JCPSLP Vol 17 No 1 2015_lores

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Diversity in practice
JCPSLP Volume 17, Number 1 2015 27
KEYWORDS
HOSPITAL
STROKE
SUPPORTED
CONVERSATION
PARTNER
TRAINING
VOLUNTEERS
THIS ARTICLE
HAS BEEN
PEER-
REVIEWED
Kathryn
McKinley (top),
Renee Heard
(centre) and
Sally Brinkmann
adverse events (Hemsley, Werninck, & Worrall, 2013) and
are more likely to be judged as unable to participate in
decision-making about their health care (Carling-Rowland,
Black, McDonald, & Kagan, 2014).
Another less obvious consequence of having a
communication disorder in hospital is that there may
be fewer opportunities to engage in social conversation
(Hersh, Godecke, Armstrong, Ciccone, & Bernhardt,
2014). Social conversation provides people with an
opportunity to describe their experiences, express
personal attitudes and opinions, and feel known by
another. Engaging in successful social conversations is
fundamental to a person’s psychological well-being (Kagan
& Gailey, 1993). People with aphasia have identified social
companionship, positive interactions with others, and a
feeling of connectedness as integral to living successfully
with aphasia (Brown, Worrall, Davidson, & Howe, 2012).
Experiences of successful social interaction may also
afford those patients with a newly acquired communication
disorder such as aphasia with opportunities to experience
themselves as competent communicators. Such
opportunities might offer a contrast to other medically
oriented interactions that occur in the hospital setting
where they may experience themselves as incompetent
communicators (Hersh et al., 2014; Shadden, 2005).
The skills required to support a person with an acquired
communication disorder such as aphasia to engage
successfully in conversation can be learned (Kagan, Black,
Duchan, Simmons-Mackie, & Square, 2001; Parr & Byng,
1998). Based on a systematic review of the literature,
Simmons-Mackie and colleagues (2010) concluded that
communication partner training is effective in improving a
communication partner’s ability to engage in conversations
and probably effective in enhancing the ability of the
person with aphasia to engage in conversations. Family
and friends may need time to adjust to the changes that
have occurred and the time and opportunity to learn how
best to communicate with their loved one. Volunteers
who have received communication partner training may
provide immediate opportunities for inpatients with newly
acquired and chronic communication disorders to engage
in rewarding social conversation.
St Vincent’s Hospital Melbourne delivers a variety of
programs with the help of volunteers. In one program
named “Angel Volunteers”, trained volunteers provide
companionship to patients identified as being at risk of
falling. The volunteers engage them in a range of diversional
activities such as conversation and reading. Ways to
expand the role of the Angel Volunteers were discussed by
the first author who had visited Connect
This paper describes the implementation of a
supported conversation training program for
volunteers at a tertiary hospital in Melbourne.
The objective of the program was to provide
increased opportunities for patients with
acquired communication disorders as a result
of a stroke to engage in social conversation
with trained volunteers. Later, the program
was extended to include inpatients with other
communication-related disorders. The
program was highly valued by patients, their
families, volunteers, and hospital staff. Future
directions include a formal evaluation of the
program and rollout of the program across
different health care services within the
organisation.
The National Stroke Foundation estimates that 67%
of people admitted into hospital with stroke have a
communication disorder such as aphasia, dyspraxia
of speech, or dysarthria (National Stroke Foundation,
2010). O’Halloran and colleagues (2009) also found that
the number of people with communication disorders in
hospital stroke units is very high. Of 69 consecutive patients
admitted into acute hospital stroke units, 79% had a mild
or greater hearing loss, 47% had a mild or greater cognitive
communicative disorder, 44% had a mild or greater
language disorder, and 26% had a mild or greater speech
disorder. Of all the patients assessed, 88% had at least one
kind of communication disorder and 69% had two or more
communication disorders.
The consequences of having a communication disorder
in hospital have also been explored. The majority of this
research has focused on the consequences of having a
communication disorder on health-care delivery. Sixty-
four percent of the stroke patients identified as having a
communication disorder by O’Halloran and colleagues
(2009) had difficulty communicating with their health-care
providers about their everyday health-care needs. As a
result of their communication disorder, these patients did
not always understand what was happening, could not ask
questions about their care, and/or were unable to call for
help when they needed it (O’Halloran, Worrall, & Hickson,
2012). When patients with communication disorders and
their health care providers are unable to communicate
successfully, the patients often experience distressing
Social conversations for
hospital patients with
acquired communication
disabilities
Kathryn McKinley, Renee Heard, Sally Brinkmann, Julia Shulsinger, and Robyn O’Halloran