Sticky Situations in Hospitals

3 Challenges Deaf Patients Face in Hospital Settings

Have you ever seen Squid Game? Do you remember the dalgona cookie challenge? How each player had to patiently and methodically lick or prick their way against the countdown before they were eliminated for good? Can you imagine being trapped in a life-threatening situation forced to play a game that may determine whether they survive? 

Deaf, DeafBlind and Hard of Hearing patients often end up in situations like these, where they are trapped by necessity and circumstance. They show up to the emergency room or to their doctor’s office and are not provided the communication access they need so they can discuss their needs or decisions, often leading to miscommunication, misdiagnosis and mistreatment. 

In Canada and the U. S., Deaf patients face issues whenever they try to access medical care. The top 3 challenges they encounter are 1) problems accessing Video Remote Interpreting (VRI), 2) lack of staff knowledge about Deaf community, 3) assumptions about the patient’s use of English. But how do these issues impact Deaf patients? Let’s break them down: 

1. Problems Using VRI
   
   While VRI helps hospitals provide sign language interpretation without having to wait for a live interpreter to show up, it is no replacement for one. Considering slow connections, small screens or low resolution, it is recommended that you use VRI for short periods of time, instead of trying to use VRI to replace live interpreters. On top of the quality of the technology, the full nuance of sign language is limited when viewed through a screen alone; there is a lot of subtlety and facially located grammar that impacts the accuracy of the interpretation and therefore the patient requires a live interpreter to communicate with full nuance. Finally, not only are staff ill-equipped to set up and use the equipment, Deaf patients often have to take on the responsibility of setting up VRI even though they are the ones requiring medical attention, costing Deaf patients and medical staff precious time best reserved for treating the patient.
   
2. Lack of Staff Knowledge About the Deaf Community

In addition to the potential lack of tech training, the lack of staff cultural competency or even general awareness that Deaf people exist impacts Deaf patients immensely. In situations when medical staff do not have much experience working with Deaf patients, Deaf patients throughout Canada and the U.S. have described how staff were unable or unwilling to meet their communication needs, including staff speaking when the Deaf patient cannot hear or speak back, as well as little to no visuals to support communication between hospital staff and Deaf patients. 

1. Assumptions Around English

Finally, in such a multicultural country as Canada, many professions are used to varying levels of English skills, from patients with thick accents, to uncommon English sentence structures, and patients who cannot speak or write English at all. In most scenarios that prioritize the patient, hospital staff work with patients by consulting them on how they best communicate, including hiring a spoken language interpreter when needed. Similarly, medical workers cannot assume that any Deaf or Hard of Hearing patient speaks or writes English. Just like everyone else in this diverse country, Deaf people communicate in many different ways: some can hear and speak, some can read lips, some can write in English, but many use sign language and require sign language interpreters. If patients have the right to make their own decisions regarding their health, why don’t Deaf patients get their choice for language access?

The lack of options provided have led to lawsuits defending the rights of Deaf people to choose how they communicate. The legal precedence these cases have provided current and future Deaf patients ways to advocate for equitable access to communication that is legally their right in these settings. Moreover, contemporary approaches to medicine are now shifting towards more culturally-competent and patient-centred strategies to meet the needs of their patients. 

Visiting a hospital shouldn’t be treated like a game. More than anything, hospitals and other health care settings should be ready to work with any patient that needs medical attention, including Deaf and Hard of Hearing patients who don’t want to play around with how they communicate. 

Resources: 

https://www.hopkinsmedicine.org/news/publications/hopkins_medicine_magazine/features/winter-2016/making-their-voices-heard

https://wfdeaf.org/news/world-federation-of-the-deaf-wfd-health-resources-initiative/ https://cad.ca/issues-positions/health-care/