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.)
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 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!
People living in regional areas often miss out on supports or services available in metropolitan cities. It’s no different for people living with a communication disability and those who support them. The South West Regional Communication Service partnered with the Warrnambool City & Moyne Shire Council Rural Access Officers to bring a Communication Access and AAC (Alternative and Augmentative Communication) Expo to the South West.
The Expo took place over two days in the lovely seaside town of Port Fairy. There were three separate sessions for different audiences: individuals with communication difficulties, their families and support workers; speech pathologists and other healthcare professionals; and staff from a number of South West Councils. Close to 60 people came along to the expo across the two days. A guest presenter, Alison Heppell, from Scope’s Non-Electronic Communication Aid Scheme (NECAS) and Kids Chat attended both days of the expo. Alison talked about the services provided by NECAS and Kids Chat for individuals with communication disabilities. She demonstrated a large number of non-electronic communication aids. After her presentations, everyone had the chance to try the aids out and ask Alison questions.
Everyone was also able to learn about some of the electronic communication devices available to people with communication difficulties. Liberator (a company which makes communication devices) loaned us a number of devices for the expo. Everyone had fun trying out the different devices, programs and iPad apps, directly touching the buttons or screen) or by using alternative access methods, such as switches and head pointing.
Staff from a number of local councils participated in communication access training to help them make their workplaces and offices more inclusive and welcoming for people with communication difficulties. They then took part in accessible information training and learnt how to produce documents and written information in a way which can be more easily understood by those who have difficulties reading.
Speech pathologists, health care professionals and council staff also heard from a guest speaker with a disability, Sonia, about her experiences and the barriers to access she has encountered. Sonia, and her IT consultant, Justin, demonstrated a number of ways she maintains her independence at home and out in the community. She uses switches to control her iPad, lights, and electrical appliances in her house. Sonia showed everyone the computer program which enables her to type messages, surf the web and keep working as a tutor.
Feedback from the two days of the expo was extremely positive. Everyone said they learnt a lot of new information about communication difficulties, the different types of electronic and non-electronic communication aids and supports available to those with communication difficulties.
Charlotte – South West Regional Communication Service.
Working Together to Build Communication Access – Our First Award!
The four young women taking action on communication access in Bendigo (see last month’s blog) have made their first award to a local small business for being so communication friendly.
They regularly visit the Terminus Milkbar in Golden Square. They have always felt respected and have been able to communicate successfully without speech.
The staff were delighted with the certificate. They put it up where everyone could see it.
In July we wrote about the Communication Access Group in Bendigo.
In the first half of 2018, These four young women got ready to work for more communication access in their town.
The group is supported by the Southern Loddon Mallee Regional Communication Service and Distinctive Options.
The Regional Communication Service has continued to attend the group each month. The trained Communication Coordinator in Distinctive Options has continued with the group.
The group has steadily built skills. It is now easy for group members to identify items on picture communication displays and use them to communicate their opinions and wishes. (Through using the communication aids, some members of the group are saying some more words and recognising more symbols and printed words.)
In August, the group contributed to a video. It showed people from all over Victoria using communication aids. The video was for Speech Pathology Week, which had the theme “Communication access is communication for all”.Group members showed community request cards and a communication board in the video.
Makng the video: Bendigo’s fountain and community request cards
In September, the group consulted on communication aids being developed by the local water authority. They were paid for this work by Coliban Water.
After reviewing the details, this group member was happy with the communication book
The Group also prepared to acknowledge good communication access at a local small business. They used a communication board to identify the good things the business does so that everyone can communicate.
A communication board to talk about communication access
The Group is now well on its way and contributing to communication access in Bendigo!