Communication Methods Available for Completely Paralyzed Patients
Communication Methods available to people suffering from paralysis or significantly impaired mobility
Imagine for a moment if you will, that you wake up one day and you are completely paralyzed. How would you communicate with others in the room? How would you get your morning coffee, or breakfast for that matter? You can’t effectively say what you want so you are now at the mercy of a dietician who choose foods that are “best” for you. How can you tell them that you don’t like the taste of lemon in your tea or burnt toast? For that matter, how will you be able to communicate anything with others regarding pain levels, basic needs and anything else you have to say?
For you, this was just an exercise, a learning experience that you can leave at any time and communicate freely with anyone you choose about anything you like. For some, especially those who are partially or completely paralyzed due to injury or disease, this is the harsh reality of their life. The face these challenges every day and have a hard time communicating something as simple as a “Hello”. How do these people with significantly impaired mobility communicate with others? What means of communication are available to them?
For those suffering with severe forms of paralysis or having significant mobility problems like those associated with quadriplegia, there are a few, not many, available options for communication; let’s take a look at some here.
For those who have some remaining use of muscular activity, a muscular contraction strong enough to move a mouse or at least press a button on a keyboard that has simple commands or text associated with it, could be just what is needed to communicate their needs with others.
Even if they are only able to move one of their fingers, they can use partner assisted scanning to type and send text messages. Here is how this works:
The user, this would be the person with the disability or immobility, would indicate by either pointing at or using some other gesture, a letter, phrase, word or symbol indicating what they are in need of. This is a very low tech system that would require the communication partner to read the letter, phrase, word or symbol aloud or transfer it to a messaging system for family, friends or medical or service personnel.
If the impaired person is a quadriplegic or tetraplegia, they could use some other part of their body to indicate the desired response. Some patients will use their tongue on a specialized mouthpiece which is wired to the keyboard button. This method would see the user selecting a symbol or key word and highlighting it at that particular moment.
What is the person doesn’t have enough mobility or strong enough muscular activity to operate a keyboard, mouse or pedal on a mouthpiece? What are they to do when they need to communicate important information to others?
In more serious cases of paralysis, if the person doesn’t have enough muscular activity to indicate their needs, that may still be able to communicate using visual or audio signals. Let’s take a look at some options available to them.
If the patient can perform any visually identifiable actions and those actions can be understood by an assistant, they may have an easier time communicating their needs. These visually identifiable actions can include mimics, moving a lip, raising and eye brow, blinking an eye, even moving an eye-ball and this behavior can be detected and used as a trigger event for data input via partner assisted scanning technology.
Barring any kind of movement at all, if the user can produce any kind of vocal sounds, which do not include speech of course, they can communicate using the partner assisted scanning technology as well. By loudly breathing and or out, blowing onto a microphone, sniffing, moaning or any other grunt type of noise can be used as a trigger for scanning.
Now, let’s say that none of the above options are useful for the person and they are in a persistent vegetative state, or PVS. This means that the user is not sending any useful signals of consciousness and contactless technology is useless for them. What can we do for this patient to enable them to communicate freely and indicate to others their wants or needs?
For this patient, we have the EEG, or electronic encephalography method. The EEG methods is very effective for this type of patient but it does require the use of electrodes or sensors attached to the patient’s head and recording the electronic signals generated by their brain. This method is far superior and much more technologically advanced than any of the others, but it does use a lot of specialized hardware, expensive software and it can be time consuming to install, set up and learn the proper way of using it.
As you can see, this method can be quite useful but it is not good for short term use as the equipment and training needed for this method aren’t readily available and may take time to get started. Factor that in with the cost, and this method becomes a last resort for many patients.
In conclusion, we have looked at a wide range of methods that persons with mobility limitation and complete immobility can utilize to be able to effectively communicate with others using the partner assisted scanning technology. That is, as long as they have strong enough muscular activity to press a button, move a mouse or press a pedal on a mouthpiece.
For those who aren’t able to communicate by making or sending visual or audio signals of consciousness, touchless technology would be useless. For these patients and others in a PVS, the contact technologies such as the EEG would be more effective.
This just goes to show that there is hope for those who thought they would never communicate their needs with others; there are just different methods that must be employed.
From tapping a button with your fingers or a breath of air, to moaning into a microphone and having an EEG attached to them, people with mobile impairments are entering a new age of communication that science and technology can dispute.