Vulnerable patients, companions and dignity risks

Some patients need extra help to protect their privacy and dignity. This includes people with dementia, learning disability, autism, sensory impairment, mental ill health, trauma history, limited English, low health literacy, frailty, communication needs or those who rely on carers.

Vulnerability can be situational. Someone who is usually confident may feel vulnerable when they are in pain, distressed, embarrassed, short of money, confused by choices, worried about their vision, or accompanied by a person who dominates the conversation.

Children and young people, and people experiencing domestic abuse or coercive control, may need careful handling so their voice, safety and privacy are protected.

Keeping the patient central

• Address the patient first: speak to the patient unless they indicate otherwise.
• Check communication needs: offer plain language, written notes, large print, a quieter space or interpreter routes.
• Notice pressure: companions may help, but they can also answer for or pressure the patient.
• Offer privacy: if the patient seems uncomfortable, give them a chance to speak away from the companion.
• Respect adjustments: record helpful adjustments in the approved place so future visits are easier.
• Escalate concerns: raise safeguarding, coercion, capacity or serious distress with the appropriate person promptly.

Companions and carers

Many companions provide essential support with transport, communication, memory, decision-making or practical arrangements. Involve them appropriately while keeping the patient's voice, privacy and choices central.

Related learning and accessible information

Supportive companions can improve care, but the patient should not disappear from the conversation.