Baycrest

Palliative Care Manual 2016

Baycrest Health Sciences & Baycrest Foundation Publications

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Baycrest - End of Life Volunteer Manual 45 • Speak normally. You don't need to raise your voice • Ask if they can say it a different way or give you a clue in other ways COMMUNICATION WITH SOMEONE WHO HAS PROBLEM UNDERSTANDING YOU Examples: Aphasia or cognitive impairment General recommendations to help them understand you: • Find out the techniques this person uses • There may be tools such as a communication board available • Speak naturally but pause a bit more than usual • Use gesture when you speak • Keep things simple COMMUNICATING WITH SOMEONE WHO IS NON-RESPONSIVE Examples: Deep sleep or a coma Towards the end of life when someone is actively dying, they will be in a deep sleep or a coma where they cannot be roused by touching, shaking or calling. However, often the person can hear and understand your voice or feel your touch. This is very common as it is a part of the natural progression of disease and dying. Occasionally, this state can be interrupted by altered level of consciousness marked by sudden confusion, agitation and restlessness. Eyes may open, limbs will move, etc. It might appear that a patient is waking up but it is actually a sign of terminal delirium. It is very comforting for patients in a deep sleep or a coma to have visitors. Patients can feel comforted by the peaceful presence of others. Volunteers must be observant of how their presence may affect that of the patient. Look for tiny clues about how the person is feeling such as changes in breathing pattern, tiny facial changes, or changes in rigidity of the person's body.

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