Deaf People and Healthcare Communication

Abstract

This chapter provides resources for healthcare professionals and students who work with deaf and hard of hearing patients (D/HH) in healthcare settings. This chapter also addresses different areas of D/HH topics, including the following: disability justice principles; the use of People-First Language; the theoretical lenses on Deaf Studies and Disability Studies; and the definitions of deaf, hard of hearing, Deaf, and deafness myths. In addition, the challenges of healthcare communication with D/HH patients are raised, including the advantages and disadvantages of video remote interpreting versus in-person interpreting and the intersectionality and cultural impact on patient–provider communication. Finally, communication strategies are offered for working with D/HH patients.

Appendix: Communication Strategies for Working with Deaf and Hard of Hearing Patients

It is essential to understand the advantages and disadvantages of interpreting services, deaf and hard of hearing (D/HH) patients’ communication needs, and the legal obligation to provide communication accommodation. It is also critical to recognize the various aspects of the hearing culture and the Deaf culture, and to be aware of not only communication and language barriers, but also their intersectionality with language, race and ethnicity, gender, socioeconomic status, and disability.

Moreover, it is important to consider various communication strategies with these patients such as providing appropriate interpreting services, ensuring a clear visual field, refraining from sitting in front of a bright window, talking to the patient without overenunciating, and speaking directly to the patient rather than directing communication to the interpreter (Meador & Zazove, 2005).

The following tips are summarized from the training guide Access to Medical Care (Saxton et al., 2011).

1.1.1 Treating Deaf and Hard of Hearing Patients

When you treat patients who have identified themselves as “deaf” or “hard of hearing” and use English as a primary language, there are several things to consider:

First, please ask the patient how to best communicate with him/her and prepare to provide written educational materials while minimizing background noise and glare.

Second, please do not talk to the patient from a distance (or from another room), shout or exaggerate mouth movements, or talk rapidly. Simply look at the patient while speaking clearly in a normal tone of voice and make sure that he/she can see your mouth.

Third, since lip movement is only 30–40% visible, it is very difficult for a patient to speech-read medical terminology that is unfamiliar to them. Please draw on their capability to see the information such as by drawing pictures of symptoms, writing out medical terminology, using an interpreter for a group conversation, and removing your mask to allow the patient to see your facial expressions.

1.1.2 Treating Cultural Deaf Patients

When you treat patients who have identified themselves as culturally “Deaf” and use American Sign Language (ASL) or other sign languages as a primary language, there are several things to consider:

First, please ask the patient how best to communicate. The patient may request an interpreter who is an ASL interpreter, a Pidgin Sign English (PSE) interpreter, or a certified deaf interpreter (CDI). Each deaf individual has different communication preferences. PSE is a mixture of ASL and English, which differs from ASL as a distinct language (CDC, 2020b), while a CDI provides interpreting services to Deaf individuals who use other sign languages or have linguistic limitations that prevent them from understanding an ASL interpreter (National Consortium of Interpreter Education Center, 2014).

Second, hospitals are responsible for providing interpreting services. You should not charge the patient nor ask him/her to bring family members or friends for translation.

Third, avoid calling the patient “hearing-impaired.” Please speak directly to the patient and do not say things to the interpreter like “Tell them…” Eye contact is essential for language access, and it respects Deaf cultural manners.

Finally, if the patient does not understand your instructions or questions, then repeat or use other words or find another approach to providing the information. Please take the necessary time to meet the patient’s healthcare needs.