CNA Skill: Communicating With Residents Who Have Problems with Speech

Many residents in a long-term care facility have difficulty with speech and communicating their needs and wants.   Noises and grunts are sometimes a residents way of communicating with their caregiver/CNA.  Depending on the cause of the speech difficulty, the resident may or may not be able to understand what they are saying or what is communicated to them.  Within time, you as a CNA will come to know and understand the resident and have them understand you as well, but it takes time.  It can be just as frustrating for your resident as it is for you.

A) Knock, Announce, Approach: knock on the door, call out to the resident by name, and introduce yourself.   Approach your resident from the front or side, in a non-threatening manner.  Be respectful.

B) Conversation: keep conversation to the point and brief and often.

C) Use Simple Direct Questions: Ask simple yes or no questions; “Are you comfortable?”, “Are you hungry?”, “You’re smiling are you happy?” simple short questions asked in a respectful adult tones.  If speech is problematic, ask the resident to nod or shake their head for yes or no. If head responses are not possible, ask the client to blink once for yes and twice for no.

D) Allow time for answers: You resident may understand what you are saying but it may take them a moment to respond.  Be patient and wait for them to answer in their time.

E) Communication tools: There are all kinds of things and objects and aide can use to help their resident communicate effectively.  Note pads and pens, scrabble tiles, flash cards, pointing, picture boards and maybe charades.  If it works, use it.

F) Feedback: If you think you know what it is your resident wants, repeat it back to them as simply as you can, to make sure that is what they are communicating. Do not pretend to understand the resident.  If you do not understand, what the resident is communicating, try again.  If it becomes too frustrating, ask for help.  Guarantee there is an aide who can understand your resident and they can help with the communication process.

G) Emphasize the positive aspects of the communication: Let your resident know that you understand them, by repeating back what they have communicated to you, smile and show your resident you understand.

H) Time: Allow adequate time for the conversation between you and your resident.  Don’t leave a conversation incomplete.  If you have to explain to your resident that you have to leave but will be back to finish the conversation as soon as you can.

I) Encourage: Allow time and encourage you resident to point to objects, pictures, words that will help communicate their need to you.

J) Attitude: Giving your resident the impression that you are in a hurry or frustrated is not going to help.  Keep your attitude light, relaxed, and pleasant.  Actions speak louder than words, and your attitude will set the stage for ease or difficulty in communication.

K) Let the Resident know you are leaving: let the resident know when you are done, making sure the resident is clean and safe, with their call button; needed personal items and water are within reach.

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