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Disability support worker comforting a person with intellectual disability as they wait in Emergency

Disability Staff

Transitions

Here you will see Jeff with Amelia, his disability support worker, and Lynne, his sister. You will also meet Cassandra, who is with Johnno, her disability support worker. They are joined by Lorraine, a social worker.

Applying the Framework

Diagram showing the four framework processes, with the Knowing segment highlighted.

Knowing that

  • Patients often move to different parts of the hospital before being discharged.

  • People with intellectual disabilities can find these transitions difficult.

  • Short Stay Units (SSU) are designated areas within or close to the Emergency Department. 

  • Patients may spend up to 24 hours in SSU for assessment, observation and/or treatment.

  • Patients are admitted to a ward when they need further medical assessments or observations and care. 

  • Hospitals transfer patient information from one part of the hospital using electronic records or written notes.

  • People with intellectual disabilities communicate in different ways, with some using  Augmentative and Alternative Communication (AAC), such as signs,  gestures, pictures, or electronic devices.

  • Using a person's AAC can also help them to understand what you tell them and to prepare for transitions.

  • Hospital staff often know little about AAC.

Diagram showing the four framework processes, with the Informing segment highlighted.

Informing

 

You will need to

  • repeat information with new hospital staff that you meet 

  • ask questions of hospital staff and relay answers to the person in ways they can understand

  • explain to hospital staff how the person communicates and their care needs

Diagram showing the four framework processes, with the Collaborating segment highlighted.

Collaborating is when you

 

  • are clear about what you know about the person's health and who can answer questions that you can't

  • share information and support with family

  • show hospital staff how to communicate with the person using AAC

Diagram showing the four framework processes, with the Supporting segment highlighted.

Supporting

 

The person in your care will feel supported when you

  • incorporate their communication system into your explanations 

  • demonstrate to hospital staff how to involve the person in a conversation, even if they might not understand what is being said

  • help hospital staff understand how to meet their care needs, including how to reduce anxiety 

  • calmly explain upcoming transitions to the person

Summary

Knowing something about the hospital system will be useful background when you accompany a person with intellectual disability to hospital.

People with intellectual disabilities are usually comfortable when in familiar surroundings with familiar people. They can become anxious when moving to a new place in a hospital after they have settled. You can reassure them if you know about upcoming transitions and explain them to the person in ways they understand. Picture supports, such as those that might be part of a person's AAC system, can be used to help them understand what is about to happen and give them a way to communicate. Even if the person does not understand what is being said, your use of their communication system can include and reassure them.

  

You can find information in Resources about Augmentative and Alternative Communication, communication and people with intellectual disabilities, and hospital short stay units.

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Activities

These are provided to support your learning, individually or in a group. You can write responses in the workbook sections available for download. 

Consider that you are supporting an adult who does not speak, but rather communicates largely through her facial expression and some gestures. She is being transferred to a ward from a section of an Emergency Department, such as the short stay unit. An orderly arrives and is about to wheel her to the ward.

Write down your responses to the following in your workbook:

  1. Describe what you would do. 

  2. List the information you would share with the orderly. 

  3. List the questions you would ask the orderly. 

  4. Explain how you would let the person you support understand what is about to happen and reassure her. 

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