Dwellness • Communication


Dwellness customization for:

Your Patient

General Principles

  • The two main areas of communication each need to be 2-way
    • 2-way communication with your patient
    • 2-way communication with other staff


Modes of communication
Communication with a person who has disabilities usually involves different modes of communication. A mode of communication is simply a set of tools that the person with disabilities is able to use. Among the tools that a person with disabilities has: Styles of communication
In communication, each person has their own style. Style can be defined in many ways, but it usually involves:
  • Loudness and variability of dynamics
  • The "formant", which is the consistent frequency on which your voice is based
  • Clarity of articulation
  • Amount or persistence of talking
    • Extreme persistence of speech is called "hyperverbal" speech
  • Pace of language
Communication timing
With different disabilities, the initiation/response timing of communication can vary widely.
  • Rapid pace of initiation/response
  • Very slow pace of initiation/response
  • One-sided initiation, with response unpredictable or not required
  • Need for repetition and reinforcement
  • Need for conversation to drop, and then pick up later

2-way Communication with your patient

Your patient to staff
Your patient may have a multi-modal way of communicating. Your patient's style is unique and can be quite varied. Your patient's timing in communication is usually very long, but can be very short, depending on your patient's central nervous system arousal. In a unique mix of modes, your patient may regularly use clear speech, word approximations, American Sign Language (ASL) (PDF), body language, facial expressions, singing, and vocal noises. Additionally, Verbal Behavior (PDF) and Verbal Behavior Analysis (PDF) are very important to understanding your patient's particular blend of communication modes.

[NOTE: Here is your patient’s Vocabulary list and other information.]

Staff to your patient
Your patient's receptive language is very keen. Your patient may understand much more than most people imagine at first. Under normal circumstances, use ordinary conversational language to express yourself to your patient. Speak clearly, watching for expressions showing that your patient hears and understands you. Allow plenty of time for your patient to respond. Use repetition whenever you might expect a response. Often your patient may be responsive to intraverbals or simple questions.
Your patient may respond with different modes and timing, but your patient will understand what you say in your modes and style of communication.

Unique language characteristics
  • Clear speech
  • Word approximations
  • ASL
  • Body lanuage
  • Facial expressions
  • Singing
  • Vocal noises
Verbal Behavior Analysis

2-way Communication among Staff

  • Staff Communication Log
    • Fill out the log for each shift
  • Kitchen calendar (use graphic representations for confidentiality and dignity)
    • For BMs, use yellow highlighter to color the date
    • Solid block = normal consistency of BM
    • Size of block = amount of BM
    • Scribbled highlighter = loose stool or diarrhea
    • For seizures, write the code for the type and time of occurrence
      • ‘X’ = tonic seizure (write the time of occurrence)
      • ‘O’ = drop seizure (write the time of occurrence)
  • Seizure Log (PDF)
    • Document all seizures carefully
  • Whiteboard

HPCA Input

Dwellness input from HPCA and family caregivers can serve to improve the ongoing support system. Feel free to speak up!