When I was a student at university, I worked in an assisted living facility as a certified nursing assistant (CNA). During that time, I had the privilege of caring for a woman who I will call Jane.
I was told that Jane had lost her spoken language as the result of a past stroke. She had physically recovered, but spoke only in sounds; no mouth words. Although it was clear that she could understand my words, Jane couldn’t communicate that way. Make no mistake though, Jane told me what she needed every single day. She was still a highly effective communicator with any caregiver who took the time to learn Jane’s “new language”.
I tell you this story because May is “Better Hearing & Speech Month”, and I want to remind both myself and you readers, that speech can be more than spoken words. There are many adults who don’t use mouth words to communicate, and as caregivers and loved ones, we can communicate well with them, and care for them well, if we know how to.
Let me elaborate: When Jane wanted a cup of coffee, she drove her power wheelchair into the dining room and poured herself a cup. If she was unable to do that (something was blocking her path, the coffee pot was empty, no cups were out, etc.) she used her arms and sounds to flag down kitchen personnel, motioning to them with her hands to follow her, and pointing at the problem. Jane also used facial expressions, sad/happy grunts, and other body language to communicate.
Some ideas for communicating with a non verbal person:
- Watch body language and physical cues– Facial expressions, eye movement, sudden movements, sounds like groaning or giggling, restlessness, angling the body toward or away from someone or something..
- Write it down–This can especially work well when working with deaf people.
- Learn some basic ASL– Sign language is a real language and can provide language access to any person who doesn’t use spoken words. It can also be used alongside spoken language for clarification and reinforcement.
- Ask simple questions– Specifically closed ended questions
- Be patient– It will take time and intentionality to develop these skills
I remember a morning when I had finished my shift but was stopped on my way out the door by a newer day-shift CNA. She didn’t yet understand Jane’s language and needed help. She was trying to dress Jane and Jane wasn’t having it. I entered the room and Jane’s facial expression immediately softened as she recognized me. A few points, worried looks, closed ended questions from me, and Jane breathed a sigh of relief as we found the outfit she wanted to wear, and got her situated correctly. It was a simple solution because this wasn’t me dealing with a “non-verbal, stroke victim”. This was me caring well for Jane, a highly opinionated, gentle and loving woman who loved wearing matching pantsuits, having her nails painted, seeing fresh flowers in her vase and watching evening television before bed, among many other things. Those labels– “non-verbal”, “stroke victim”, “aging adult”, “patient”– are only helpful if we allow them to guide us toward methods of care that reflect that person’s specific needs.
My ability to understand Jane didn’t develop over night, either. It was a lot of asking closed ended questions. That means questions that can be answered with a simple “yes” or “no”. “Are you cold, Jane?” I might ask as Jane lay in bed, visibly agitated. Jane might shake her head “no”. “Do you need to use the bathroom?” Again, a head shake for “no”, and maybe a frustrated sigh or teary eyes. “I’m sorry, Jane. Let me try again, Are you uncomfortable?” Jane would start nodding, excitedly “Yes! Yes!” “Ohh, is it your pillows? Are you ready to lie back?” And then the smile and the grasping of my head as she firmly nodded. “Yes! Yes, that is the problem,” is what I imagined she was communicating to me. Turns out, Jane had a pillow routine: 2 behind her back when she first got into bed, because she wasn’t quite ready to sleep. Later, take one pillow away. If I worked through the night, the extra pillow would eventually be used to prop her on one side and later shift to the other side. It was a process, but it was important to Jane. Had I not spent a significant amount of time asking Jane questions, using trial and error, studying her and asking for help from other caretakers, I would have stripped Jane of her autonomy and forced her to comply with what I assumed she needed and what was convenient for me, instead of caring for her actual needs.
Jane taught me to ask more questions and to be more patient. She taught me that communication is much more than speech. Even a person who uses spoken words tells so much more about themselves by their non-verbal cues. Developing the habit of watching, not just listening, meant I could care for and support that person better. Nonverbal people are more than the labels that are giving them. They are our mom, dad, grandparent, child, neighbor, friend…They are humans, first. And every human deserves the dignity of language and communication, no matter what that looks like.
–Bethany Sellai is the Resident Blogger at Be Active Be Well. She lives well with her husband, three sons and one very lazy Shih Tzu, in the Central Valley.
DISCLAIMER: This article contains information that is intended to help the readers be better informed regarding exercise and health care. It is presented as general advice on health care. Always consult your doctor for your individual needs. Before beginning any new exercise program it is recommended that you seek medical advice from your personal physician. This article is not intended to be a substitute for the medical advice of a licensed physician. The reader should consult with their doctor in any matters relating to his/her health.
