AAC and COVID-19: Ventilator Use May Necessitate Alternative Methods of Communication for Patients in Acute Care

Augmentative and alternative communication (AAC) can play an important role helping COVID-19 patients communicate their condition and wishes with their medical teams. AAC includes the use of gestures, picture and word boards, and messages on computers or phones to help people communicate more effectively. The need for AAC is heightened by the fact that patients in acute care may not have loved ones around who would normally advocate for their care.

Many COVID-19 patients in serious condition require a mechanical ventilator to help them breathe while in acute care. Although this is intended to be a life-saving measure, ventilator usage can result in complications—short- and long-term. This includes a person’s ability to speak, which can have serious repercussions if not appropriately addressed.

“It is essential that everyone have the ability to communicate at all times—and be provided an alternative method of communication if they cannot use speech,” said Theresa Rodgers, MA, CCC-SLP, 2020 ASHA President. “Not only do people deserve to have their basic needs met, such as to communicate that they are in pain or request that a loved one is called, but patients may be more likely to have a serious adverse medical event if they cannot communicate with their health care providers.”

Under typical circumstances, speech-language pathologists can work with patients at their bedside to introduce some form of AAC. However, given the tight restrictions on the number of people (including health care professionals) who interact with COVID-19 patients, this may not be happening routinely.

Patients and their family members should know that they have a right to communicate and that there are effective communication options via AAC. Although many staff members in acute-care settings have some experience with basic AAC, such as picture boards, there may be facilities where that isn’t the case.  

In response, an interdisciplinary group of practitioners drawing from the professions of speech-language pathology, nursing, and psychology developed a comprehensive set of free resources for patients and families who require short-term AAC use.

These resources include downloadable communication boards with COVID-19–relevant messages to support patients of different ages and abilities in a critical acute medical setting. Patients can also use these boards beyond the acute-care setting, including by family members interacting with their loved one throughout the recovery process.

Learn more about communication and AAC for people who are now or who were ventilator dependent.