Communication in hospital

Also called Inpatient communication, Communication on the ward

A ward is loud, fast and full of strangers. Here is how to get your needs met there when you cannot speak.

What it is

Hospital communication is everything that has to pass between a patient and the people looking after them: pain, thirst, fear, the toilet, a question about what the drip is for, a decision about treatment. For a person who does not speak, or who cannot be understood by strangers, most of that traffic fails unless somebody plans for it.

It fails in predictable ways. The device is at home. The one nurse who understood the person has gone off shift. Nobody has time to wait for a slow answer, so nobody asks. And a patient who cannot object is treated as a patient who has agreed.

Who it can help

Anyone who uses AAC, signs, or is hard to understand, and their family. It matters most for unplanned admissions, where nothing has been set up, and for people whose speech is unreliable when they are ill, in pain or medicated, which is a much larger group than lifelong AAC users. A person with dementia or after a stroke can lose their usual words on the ward and need exactly this.

It is not a substitute for a hospital passport or for an advocate. It sits alongside them.

How it works

Under the Accessible Information Standard, every NHS body in England must find out how a patient communicates, record it, flag it and act on it. That is a duty, not a kindness, and it covers the ward.

In practice, good hospital communication has three layers. A one-page summary at the bedside says how this person says yes and no, what they need to see, and what upsets them. A paper board or communication passport sits within reach for the moments the device is charging or in a bag. And the person's own aid, if they have one, comes in with them and is treated like their glasses: theirs, not the ward's.

Larger hospitals have a speech and language therapy team that can lend hospital communication boards and set up a bedside system inside a day. Ask for them by name.

Getting started

This week, write the one page. How I say yes, how I say no, how I show pain, what helps, who to phone. Put it in the bag that goes to hospital with the person and tape a copy above the bed.

Bring the device, its charger and the paper backup. Tell the nurse in charge that the device is the person's voice and must stay within reach, and write that on the whiteboard.

Load Fiducia Talk on a family phone as a spare. It needs no account and works with no signal, so it is there when the main aid is not.

Ask on day one for a referral to the ward speech and language therapist, and ask whether there is a learning disability liaison nurse. Both exist in most acute hospitals and neither will come unless someone asks.

Where to get help

The ward speech and language therapy team is the NHS route; the Royal College of Speech and Language Therapists explains what they do. Mencap publishes hospital passport templates and runs a helpline for families of people with a learning disability. Communication Matters has guidance on taking AAC into hospital. PALS, the hospital's Patient Advice and Liaison Service, is the fastest way to escalate when a ward is not listening.