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I guess "service user" is the new medico-babble to mean "patient"? A patient may, first, just not feel like talking much, if at all when ill. Second, illness usually causes fatigue, sometimes so profound that the patient does not feel up to talking. Third, boredom or depression, or feeling misunderstood, can lead some patients to shut down. Also, if the patient is in complete denial of her physical problems, the patient may elect to not speak.

A word of caution is in order, though. Many health workers assume what is causing a patient to not speak. First, make sure the patient understands the language being spoken. Second, be aware that some patients with aphasia cannot get words from the brain to the mouth, even though the patient understands what others are saying. Rule out aphasia or other obstacles to speech. Make sure the patient has their dentures in before trying to communicate with them. Make sure to keep a pen and paper nearby so a patient can try to write if they cannot speak.

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Q: Why might a service user choose not to communicate with staff or other people within the care environment?
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