Communication skills vital to good living

Nancy Jeruzal can pinpoint a weak tongue in a sound bite, and she knows the exercises to help build back strength. She's heard plenty of people hunt in frustration for a word that's just out of reach, and she's given them the pathway to find it.

"Communication is the human connection and at the heart of it all," says Nancy, a speech therapist for Panhandle Health District's Home Health program. "It improves the quality of life, helps keep people in their homes, allows a person to function safely."

The American Speech-Language-Hearing Association calls effective communication a human right, which makes Nancy a human rights activist. A passionate believer in the power of communication, Nancy first studied the art of communicating and then the mechanics. She's now putting that well-rounded knowledge to work for the people who live in northern Idaho.

"She'll round out the whole team," says Mary DeTienne, director of PHD's Home Health division. "Speech therapy, physical therapy, occupational therapy - the therapists all work together and it's a beautiful mix of what can happen for a patient's outcome."

Nancy is one member of a care team from Panhandle Home Health that provides doctor-ordered health care to patients in their homes. The team's goal is to help patients gain as much independence as possible.

Nancy specializes in speech and language disorders associated with strokes, Parkinson's disease, traumatic brain disorders, swallowing disorders and dementia. Patients with such conditions may need help regaining muscle strength and the ability to dress themselves as well as help understanding the world around them, expressing themselves and swallowing. Nancy is as vital to the care team as the shortstop is to the baseball team.

"I love the collaboration with the team," she says. "The physical therapist wants the patient to do exercises. I give the patients strategies so they understand and remember what to do when. I work in conjunction with the other disciplines."

Imagine studying the directions on a microwave meal in your kitchen and nothing makes sense, or trying to tell someone you want to eat an apple but you can't remember the word. Nancy helps people who face such problems every day.

"I diagnose and present patients with techniques and strategies," she says. "They have to do the work, but we move incrementally. I want them constantly feeling success."

She tells patients who can't find the words they want to say to talk around the word, give people clues about its function, parts or description until it comes to them. She tells family and caregivers to help by asking questions with yes/no answers to narrow down the choices.

For people who can't comprehend instructions, she simplifies them.

She may recommend instructional notes posted throughout the kitchen.

Some patients have no problem understanding others or expressing themselves, but their words come out garbled. Nancy recognizes a weak muscle problem and gives exercises that strengthen the tongue, cheeks and lips.

"The tongue is a complex muscle and very subtle movements make different sounds," she says. "If the tongue is weak, those sounds come out distorted or garbled."

She worked once with a woman whose primary language was Greek. Nancy doesn't speak Greek, so she asked the woman's son to sit in on her visits. The son identified the sounds his mother mispronounced so Nancy knew which muscles needed strengthening.

Regardless of a patient's communication problem, Nancy has ideas for solutions. When patients have lost the ability to communicate much at all, she helps families create a board with pictures the patient can point to. When patients don't understand when to take their medications, Nancy may suggest color-coding as a strategy.

Nancy helps caregivers and nurses cope when patients don't understand what they want them to do. She may suggest attaching notes to equipment, such as a walker, to remind them what to do with it.

"I can modify and adjust therapy and strategies for what works for them and their caregivers," she says.

With Nancy on board, Panhandle Home Health offers patients a complete therapy team.

For more information on Panhandle Home Health's therapy services, call (208) 415-5160 or (800) 226-2053 or visit www.phd1.idaho.gov.