ACQ Vol 12 No 3 2010

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Accessible healthcare
150 ACQ Volume 12, Number 3 2010 ACQuiring knowledge in speech, language and hearing
prefer interacting with the carers rather than attempting to
communicate with the adult patient who could not speak.
Overall, the article highlights the potential role of speech
pathologists in facilitating communication for people with
CCN in hospital. Future research is indicated to explore
the potential for hospital staff education in the area of CNN
and AAC systems, and in the development of policies and
procedures for people with disability in the hospital, including
aspects such as pre-admission planning, involvement of paid
disability support staff, availability of adapted equipment, and
improved discharge planning.
Leading by example: Communication access
at Connect, UK
Parr, S., Pound, C., & Hewitt, A. (2006). Communication
access to health and social services. Topics in Language
Disorders, 26(3), 189–198.
Pound, C., Duchan, J., Penman, T., Hewitt, A., & Parr, S.
(2007). Communication access to organisations: Inclusionary
practices for people with aphasia. Aphasiology, 21(1),
23–38.
Kyla Brown
Communication access is an essential ingredient for an
inclusive society. This is a key message of these two articles
describing initiatives for improving communication access
undertaken by the voluntary sector organisation for people
with aphasia, Connect – The Communication Disability
Network, located in the UK ).
In the first article, “Communication access to
organisations: Inclusionary practices for people with
aphasia” the authors describe how they have addressed
communication access within their own service. They
describe the communication support methods used to
implement projects for people with aphasia in the roles
of 1) recipients of services, 2) co-facilitators of services,
3) as trainers in courses for service providers, and 4) as
employees within Connect. In each instance different
levels and layers of communication support are detailed. A
useful table is included, which gives examples of materials
used to support communication access and lists some of
the behind-the-scenes processes involved. The authors
note that in order to provide communication access that
promoted authentic involvement, they needed to spend
more time and work “around the edges”, for example, in
preparing support materials (Pound et al., 2007, p. 35).
However, they argue that the additional time and resources
have provided individuals with aphasia increased confidence
and opportunities to demonstrate their competence, and led
to many improvements in Connect services.
The article also discusses some of the challenges Connect
faced in order to improve user inclusion and access. These
included: resistance to change, using time differently
(through reflecting on priorities and reallocating time and
resources), the need for new skills and creativity, and revising
Hospital experience for older parents of people who
cannot speak
Hemsley, B., Balandin, S., & Togher, L. (2007). Narrative
analysis of the hospital experience for older parents of
people who cannot speak. Journal of Aging Studies, 21,
239–254.
Nerina Scarinci
Caring for a child with cerebral palsy and complex
communication needs (CCN) is a lifelong commitment for
parents, and when there is a need for hospitalisation their
role as carer extends to this environment. Although there is a
plethora of research available on the experiences of parents
of children with developmental disability in hospital, there is
little information regarding the needs and experiences of
older parents who care for their adult dependants in hospital.
This study fills a gap in the literature by investigating the
experiences of older parents in supporting their adult child
with cerebral palsy and CCN in hospital.
Eight parents aged 60 years and older participated in
individual in-depth interviews about their roles in hospital and
the impact of caring for their adult son or daughter on their
own health and well-being. These participants provided care
for their son or daughter in hospital for extended periods
of time, ranging from 10 to 77 days, with an average of
30.5 days. Most participants spent the majority of the day
in hospital providing care, being present either 24 hours
per day or from early morning until late at night. Clearly,
participants had a high level of commitment to providing
care for their adult son or daughter, despite the presence of
nursing staff.
Analysis of the interviews identified a common narrative
in the hospital care experience and a several areas for
improvement were suggested by participants so that
the hospital experience could be better for all involved.
Participants discussed a number of areas relating to their
hospital experiences including: their history in providing care
for their child in hospital, admission procedures and their
imperative to care, the communication difficulties faced by
their dependent child in hospital, the negotiated process of
care when working with hospital staff, being an advocate for
their child in hospital, and the challenges of transition from
hospital back into the community.
Of significance to speech pathologists are the reported
communication difficulties of the adult with CCN during
the hospital stay. Parents noted that as their adult children
did not have any functional speech, when they were not
present to assist with communication, their sons and
daughters were not able to communicate with hospital
staff. Participants also perceived that the hospital staff did
not have enough knowledge or experience in working with
adults with disability, and staff were unwilling or unable to
take instruction directly from the adult with cerebral palsy.
Despite assurances for the parent carers that their adult
child was able to understand speech, staff appeared to
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