Occupational and speech therapists help these individuals—many of whom require breathing or feeding tubes—speak to their loved ones and care team through a device called an “eye gaze system.” Users can create a message or choose from a menu of phrases through brief eye contact with icons on an overhead screen. The message is then vocalized by the machine or sent as an email.

“It gives patients a sense of control,” explains Kelly Casey, an occupational therapist and assistive technology practitioner at The Johns Hopkins Hospital. “The system also helps us better understand patient needs and preferences, especially at critical moments like the end of life,” Casey says.

Casey recalls how the system helped a middle-age woman regain independence during a difficult recovery following surgery to remove a brain tumor.

“She was in a lot of pain and in a really bad place,” Casey says. “The second we put the eye gaze system in front of her, she lit up. She was able to talk to her husband again and email her friends.”

Tablet applications are another popular tool to help patients communicate. One app called Proloquo2Go pairs images with words and plays selected phrases aloud when pressed. Like the eye gaze system, patients can use the app to talk with their loved ones or to ask their care team a question.