3/30/2018. Breaking Down Communication Barriers: Communication with Patients Who Are Deaf, DeafBlind or Hard of Hearing.

Transcription

1 Breaking Down Communication Barriers: Communication with Patients Who Are Deaf, DeafBlind or Hard of Hearing Kim Davis Advocacy Specialist Care Plan Development and Cultural Diversity NNFA/NALA 2018 Spring Convention Objectives Facing Communication Barriers Identity and Communication Diversity Breaking Down the Communication Barriers Resources Facing Communication Barriers 1

2 Stories Told I got into an accident at work with my legs. Went to the hospital and requested an interpreter. They weren t able to find one and went ahead with the surgery. After surgery, they gave me papers and gave me antibiotics. I told them I didn t need antibiotics because I had some at home and prefer to save money. My friend came to see me and said I wasn t supposed to take those kinds. I didn t know there are different types of antibiotics. I couldn t understand what was written to me by the doctor/hospital. - Deaf Think Tankers (2003) Stories Told When I moved from Arizona, I had back problems and in pain (chronic). My doctor referred me to a specialist at the hospital. They already had a good skilled signer, a nurse. She interpreted good, good job. She knows medical terms. - Deaf Think Tankers (2003) Stories Told My doctor sent me to another doctor for a test. When I showed for my appointment They did provide interpreter, but I said I didn t need one. I could just read and write. But they insisted because of the law. I preferred reading and writing and saves time. I was wondering who told doctor that it is REQUIRED to have interpreter at ALL times? - Deaf Think Tankers (2003) 2

3 Stories Told My hearing Ex s mother is Deaf, so is his father, brother and sister. His mother had breast cancer. The lump she had was so bad and BIG. My Ex interpreted for his mom when she had the mastectomy. He said they got all the cancer and she will be fine. He continue to interpret for over a year with her medical appointments. She had to go through chemo and radiation for a long time to be sure that it doesn t come back. One day he was not able to interpret, so the doctor found a really good interpreter to take his place. His dad called us by telephone afterward and said The cancer was always there. They never were able to catch it in time. It spread to her brain and back. She and the medical providers finally stopped using my Ex to interpret so he could be her son. - Deaf Think Tankers (2003) Deaf Culture: Competencies and Best Practices Unfortunately, 90% of deaf children are born to hearing parents and do not develop language skills early on, which negatively impacts their ability to access health information and healthcare. Healthcare providers must ensure they provide culturally competent care and their practices accommodate the needs of deaf patients to mitigate communication barriers and ensure equitable care with positive health outcomes. - Kathleen J. Richardson, DNP, ARNP, NP-C, CEN (Pub. 2014) Identity & Communication Diversity 3

4 Identity Diversity Deaf (capital D ) deaf (lowercase d ) Oral deaf Late-deafened Adult Hard of Hearing Hearing Impaired DeafBlind Estimated Nebraska Population 371,200 Deaf and Hard of Hearing 18,560 1% are Culturally Deaf 280 are registered as DeafBlind 2010 US Federal Census: 1,826,341 Nebraskans US Department of Health: Estimate based on 20% of total state population 4

5 Communication Diversity Careful, one size doesn t fit all Speaking Writing Fingerspelling Sign Language American Sign Language Pidgin Signed English Signing Exact English Speechreading Gestures / Body Language Residual Hearing With or Without Hearing Aid or Cochlear Implant Text Reading Pen & Paper Computer Smartphone / Tablet Tactile Cues Breaking Down the Communication Barriers Indications that a Person is Possibly Deaf or Hard of Hearing Does not respond to environmental sounds or your voice Stare intently at your face to read your lips Unable to speak or pronounce words clearly Points to their ear and mouth / point to their ear and shake their head Gesture to communicate in writing Tilt their head to rely on remaining residual hearing Does not see or hear you come in the room Speak too loud Wear one or two hearing aids or cochlear implants Accompanied by a service dog 5

6 Getting the Attention of a Person Deaf or Hard of Hearing Before starting to speak, do one or more of the following: Stand directly in front of the person Avoid light sources that are directly behind you Waive your hand in front of their face Gently tap their shoulder Immediately establish your identity as a Check to see if any access to communication is needed or being arranged Ways to Find an Interpreter Nebraska statute requires sign language interpreters to be licensed Nebraska Interpreter Referral Services Free-Lanced Interpreters NCDHH After-Hours Emergency Registry of Interpreters for the Deaf, Inc. (RID) A list names and contact information from the Deaf patient Video Remote Interpreting Services Ways to Find Captioning Service Providers NCRA CART Captioner Directory Contact our agency for an updated list of individuals 6

7 Communication Devices NCDHH Equipment Loan Program TTY Amplified Telephone Captioned Telephone Personal Assistive Listening Device Other Communication Devices UbiDuo Job Accommodation Devices Specialized Stethoscopes Check out Association of Medical Professionals with Hearing Losses (AMPHL) 7

8 Special Considerations If your medical facility has frequent deaf and hard of hearing visitors, and provide public access to a telephone Videophone Resources Resources: Sign Language Interpreters [Onsite] Interpreter Referral Services ncdhh.referral@nebraska.gov or (402) (during regular business hours & non-holidays) Free-Lanced Interpreters (Click on the Members Directory and search for RID interpreters in Nebraska or zip code for a more surrounding area) Ask the deaf individual for names of possible qualified interpreters for you to contact directly to negotiate an interpreting service fee. Video Remote Interpreting Services 8

9 Resources: Captioning Service Providers NCRA CART Captioner Directory For additional contacts, feel free to perform additional searches using only State/Province NE to pull all of those who may be experienced in providing CART in Nebraska. **Could look for RPR or CRC RPR = Registered Professional Reporter (RPR) CRC = Certified Realtime Captioner (CRC) Resources: Devices to Aide in Communication NCDHH Equipment Loan Program ** Or contact us for a list of vendors who sell specialized products to aide in communicating with individuals who are Deaf, DeafBlind and Hard of Hearing. Resources: Publications Deaf Culture: Competencies and Best Practices, publication by Kathleen J. Richardson, DNP, ARNP, NP-C, CEN Advocacy Handbook for Nebraskans who are Deaf, DeafBlind and Hard of Hearing, publication by Nebraska Commission for the Deaf and Hard of Hearing Note: Passage of Nebraska Revised Statute, as of January 1, 2016 all sign language interpreters and Video Remote Interpreting Providers who practice for compensation must have a Nebraska Interpreter Licensure to interpret. Position Statements Related to Health Care and Mental Health 9

10 Resources: Media Health Care / Mental Health Care Webinar from this above publication also available Contact Information Kim Davis Advocacy Specialist Nebraska Commission for the Deaf and Hard of Hearing 4600 Valley Road, Suite 420 Lincoln NE (800) NCDHH@nebraska.gov 10