Hospital Passports for people with disabilities

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.

The first and second pages of the Bendigo Health Hospital Passport

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

Workers learn to support people with disabilities to communicate effectively

East Hume 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.

Signing together

Participants included disability support workers, parents and family members of people with communication difficulty, and NDIS support coordinators.

Communication with Key Word Sign

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

Better communication

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.

Hannah

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.)

Communication Access at the Royal Melbourne Hospital – Royal Park Campus: A Communication Access Consultant

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.

Donna 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 community.

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.

Stephanie and 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 with the Royal Melbourne Hospital staff she mentors

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

Happy Ninth Birthday, Stroke a Chord Choir!

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!

Communication Access at the City of Greater Bendigo

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.

One of the CoGB Service Desk Communication Book produced in collaboration with Service Desk staff and clients by the Regional Communication Service

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.

City of Greater Bendigo promoting its communication access initiatives

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. 

The Communication Access Symbol

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

Increasing communication access at Information Centres in Gippsland

Bairnsdale Information Centre with the new symbols displayed

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

Preparing for NDIS Planning with Regional Communication Service Support

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.

Exploring communication aids and strategies

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

It is recommended to start planning 3 months before your next review. There are lots of different ways to get prepared including planning workbooks and group sessions.

Collect any 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. You can talk to your current service providers for support in writing goals.

Use the 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 lingo. 

Write a written justification if you didn’t use all the funding in your plan

There are 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.

Other tips

  • 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.

A special recipe for Bourkie’s Bakery

The Woodend Communication Access Group has recognised Bourkie’s Bakery as a great place to be.

Bourkies Manager receiving the award from two of the Woodend Communication Access Group members

What was the recipe for this award to happen?

Ingredients:

The Group, comprising five people with communication disabilities living in Woodend.

The Woodend Communication Coordinator, who was trained and participates in the network supported by the Regional Communication Service.

The Regional Communication Service speech pathologist

The staff and management of Bourkies

Method:

Take the partnership between the Regional Communication Service and the Communication Coordinator. Mix with the Woodend Communication Access Group.

Add the Communication Access Network’s communication friendly certificate and the Regional Communication Services’s picture based communication board.

Leave to rise.

Take the risen mixture and bake… into a certificate that lists the great things Bourkies does

Serve:

VIsit Bourkies and present the certificate to the Manager and Staff with each Group member pointing out one reason for the award.

The icing on the cake

Next, the Communication Coordinator and the Communication Access Group will work with Bourkies to develop some picture based communication aids, so there can be even better communication.

Meg Irwin (Southern Loddon Mallee Regional Communication Service) with apologies for stretching a metaphor

The Year in Review: The North West Communication Coordinator Network

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.

A visual aid to support understanding and participation

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.

Achievements in 2018

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.

Some cards for Talking Mats

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!