Intuition! I think all nurses have the potential of having good intuition with regards to patient needs. I have come across lots of patients with communication difficulties due to language, dementia, speech impairment, hearing impairment and cognitive decline. Each resident will have their own way of letting us know what is wrong and if they can't then intuition comes into play. I currently use a note book (writing on block capitals, simple short questions/ answers) for a lady with hearing impairment, I have used humour and smiles to convince a depressed man to even give me yes or no answers and I have used my intuition in many residents unable to give verbal, physical cues.
PS. I have a wee lady who does not speak much but moans a lot (it is due to her dementia), she was very noisy the other night, I sat beside her, held her hand and asked if she was tired, she replied yes between moans. I gave her a cuddle and a peck on the cheek and as I walked away she said 'thank-you' and smiled. Little things mean a lot in the job don't they!:spin: