In Sickness and in Health
There are over 28 million deaf and hard-of-hearing people in the United States. Many of them will need hospital, medical, or emergency care at some point in their lives. The anxiety associated with this experience is profound. A hearing person can only imagine the distress produced by the soundless images of the emergency room, operating room, recovery room, testing laboratories, medical equipment, and medical personnel in a hurry. Even more apprehension is generated for the deaf and hard of hearing by their fears of being isolated, misunderstood, and failing to understand questions and instructions.
Today, medical and hospital personnel all possess the ability to alleviate the kinds of problems encountered by the deaf and hard of hearing in medical situations and to deliver effective, quality care to them. Increased awareness, preventive actions, and simple considerations will ease many of the fears and apprehensions that accompany medical and emergency services.
Knowledge of ASL is the medical community's most effective line of communication. Establishing this mode of communication will help facilitate an accurate and quicker evaluation of a deaf or hard-of-hearing patient.
In addition to sign language, patients can, or may, use any one of these various methods of communication with medical staff:
Lip reading
Writing
Gesturing and mime
Use of hearing aids
Speech
Use of interpreters
Communication Strategies
The technological world of electronic medical records is quickly becoming the norm in doctors'offices, hospitals, and medical facilities.
Deaf or hard-of-hearing patients are faced with medical personnel looking at computer screens and keyboards, with less face-to-face communication and limited eye contact. To improve interpersonal communication between medical personnel and deaf and hard-of-hearing patients, here is a list of very important communication strategies:
Ensure that you are facing the deaf or hard-of-hearing patient.
Maintain eye contact by looking directly at the patient's face.
Do not turn away in the middle of a sentence.
Speak clearly and in simple sentences, rephrasing rather than repeating.
Speak naturally, not too fast, and do not shout.
Do not exaggerate your lip movements.
Allow more time for communication.
Do not allow two people to speak at the same time.
Face the light while speaking, eliminating shadows, and easing lip reading.
Use pantomime, gestures, and facial expressions to assist you in communicating.
Avoid technical terms and keep the information straightforward.
Write important instructions in clear language.
Provide an interpreter when the patient is unable to comprehend.
Provide an interpreter when an injury or medical problem is complex.
Speak to the patient, not to the interpreter.
Explain medical procedures as they are being performed.
Specific Medical Considerations
Due to unintentional communication barriers, the deaf, and hard of hearing often need more support and explanation than is required for other patients.
If you are in the medical profession or are tending to a deaf person in any medical situation, keep the following suggestions in mind:
When it is necessary for medical personnel to use masks, the use of clear masks should be used at all times when communicating with a patient who needs to lip read. Clear masks should be available at all medical facilities for personnel.
Patients may need or want to use sign language; therefore, it is important not to restrict the patient's hands or arms. If possible, use the forearm area to insert any intravenous needle (IV). When placed in the back of the hand or the wrist area, IVs limit hand movement and cause discomfort. (This same rule applies to those patients who are not deaf or hard of hearing but who use sign language as a mode of communication with their family members.)
Patients who are lying down will have difficulty lip reading. Try to speak from the same level. Only 30 percent of all language can be seen on the lips, even under the best of conditions. Do not assume you have been understood.
The face of a patient should not be covered unless necessary. This is due to the importance of sight for comprehension. If vision is compromised for any reason, gentle and constant reassuring touching should be given.
Always explain to a patient why you are leaving the room and when you are coming back. Do not just walk out. Patients should not be isolated or left in complete darkness.
Do not engage in small talk. Although this is reassuring to hearing patients, it may cause deaf or hard-of-hearing patients to feel that they are missing important information, and they may become agitated and confused.
Ensure that patients have access to their hearing aids, glasses, and a sign language interpreter when instructions are complicated. These are vital communication tools.
It is inappropriate both ethically and legally for medical personnel to use family members as interpreters. Specifically, it is extremely inappropriate to use children as interpreters in any medical situation.
SIGNER'S HANDS: The “Signer's Hands” symbol denotes sign language interpretation is provided at the facility.
