08.03.16

We are delighted to welcome guest blogger, Charlotte Orrell to the Renaissance family. Charlotte is a Speech and Language Therapist and also an Intermediary in the legal system, facilitating communication between legal professionals and people with communication difficulties. In this blog Charlotte discusses the speech and language implications of reading and understanding legal documents for disabled and vulnerable individuals.

The Mental Capacity Act

The Mental Capacity Act is clear in its message that ‘all adults have the right to make decisions for themselves unless it is shown that they are unable to make them’.  And that ‘people should be supported as much as possible to make their own decision before anyone concludes that they cannot make their own decision’.  It is this decision making process, in those people who have been deemed to have capacity, but for whom there may be issues regarding their communication, that is the focus of this blog.  After all, decisions about key aspects of our lives, such as health treatment options or making a Lasting Power of Attorney, are challenging for all of us.

“It does not take much strength to do things, but it requires a great deal of strength to decide what to do.”

― Elbert Hubbard

If there are communication issues for a person, this can add a layer of complexity to the decision making process.  So in this blog we will consider how people can be ‘supported as much as possible’ to make their own decisions.

Understanding

When supporting a person with communication difficulties to make a decision, a thorough understanding of the communication skills of that person is vital.   It can sometimes be challenging to know what a person is able to understand. For example, a person with language difficulties brought on by a stroke (“aphasia”) may have limited speech, but their actual understanding of language may be good.  Conversely, a person with autism may be very verbal, but this might mask underlying difficulties with processing the language that they hear.  That said, it is not possible to generalise about communication difficulties; everyone experiences conditions like aphasia and autism differently.  If in any doubt, it would be wise to seek further information about this, or even consider a specialist assessment of their communication skills.

Support

Supporting someone’s understanding of the options that they have to choose from can be done in a variety of ways:

• Providing information in different formats, such as audio or Easyread;
• Use of words, photographs, signs and symbols – for example “Talking Mats” are simple and effective symbol-based tools.  These are used to help support decision making in a highly visual manner. It is also possible to keep a visual record of these mats, which can help to evidence the decision making process and also act as a possible prompt for the client to remember what has been discussed.  For example, Talking Mats may help someone in the early stages of Alzheimer’s disease to communicate what is important to her regarding her personal welfare, when appointing a Health and Welfare Attorney;
• Communication is always a two-way process. The ability of legal professionals to support someone to make key decisions will depend on their own ability to adjust their communication style to meet the needs of their client. Establishing an environment in which a client feels they can say if they don’t understand something is essential;
• Obtaining information from other people who know the client well about the “signs” to look for when they don’t understand; for example puzzled facial expressions, pauses, changing the topic of conversation, is likely to also be helpful;
• Asking “do you understand what I said?” is likely to be an inadequate strategy; asking “tell me what you have understood” is more likely to reveal possible communication breakdowns. Closed questions, including those that lead to a yes/no answer; “do you want to appoint X?”, or even worse, the highly leading “you want to appoint X, don’t you” can be at high risk of leading to inaccurate answers for many people with communication difficulties.

If a member of your family or a friend, who has complex communication needs, requires support when working with a professional on legal documents you can always call upon the services of an independent advocate, or a communications specialist who can facilitate communication with their client.

Charlotte can be contacted by e-mail on: charlotte@courtintermediary.com