healthcare-for-the-deaf-blog

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I was misdiagnosed last year because of a doctor’s unfamiliarity with treating deaf patients. This was evident in his physical shaking and awkward demeanor as he tried to engage with me. Additionally, my rights to effective communication were denied, as they did not provide an in-person ASL interpreter. I suffered two weeks with pneumonia (while taking the wrong medication) and later had to go to the hospital for an emergency antibiotic IV. Although doctors have the best interests of their patients at heart, these same doctors are not always appropriately educated to become culturally responsive practitioners.

TraciAnn Hoglind (http://www.bu.edu/sph/2018/10/11/healthcare-language-barriers-affect-deaf-people-too/)

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I have made this video to serve as an education tool and guidelines for what Deaf culture consists of. It provides some guidance to interacting with Deaf individuals and a sneak peak at what to expect if treating a Deaf patient. Increasing cultural competency will decrease the negative feelings that Deaf patients have towards healthcare settings and better their lives. 

Enjoy!

Transcript: 

“As quoted from the Culture and Diversity in CSD textbook by Steven Surrency, “One of the biggest ways that identity is performed is through the language that we speak”. American Sign Language has long been an oppressed and stigmatized language of this community and is wrongfully thought to be signed English. It was not until the 1960s that the truth was recognized by many that ASL was in fact its own language with unique grammar and independent complexities. Since then, it has further come to light that not only do the Deaf have their own language but their own values, morals, behaviors, traditions and essentially their own culture. The Deaf community and their culture have numerous traits, many of which may not be listed in this video. Nonetheless, these traits that are included are popularly associated with Deaf culture and are cited from the private university for the Deaf and Hard of Hearing, Gallaudet University. Deaf culture revolves around a visual environment for communication. This provides them with details on the world around them and allows them independence. This community promotes the use of ASL in Deaf children so that their culture can continue to flourish for many years to come. However, that is not to say that they discourage bilingualism. In fact, they support educating in both ASL and English so that they may succeed in both. Consistent eye contact which indicates the listeners visual attention is expected when communicating with Deaf individuals. Many beginning signers tend to direct their gaze to the signer’s hands, but it is important to note that this is culturally incorrect and over time it will feel more natural to make eye contact. Their inability to hear has not restricted this culture from manifesting their own art forms. These consist of films, folklores, literature (including poetry), athletics, celebrations, organizations, theaters, and even their own music and dance. Lastly, there are unique accepted methods for getting the attention of a Deaf individual you would like to initiate conversation with. These include: tapping the shoulder of whomever you would like to talk to if you are not in their view, waving to them if they can see you, or in group settings flicking a light switch a couple of times. Being more culturally competent and aware decreases the chances for cultures to develop unfair stigmatization and hurtful stereotypes. It is important to prevent oppression of Deaf individuals because it can be done so easily. It is critical to keep in mind the communication barriers that exist and to do our best to improve their ease of access to communication”. 

Works Cited: 

http://www3.gallaudet.edu/clerc-center/info-to-go/deaf-culture/american-deaf-culture.html

https://www.lifeprint.com/asl101/topics/eyegaze.htm

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This linked article describes the disparities that Deaf individuals are more likely to succumb to because of the unequal access to health knowledge and services. Major factors include lack of education, barriers in communication, and lack of cultural competency. 

Check it out to find out more on this topic!

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This video and article were made by a Deaf individual and details not only her personal experience but also describes the federal laws to protect rights to communication. The author, TraciAnn Hoglind, was misdiagnosed by a physician because they were not used to working with Deaf patients. It’s a very interesting read and it really sheds light on the subject from a personal perspective. 

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The National Association of the Deaf is an advocacy group that began in 1880 to promote deaf culture and the use of sign language. It also allows Deaf individuals to have their values represented by a national organization. The link above leads you to their position statement on how healthcare should be modified to better accommodate Deaf patients. It gives many great examples for improvements that have been researched to promote effective communication. 

Check out the link to read and learn more!

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Barriers to healthcare services and supports for signing deaf older adults.

As quoted from this article, “With 60% of deaf Americans over the age of 65, barriers to care for members of the Deaf community who use ASL as their primary language are substantial and pose great risk to health and well-being”. This article provides an intriguing take on older adults and their experiences with healthcare. The results explain that lack of cultural competence and knowledge of interpreters causes feelings of distress and distrust towards doctors in Deaf patients. 

Check out the link below to read more about it! 

Barriers to healthcare services and supports for signing deaf older adults.

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I found this video on YouTube extremely interesting and can be very beneficial for medical staff! It explains the measures that those at University of California, San Diego Health have taken to better accommodate their Deaf patients and make them feel more comfortable talking to their physicians. They have implemented some very helpful programs so check out this video to learn more!

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Deaf LGBTQ patients’ disclosure of sexual orientation and gender identity to health care providers.

This article details the struggles that a minority within the Deaf culture faces. It takes a look at a different perspective and examines how the role of an interpreter being in the room affects the Deaf patient’s comfort level. 

Check out the PDF linked below!

Deaf LGBTQ patients’ disclosure of sexual orientation and gender identity to health care providers.

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Need to hire an interpreter and don’t know where to start?

I made this video to help educate and provide guidance on how to work with and hire interpreters. It provides a few guidelines and helpful tips for locating and hiring interpreters in the area. 

Transcript:

“It is clear that Deaf patients often do not receive the access to effective communication within healthcare that they should and many report “communication in the healthcare setting is fraught with difficulties and believe that misunderstandings resulting from miscommunication have the potential for serious consequences” (Olson and Swabey 191). According to Olson and Swabey, “In one study, most of the physicians surveyed identified the importance of using qualified interpreters, but only a small number reported using them. Instead, many physicians relied on lipreading and writing, which have been documented as having serious limitations” (191). Although there are many improvements to be made to the system in place, small steps can be taken to ease communication and better help the relationship between the patient and their physician. But what exactly are these steps? Hiring an interpreter may seem like a daunting task for medical professionals but there are resources out there to ease the process along. The patient will typically give guidelines for the kind of interpreter they prefer which can include criteria such as gender, form of interpretation, and they may even have an interpreter they traditionally use and provide you with their contact information. If only given guidelines, the provider can use the organization RID, which stands for Registry of Interpreters for the Deaf. Going to their website, RID.org gives professionals the ability to use their interpreter database to locate interpreters by city and the required qualifications for the task. This provides you with the opportunity to use an interpreting agency in your area or find freelancing interpreters near you. The Standard Practice Papers is a resource for healthcare professionals to use in preparation of the use of an interpreter as well as setting an expectation for what the visit will be like. This can also be found on the RID website. Education is a key factor to decreasing the difficulties deaf patients face when visiting health professionals. Using the RID Standard Practice Papers as a teaching tool can benefit staff members by making them more aware of the behaviors and roles of interpreters they may encounter at work. Incorporating interpreters into the team and providing them with all the necessary information to do their job can facilitate easy communication between the medical staff and the patient. To further improve cultural competency among staff members and reduce stereotyping Deaf patients, simulations of encounters with Deaf patients can provide hands on experience to the medical team.”

Works Cited:

Olson, Andrea M., and Laurie Swabey. “Communication Access for Deaf People in Healthcare Settings: Understanding the Work of American Sign Language Interpreters.” Journal for Healthcare Quality, no. 4, 2017, p. 191. EBSCOhost, doi:10.1097/JHQ.0000000000000038. 

https://journals.lww.com/jhqonline/Fulltext/2017/07000/Communication_Access_for_Deaf_People_in_Healthcare.1.aspx

https://www.rid.org/about-rid/about-interpreting/

https://www.rid.org/about-rid/about-interpreting/standard-practice-papers/

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Issues with health services that Deaf individuals face are not limited to US borders. This articles focuses on a survey study done by The Cheshire Deaf Women's Health Project that revealed many inequalities in access to healthcare. At the conclusion of the article, it offers many improvements and accommodations that could be made to help facilitate communication. 

Check it out to learn more!!

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Unfortunately, many Deaf individuals who make visits to see health professionals are faced with communication barriers that turn what should be easy visits into difficult and dreaded appointments. Many feel stressed about requiring an interpreter and may feel burdensome. However, having an interpreter there is critical to their visit or the individual will likely leave feeling unsure of their diagnosis or treatment plan. A miscommunication could easily occur which could result in the decline in health in the patient. 

The linked study examines if there are any other factor that cause Deaf individuals distress when visiting healthcare professionals. Check it out to learn more!

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The Deaf community faces many unknown struggles when visiting health professionals. This video unveils many misconceptions about appropriate and inappropriate methods for delivering medical information. The goal of the video is to shed some light on the topic and help professionals become culturally competent. Check it out to learn more about this topic!

Transcript:

“Unbeknownst to many, Deaf individuals to this day still struggle with communicating effectively with their health professionals. As explained in the quotes on the screen, difficulties encountered due to communication leads to distrust in clinicians which can lead to detrimental declines in the health of the Deaf patient. A contributing factor to consider is the lack of cultural competence about the Deaf community. Many utilize harmful misconceptions and stereotypes such as believing that lip-reading will provide effective health communication and practicing this when delivering medical information.Note writing is ineffective in numerous ways when consulting Deaf patients. In itself, it is an informal way of providing information and may further cause distrust between the professional and client. Additionally, it is restricting due to the medical terminology and low health literacy abilities the patient might possess. An equally ineffective tool is lip-reading. As quoted on the screen, expert lip-readers can understand 30 to 45% of spoken language at their very best. With over 55% of information being lost during lip-reading, this method can very easily cause miscommunication between doctor and patient. Moreover, it may be indirectly insulting to those of Deaf culture to assume that ASL is similar in vocabulary and grammatically the same as English.Just as dialect exist in English, such varieties in language occur in American Sign Language as well. A cultural issue to consider is that deafness may arise later in life which in turn causes late exposure to sign language, resulting in language dysfluency which can contribute immensely to miscommunications. “Late and/or inadequate exposure to sign language often results in what is known as language deprivation among [Deaf and Hard of Hearing] individuals” which in turn will ultimate lead to a serious misunderstanding between the patient and their doctor (Kuenburg, Alexa, et al. 3). Deafness can be perceived as a disability, a culture, or even both by many people. Regardless, it creates a communication barrier in the healthcare setting but it is not a barrier that cannot be overcome. The first step is to ensure all medical staff are culturally competent in Deaf culture and make strides to only use helpful generalizations rather than harmful stereotypes. Furthermore, following the results seen by Kuenburg and colleagues, “for patients with limited English proficiency, the use of professional language interpreters is correlated with improved clinical care, and deaf patients report positive experiences in health care encounters when medically experienced professional sign language interpreters are present” (Kuenburg, Alexa, et al. 4).” 

Works Cited: 

Kuenburg, Alexa1, et al. “Health Care Access Among Deaf People.” Journal of Deaf Studies & Deaf Education, vol. 21, no. 1, Jan. 2016, pp. 1–10. EBSCOhost, doi:10.1093/deafed/env042.

https://academic.oup.com/jdsde/article/21/1/1/2404217