1 developmental disability etiquette patti higgins, rn ccbdd (216) 736-2686...
TRANSCRIPT
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DISABILITY ETIQUETTEPresentation Objectives:
Identify the different modes of communication that individuals with DD utilize
Discuss general communication strategies when working with individuals with DD
Identify actions to take when individuals with DD have behavioral issues.
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Communicating with Individuals with Developmental Disabilities
MYTH # 1
People with DD cannot
understand speech, let
alone medicalinformation
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Premise #1 Many people with DD can
effectively communicate their needs
People with DD have a wide variety of communication skills and abilities
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Premise #1 (continued)
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Premise #1 Individuals who
are non-verbal can communicate with gestures and / or body language.
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Premise #1 – Medical Info
Many people with DD are very involved with their healthcare.
Healthcare providers may have to adapt their physical environment and interaction techniques.
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MYTH # 2
People with DD cannot make decisions
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Premise # 2
People with developmental disabilities participate in decision making in a variety of ways.
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PREMISE #2 (cont’d)
Many individuals with DD are their own guardians
Many individuals with DD are capable of informed consent for medical procedures / treatment.
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MYTH #3
People with DD are sick.
People with DD are dependent on others to meet many / all of their needs.
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Premise #3 Many people with DD
are not sick, incompetent, dependent, unintelligent or contagious. They are like the typical population, i.e. healthy, chronic medical conditions, mental health diagnoses and acute care issues
People with DD have master’s degrees, work full-time, drive, own businesses, participate on committees, are married and have children.
They are individuals and you use the same assessment skills as with typical population.
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Premise #3 – (cont’d)
TriageCommunication issuesBaseline healthMirrors other individuals that may be in shelters, with mental health issues, alzheimers, elderly, typical population.
Cooperative, communcative and compliant
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MYTH #4
People with disabilities can access health care easily.
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Premise #4 Healthcare
providersmay have to adapt
their physical environment and interaction
techniques.
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Premise #4 Talk to the person, rather than through
their caregiver or sign language interpreter.
If the caregiver needs to be involved in their healthcare conversation, ask the individual’s permission.
Listen patiently. Don’t complete sentences for the person unless he/she looks to you for help.
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Premise #4 Allow extra time for
the visit and give specific directions.
Don’t pretend you understand a person with a speech disability just to be polite.
Be prepared for various devices or techniques used to enhance or augment speech.
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General Communication Strategies
NO
USSR (adapted from Seigel-Causey and Guess,
1989)
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Nurture Develop a trusting
and supportive environment
Show real interest in communicating
Act and speak naturally
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Opportunity
Communicate about what is happening now
Provide choices
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U “You” always play a key role in
assuring effective communication Talk to the person Ask permission to talk with whoever
is assisting them Listen Clarify Restate
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Sensitivity
Recognize an individual’s readiness to communicate
Respond at the person’s level Recognize the communication
modes of the individual Respond appropriately to all
communicative attempts
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Sender
Get the person’s attention Present info using person’s
receptive mode Repeat the message once, then
restate Rephrase using different words or
modes Recognize all attempts to respond
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Sender Treat Adults as
Adults Do not shout at
the person with DD
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Receiver Pay attention and
be aware Ask for
clarification when needed
Be honest Encourage
individual to use many modes
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Cognitive Disability Use very clear, specific language
Be patient. Allow the person time to tell or show you what he or she wants.
Condense lengthy directions into steps
Use short, concise instructions (Commission for People with Disabilities, November
2007)
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Cognitive Disability Present verbal
information at a relatively slow pace, with appropriate pauses for processing time and with repetition if necessary, e.g. “In five minutes, we’ll be going to lunch.”
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Cognitive Disabilities Reinforce information with pictures
or other visual images Use modeling, rehearsing and role
playing Use concrete rather than abstract
language Limit the use of sarcasm or subtle
humor
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Cognitive Disabilities If you are not sure
what to say or do, just ask the person what he/she needs.
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Dealing with Behavioral Issues Dual Diagnosis:Individuals who have both a mental illness and a developmental or intellectual disability. Increase incidence ofmental health issues within people with DD – may be due to brain
pathology.
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Behavioral Issues “Unlike the general population,
individuals with a dual diagnosis may be more likely to exhibit sign and symptoms of their disorders in the form of behavioral outbursts including verbal or physical aggression, self-injury, property destruction, impulsive behaviors and/or elopement .”
(Family Crisis Handbook, Donna Icovino & Lucille Esralew, Ph.D. July, 2009)
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Behavioral Issues Not uncommon for people with
Pervasive Developmental Disorder (PDD) or Autism to display aggressive
behavior.
May be a response to frustration, pain and limited communication skills.
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Behavioral Issues For individuals
who are non-verbal, behaviors may be their way of expressing frustration and/ or pain.
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How to Cope with Behaviors During a Disaster Stay calm Use verbal and non-verbal
techniques including relaxed body position
Limiting space by directing the person to another room or area away from others
Soothing tone of voice Avoid giving commands
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How to Cope with Behaviors During a Disaster
Identify feelings (if able) Ask Caregiver for assistance with
behavior (may be aware of behavior plan to de-escalate aggressive behaviors)
Redirect to a different activity, preferably something soothing
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Self-Injurious Behavior
For some individuals, i.e, people with autism and those who are non-verbal, aggression may be expressed by self-injurious behavior.Head banging, hitting themselves, biting themselves.
Interventions are the same as previously discussed.
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A FINAL WORD
People with DD are individuals with families, jobs, hobbies, likes and dislikes, problems and joys. While the disability is an integral part of who they are, it alone does not define them. Don’t make them into disability heroes or victims.
Treat them as individuals.
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RESOURCES www.disabilityisnatural.com Commission for People with Disabilities
(November, 2007) The Ten Commandments of
Communicating with People with Disabilities www.ucp.org
www.peoplefirstohio.org Ohio Developmental Disabilities Council Self Advocates Being Empowered