The Sounds of Silence

April 15, 2020
photo shows sarah reviewing information with a colleague - they are wearing masks
Sarah Gendreau, left, talks with her nursing colleague Katelyn Bushey at Mass. General.

Sarah Gendreau is part of a team of speech-language pathologists at Massachusetts General Hospital who are working to support communication with COVID-19 patients using non-verbal techniques and tools that minimize the chances of spreading the disease.

Gendreau, who earned her Master of Science in Speech-Language Pathology from the MGH Institute in 2014, is assisting providers using augmentative and alternative communication (AAC) tools such as whiteboards and other non-verbal techniques so they can better care for patients who cannot speak because they are intubated or connected to a respirator.

“There’s a risk every time someone goes into the room of a patient with the coronavirus, so this can reduce unnecessary entrances and exits,” said Gendreau, who noted nurses inside and outside patient rooms are also using the tools. “These are a great way to keep the lines of communication open while reducing the use of personal protective equipment.”

Image shows an array of the word cards used on the units

Gendreau, an adult inpatient speech-language pathologist at the hospital who also is a clinical instructor with the Institute’s SLP students, has been a member of an interdisciplinary task force at Mass. General since 2016. The group has focused on methods used with patients who have complex communication needs because of neurodegenerative conditions such as ALS, neurofibromatosis, muscular dystrophy, language disorders, or are otherwise unable to speak. 

Since many COVID-19 patients cannot speak because they are hooked up to a ventilator, it was important to implement the techniques during the pandemic. 

“Sarah has been a tremendous champion of this work,” said Carmen Vega-Barachowitz, director of the Speech, Language and Swallowing & Reading Disabilities Department, Chaplaincy, and Medical Interpreters at the hospital and assistant professor in the MGH Institute’s Department of Communication Sciences and Disorders. “It is not just bringing the communication boards but making it easy to use for these extremely busy nurses and providers in the work environment.”

The boards, which are translated into several languages, are not intended to replace medical interpreters. They have COVID-relevant messages to support patients of varying communication abilities. Patients who are able to write use single-use dry erase boards to create a two-way silent communication. They have been utilized on Blake 7, Blake 12, and Lunder 7 in the hospital, with more units expected to use them in the coming weeks. The communication tools’ information, said Vega-Barachowitz, was also shared with Social Services, Spiritual Care, and the hospital's ethics leader, who leads some of the efforts with end of life.

Gendreau, along with SLP colleagues Stephanie Scibilia and Rachel Towbin, are members of the Patient Provider Communication Forum, a national cohort of interprofessional health care workers that has created a COVID-19 initiative consisting of free communication supports to patients and health care workers.

Gendreau and Scibilia co-presented “Envisioning & Creating an Acute Care AAC Program for Adult Inpatients” at the 2019 American Speech-Language-Hearing Association annual conference. Scibilia, Towbin, and Gendreau are instructors on the Institute’s three Interprofessional Dedicated Education Units at Mass. General. 

Read more about efforts by the IHP community during this crisis in the "Business as Unusual" series. If you have a story about how you or other people in the IHP community are reacting to the pandemic, please email John Shaw.