Electronic communication devices with hospitalized older adults

Hospitalized older adults experience panic, anger, and confusion in response to the communication deficits accompanying respiratory tract intubation. This paper describes patient characteristics, communication quality, content, and barriers during electronic augmentative and alternative communication (AAC) device use with 8 hospitalized older adults aged 57-82 years (66.4+8.5). Observation, interview, and survey data were obtained from two consecutive pilot studies to explore the use of AAC devices with intubated adults (n=21) in medical intensive care and otolaryngology surgical units of a tertiary care hospital. Severity of illness (APACHE III=39.3+15.5) was moderately high. Older adults averaged 6+4.8 days of AAC device use. Ease of Communication scores after using the device (23.3+9.7) decreased from pre-intervention (31.0+ 13.8) (higher scores indicate greater difficulty). AAC devices were used: little/not at all (n=2), occasionally with cues (n=3), some independent use (n=3). AAC performance persisted despite narcotics and/or sedation (n=6); half could write legibly. Poor positioning, clinical deterioration, unfamiliarity with device, layered message screens were primary barriers to use. This analysis shows that electronic devices may be a useful component of AAC intervention for some older adults. Funding: AACN/Sigma Theta Tau;Oncology Nursing Foundation/OrthoBiotech.