Did you know that a lack of communication contributes to the health inequalities those with learning disabilities face within healthcare?
The Nursing and Midwifery Council (NMC) sets out the standards where we should be ‘communicating clearly’ but what does that mean? What does that mean for someone who is non-verbal due to both disability and illness? Using adaptive communication isn’t just for learning disability nurses, it is for everyone.
I think all nurses and students should be able to think of a time when their patients have been unable to communicate their wants and needs effectively. Paediatric nurses meet many children who have disabilities, as well as communication problems, across their settings and services. Mental health nurses will experience patients being in crisis or a state of confusion in dementia care. Adult nurses may have unwell patients who lose their ability to verbally communicate or families where English is not their first language. We all have a duty and a responsibility to better our communication.
“As health professionals, we should be communicating with whomever the appointment is for”
Makaton is a language programme, which uses a mixture of symbols, signs and speech which helps people to communicate. Makaton is not just for those with learning disabilities, it can be used by anyone in any setting. There has been some research on the benefits of using it within dementia care.
The signs are simple and they are often very easy to interpret and understand. For example, if you wanted to encourage someone to have a drink what would you do? Naturally, you’d cup your hand and imitate a drinking action – this is the Makaton sign.
Equally, you could hold the cup up and this is called ‘object of reference’. Objects of reference are another tool, which can be used by everyone and anyone. As long as you have familiar items, which can be interpreted and understood, then it is another good tool to assist in verbal language.
Good communication does not just stop there. As health professionals, we should be communicating with whomever the appointment is for, despite their communication needs. We should offer everyone their human right – freedom of expression. I have had lots of personal experiences whereby I have taken my sister, who has Down’s syndrome, to medical appointments and she was ignored. I will be asked all of the questions, even though the appointment is for her.
We should also be abiding by the accessible information standard. This is a law, which came around in 2016 by NHS England, and is a requirement within the NHS. This means we should be adjusting information to suit needs whether that be easy reads, pictures or information being provided in another language.
We should all also be familiar with the term ‘making reasonable adjustments’, which is another legal requirement under the Equality Act 2010. This involves simple and easy steps to make appointments and information more accessible. Like the above, this can include adjusting information but it can also include extending appointment times, finding quiet rooms for people and understanding and listening to what our patients need.
I would highly recommend all nurses, both registered and students, to look at their communication skills and look to enhance this where possible. There are great resources and training on Makaton, which is readily available on their website. Often, you can contact speech and language teams or learning disability teams to assist in providing easy-read information.
We should be abiding by the NMC, this is not an option, this is a requirement to hold our PINs. We should be compassionate and we should be able to listen and advocate for our patients. We need to be empowering them through their communication, especially those with a learning disability to reduce the prevalence of health inequalities.
Ellie Sims is a second-year learning disability nursing student, University of Nottingham and 2023-24 Nursing Times student editor