Background Image
Previous Page  29 / 60 Next Page
Show Menu
Previous Page 29 / 60 Next Page
Page Background

Diversity in practice


Volume 17, Number 1 2015















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



he 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


Kathryn McKinley, Renee Heard, Sally Brinkmann, Julia Shulsinger, and Robyn O’Halloran