4. WHEN THERE’S A PHYSICAL BARRIER TO COMMUNICATION COMMUNICATING WITH SOMEONE WITH A SPEECH IMPAIRMENT When talking with someone with a speech impairment: • Speak normally. You don’t need to raise your voice. • Be patient. • Ask the person to repeat him or herself. They will know their speech is hard to understand. • Ask if they can say it a different way or give you a clue in other ways • Ask if there is someone close by who can help interpret for you. COMMUNICATING WITH SOMEONE IN A COMA 4 Coma is a state of unconsciousness. Someone who is in a coma cannot be roused by touching, shaking or calling; however, that does not mean that the person cannot hear and understand your voice or feel your touch. Coma is not always permanent nor does it mean that death is near, even in the terminally ill. Some people will slip in and out of coma; some will suddenly just wake up. Whatever the cause or duration of the coma, you must keep trying to communicate with the person. To do that, you have to become aware of both your own and the other person’s inner feelings and perceptions. You need to look for tiny clues about how the person is feeling such as changes in breathing pattern, tiny facial changes, changes in rigidity of the person’s body. Once you are sensitive to these clues you will be able to send and receive messages. Trust your “sixth sense” or intuition. Speak normally . Tell the person what you see and feel. Encourage him or her to feel what he or she is feeling. Use touch as a way of communicating . Placing your hand on the person’s chest and breathing when he or she breathes will help you to tune into the person’s inner world. (Tell them that you will be placing your hand on their chest before you do it.) Remember that a coma is an inner experience . Do not try to make the person come out of it. The inner experience is part of dying and for most people it is a necessary experience. Be relaxed and calm inside yourself . You do not have to communicate all the time. The person experiencing the coma has less awareness of the external environment.
4 KFL&A Palliative Care Education Project, as presented in Hospice Kingston Volunteer Training Manual, Hospice Kingston, Ontario.
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