Critical care and communicating with your family member

If your family member is in critical care, they might find it hard to communicate for different reasons.

There are ways to help you communicate with your family member.

If you have any questions or concerns about communicating with your family member, speak to their doctor, nurse or speech and language therapist.

Reasons communication can be difficult

Your family member might find communication difficult for various reasons. They might:

  • not be alert
  • get tired easily
  • need help breathing with a breathing machine (ventilator)
  • have lost muscle strength (for example, in their face muscles)
  • have brain or nerve (neurological) changes (for example, because of a stroke)
  • not be able to see or hear well
  • have a tracheostomy tube (a tube that is put through an opening in their neck into the windpipe to help them breathe)
  • take medicine that makes them feel sleepy or confused

For these reasons, you might find it difficult to communicate with your family member. This can make you both feel frustrated. Your family member might also feel alone or anxious.

Things you can do to help

There are ways that you can help your family member to communicate.

How you can help

  • Bring their glasses and hearing aids to hospital, if they use them.
  • Ask questions that have a simple yes or no answer. You could ask ‘Do you feel better today?’ instead of ‘How do you feel?’
  • Encourage them to use facial expressions and body movements (gestures) rather than their voice.
  • Pay attention to what they say and give them more time to communicate.
  • Repeat their answers back to them to make sure that you have understood their message.
  • Be clear about the topic of conversation.
  • Make sure that there are no distractions and background noise, such as a television or radio.
  • Speak calmly and clearly, and do not shout.
  • Encourage any attempt that they make to communicate. You could give them a pen and paper and ask them to write important words if they can.
  • If they have a mobile phone, you could use typing to communicate.

Communication aids

Critical care units have iPads with a communicator app. Try using this app to help your family member communicate.

The speech and language therapy team can give advice about using communication aids, such as picture and alphabet charts and electronic communication aids.

If your family member has a tube in their neck

A tracheostomy is when the doctor makes a hole in the front of someone's neck. They then put a breathing tube in the windpipe below the voice box to help them breathe.

If your family member has a small balloon attached to their tube, they cannot use their voice.

When it is safe, the critical care team might deflate the balloon and put in a one-way valve. This device allows air to pass into the tube but not out of it. It can let your family member use their voice box again. They can then make sounds or use their voice to communicate.

If English is not your family member's first language

Tell a member of staff if your family member's first language is not English. This helps us to communicate better with them. We can arrange an interpreter or signer.

You can call the language support team for more support on 020 7188 7798.

Resource number: 3093/VER4
Last reviewed: September 2020
Next review: September 2023

A list of sources is available on request.

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Contact us

If you have any questions or need advice, the speech and language team at your hospital can help.

Guy’s Hospital

Phone: 020 7188 6233

St Thomas’ Hospital

Phone: 020 7188 2522

Do you have any comments or concerns about your care?

Contact our Patient Advice and Liaison Service (PALS)

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