Communicating with critically ill patients – NHS Weston Area Health

Communication with critically ill COVID-19 patients can be difficult if they are ventilated or have a tracheostomy but are still alert. To overcome communication barriers the Speech and Language Therapy Team at Weston General Hospital created a board made up of symbols to enable quick and easy communication.

The board’s symbols cover immediate care needs and messages patients want to pass on to their families. The board can be adapted, if appropriate, if a patient is considered to be nearing the end of their life.

How to use the communications board

The team created the following instructions:

  • Position the board so that the patient can see it (glasses on if required and available).
  • Ask questions such as "Are you in pain?" while indicating the relevant area of the chart (for example, the pain scale).
  • Other questions may be "What do you want?", "How do you feel?" or "How can we help?"
  • If the patient is unable to point to choices, try asking "yes/no" questions such as "Any pain?" or "Do you have a sore throat?"
  • They may be able to do thumbs-up for "yes" and hands flat for "no". If they are unable to move their hands, they can look up for "yes" and down for "no"; looking at the "yes" and "no" symbols on the chart will support this.
  • If the patient is unable to point at all, you can also ask questions such as "Is it in this box?", then scan down each line asking "In this line?", then scan with your finger along the line until they indicate (for example, by looking up for "yes") the correct symbol.


Available in multiple languages:

Available on NHSGGC's website as a resource for staff:

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