Module 1, Talk 1'3: Communicating with People with Disabilities

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Module 1, Talk 1.3Communicating with People
with Disabilities
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Communication Barriers for People with Spinal
Cord Injury

• National Rehabilitation Hospital,
• Washington, DC

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The Consumer Professional Partnership Program

• Consumers co-present in education settings for
  health care professionals
• The SCI Life Educator Concept

• Training Manual
• Disability Awareness and Communication
• Prevention of Secondary Conditions
• Physical Activity and Exercise

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Goals

• To identify communication issues and needs when
  interacting with people with SCI
• To determine critical communication skills
• To identify strategies to improve communication
  with individuals who have disabilities

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Why is communication important?

• Builds the rapport and mutual respect needed in
  order to achieve
• Accuracy in exchange of information
• Receptiveness of information
• Cooperation in treatment and rehabilitation
• Prevention of secondary conditions and medical
  complications

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Types of Communication Barriers

• Attitudes and Behaviors
• Physical/Individual
• Environmental

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Attitudes and Behaviors

• Halo-Effect Physical limitations in specific
  functions are interpreted in terms of limitations
  of the person
• Confounding physical, cognitive and linguistic
  abilities
• Stereotyping

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Attitudes and Behaviors, cont.

• Lack of knowledge about SCI
• Lack of attention to issues other than SCI (e.g.,
  preventive screenings, sexuality, exercise,
  wellness, aging)

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Physical/Individual Barriers

• Changes in the ability to communicate verbally
• Changes in communication due to functional
  limitations (use of arms and hands) and body
  position (wheelchair)

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Environmental Barriers

• Transportation
• Availability
• Timeliness
• Cost

• Office accessibility
• Parking
• Elevators and doorways
• Examination rooms
• Diagnostic equipment
• Staff communication

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Strategies to Address Attitudes and Behaviors

• Acknowledgement of and addressing an individual
  with SCI
• Address the patient in a manner befitting adults
• Never lean on the wheelchair, as the wheelchair
  is a part of his or her personal space
• When they are accompanied by an able-bodied
  person, do not ignore the patient or talk only to
  the able-bodied person

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Strategies to Address Attitudes and Behaviors,
cont.

• Do not assume the patient with a SCI needs
  assistance
• Ask if you can help and then follow the
  instructions given to you
• If your assistance is declined, don't be offended
  and do not proceed with assistance
• Do not discourage their active participation

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Strategies to Address Physical/Individual Barriers

• Maintain eye contact
• Use a normal tone of voice -- do not raise your
  voice unless requested
• When introduced to a person with a SCI, it is
  appropriate to offer to shake hands
• Shaking hands with the left hand is acceptable

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Strategies to Address Environmental Barriers

• Be flexible if a patient is late for a scheduled
  appointment
• Let your patient know about any physical barriers
  in your office/building environment before they
  arrive for their appointment

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Strategies to Address Environmental Barriers,
cont.

• Make sure your waiting area is free of clutter on
  the floor and provides enough space for a
  wheelchair to maneuver
• Schedule patients with a SCI in rooms with
  accessible exam tables
• Exam rooms need to be able to accommodate a
  wheelchair (e.g., turning radius, etc.)

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Use of Appropriate Terminology

• Awareness of language and terminology is critical
  for the development of a trusting relationship
  between the individual with a SCI and the
  healthcare provider
• In the medical community it is not uncommon to
  identify people by their condition as if that
  constitutes their whole identity

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Terminology
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Terminology, cont.

• Avoid using
• The adjective as a noun, e.g. the disabled, a
  paraplegic
• People suffering from or afflicted with
  (implying victim role) a disability
• Handicapped, crippled, invalid, spastic,
  special, or challenged
• Visually-handicapped person
• Deaf and dumb, or deaf and mute
• Wheelchair-bound or Confined to a wheelchair
• Carers

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Optional Teaching Exercise

• Circle the terms that you think are appropriate
  for describing a patient with spinal cord injury
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• wheelchair-bound spastic special
• the disabled spinal cord injured cripple
• invalid integrated independent individual
• special needs wheelchair user brave
• sufferer handicapped person with a SCI