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Objective: To explore the communication needs of cancer patients with barriers to communication, while under palliative care
especially towards the last phase of life.
Methods: We use a reflective learning process in the context of an incident that happened in the palliative care unit in King
Fahad medical city, Riyadh.
Case: 50-year-old male with locally advanced squamous cell carcinoma of the skin of the face involving the lip, invading and
destroying the maxilla and nose, had difficulty in talking. He had the history of hearing loss, unrelated to cancer but aggravating
his communication barrier. Worsening the communication gap was the language barrier where most of the healthcare staff
were non 鈥揂rabic speaking and the patient could barely write in English. He was using a list of needs written on paper in
Arabic and English. The list was not comprehensive and needed to be frequently updated and the paper required replacements.
Reflection: We did a literature search to look for documented needs of cancer patients who could not talk. We added and
updated the list of needs, printed it in both English and Arabic on a large A3 paper and laminated it to prevent damage. The
patient could now use this locally modified Augmentative and Alternative Communication (AAC) method to communicate
his needs to the health caregiver.
Conclusions: Palliative patients with communication barriers need AAC methods to effectively communicate their care needs.
We recommend further studies to standardize the items and the language used in the list of palliative care needs to make it
culturally relevant for use in the Arab population.