
Swallowing assessments and reviews are currently being funded
by the NDIS
Organisations or groups in the North West Metropolitan Region can contact the North West Regional Communication Service if interested in hosting an information session facilitated by the North West Regional Communication Service.
The Northwest Communication
Coordinator Network has been running for nearly 10 years! Two Speech
Pathologists facilitate monthly meetings and site visits focusing on training,
peer support and mentoring. Communication Coordinators from 8 different disability
services are involved in the network. Communication Coordinators are Disability
Support Workers who receive extra training and support to implement
communication strategies in their service.
Communication Coordinators reflected on the barriers, enablers and
successes of 2018.
Enablers to creating a culture of communication
Communication Coordinators listed many factors that promote a culture of communication at their services. A key factor identified was interest and support from staff. Communication Coordinators noted that having a collaborative and supportive team was essential in implementing strategies across the service. Support from managers was another factor that was identified as important.
One Communication Coordinator stated that they have a supportive manager who is pro-active in promoting communication and that it filters down to the rest of the staff.
The monthly Communication Coordinator Network meetings
were identified as highly valuable, as they provide the opportunity to share
ideas and resources, receive specialised training and peer-support. Training on
the topics of communication levels and appropriate strategies, sensory focused
approaches, positive behaviour support and supported decision making were
identified as appropriate and valuable.
Communication Coordinators commented that the specialised support provided by the speech pathologists who facilitate the Network is highly valuable. One Communication coordinator said that receiving professional support in their own working environment provides an opportunity for practical suggestions that are relevant to their service.
Barriers to creating a culture of communication
Communication Coordinators identified the biggest barrier to creating a culture of communication at their services as insufficient time. Most Communication Coordinators are given one day per week away from clients to fulfil their Communication Coordinator role. It was reported that planning, creating and implementing communication strategies across the service needs more time than this.
Many Communication Coordinators noted that there is no time allocated for staff training. Training time would be invaluable in supporting staff to increase their knowledge and skills around communication. Another identified barrier was changes in service delivery attributed to the roll out of the NDIS. Some Communication Coordinators noted an increase in casual staff and decrease in permanent staff at their service. Many reported that this makes it difficult to implement consistent and sustainable communication strategies.
There have been so many positive outcomes from the
Communication Coordinator Network in 2018!
A strong theme has been increased opportunities for participants to make choices in daily activities. Two Communication Coordinators reported that participants are now choosing and purchasing their own drinks out in the community, where they were not previously. They reflected that participants are becoming more confident and independent.
Each monthly meeting includes Key Word Sign practice on different vocabulary, such as birthdays, holidays and football. Some Communication Coordinators have seen increased use of Key Word Sign by staff and participants at their service. One Communication Coordinator is a Key Word Sign presenter and another one is attending presenter training in January.
One Communication Coordinator has been heavily involved in NDIS pre-planning at their service. She has completed communication audits for each participant. These audits are used throughout the pre-planning process to identify goals, resources and services that would benefit the individual. A pre-planning Talking Mats set has been developed and a plan has been made for each participant to have a Talking Mats conversation prior to their next NDIS planning meeting.
Visual aids are common strategies used across services. One service has created communication boards to be used in every program. Another service has created a birthday calendar which is generating a lot of excitement; some participants are even making each other birthday cards. One Communication Coordinator has focused on supporting staff to use communication apps such as Tools2Talk+ and Key Word Sign Australia. They commented that staff are beginning to create their own visual aids for programs.
A big focus of the Communication Coordinator Network this year has been
on how to successfully implement strategies. It can sometimes feel like a lot
of pressure to produce lots of strategies and content but it is important to
give each new strategy enough implementation time in order for them to be
effective and sustainable. There have been ongoing discussions about the
importance of working with staff in programs to modelling new strategies and
seek staff input. Staff may require ongoing support to understand what a
strategy is, how it is useful and how to use it with a participant. Giving
enough time and support is essential for our work as capacity builders.
It is amazing to see such dedicated Communication Coordinators and we
look forward to an exciting year ahead!