[Dysphagia] OT: dysphagia patient with deafness & sign language question

[hillivie423 at adelphia.net (hillivie423 at adelphia.net)]

Many people who have deafness and developmental disabilities use adapted signs.  It is hard to say what her communicative intent is with those signs.  Fist in open hand often means "help."  Once her signs can be decoded, a list needs to be made that follows her wherever she goes.
---- Bonnie Heintskill <bonnieh4455 at sbcglobal.net> wrote: 
> I was seeing a patient that was cognitively delayed (age 63), profoundly hard hearing/deaf, is now PEG tube fed due to aspiration pneumonia.  PMH includes seizures, agitation, was on psychotropic medications. Ended up dehydrated and aspirated.  She is also non-verbal. Lived in a SNF for 25 years which closed then went to a residential group home where she got very ill.  Her case worker said she knew some sign language but the records never got transferred to the group home.   She is now at a sister group home.  When I initially saw her, she only made one sign which was hitting one closed fist to the other palm repeatedly.  Looking in sign language dictionaries I found what she may have been doing - cup - in a modified way. She also was repeately doing a forefinger in the air (I understand?).  I tried a binaural amplification system with her without any apparent success.  
> 
> Yesterday she was doing 2 -3 more signs. One she was taking her right fist and hitting her left cheek or chin so hard that she turned the skin red, taking her left fist and hitting her head, and then doing some finger signing.  She was getting very frustrated with the caregiver and I, which I don't blame her since I'm not a signer.
> 
> She was also doing closed fist to closed fist (more?).
> 
> 
> Anyone have a clue as to what she may be signing?
> 
> She only likes applesauce and refused to eat anything after one bite yesterday.  The caregiver stated she had been crushing up her meds and putting them in apple sauce.  She used to drink out of a sippy cup but when I tried one with her (tupperware) she refused. Group home is getting a new one on Wednesday and will trial it with her (nectar thick liquids).
> 
> I put together common signs for ADL's and gave them to the group home.  They didn't know that another resident had been using sign language so at least this helped the caregivers.
> 
> I am looking in my sign language dictionaries and don't see anything comparable. She may have adapted a sign or two.
> 
> Any suggestions?
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