Notes
Outline
Hearing Loss and

the Medical Setting
Beth Wilson
President, RI Self Help for the Hard of Hearing
Pam Zellner
Coordinator, RI Commission on the Deaf
and Hard of Hearing
Topics
Myths and Facts and Real Life Stories
Hard of Hearing Perspective
Deaf Perspective
Cultural Diversity Issues
Technology Options
Business Etiquette
Interpreter
Relay
Communication Strategies
Myths and Facts...
Hard of Hearing Perspective
Beth Wilson
Myth:
Slide 5
Slide 6
Slide 7
Did You Know?
How Does Lipreading Work?
How Can I Help?
Lights Up for Discussion
have discussions in a well-lit room
don’t sit in front of a window
Minimize Background Noise
turn off background music or other noise
move away from machines
Speak Normally
Face the Person with a Hearing Loss
Don’t Obscure the Mouth
cover with hands or gestures
remove chewing gum and mask to talk
Some Need Glasses and Hearing Aid to “Hear”
Myth:
Family Member Facts
Family member may be worst interpreter
cannot be neutral in this setting
may withhold information
may start reporting symptoms
Patient with hearing loss should not be a spectator
… Real Life Stories
Deaf Perspective
Pam Zellner
Write it Down, Please
Writing is inconvenient, but critical
“write it down,” not “say it again out loud”
frustrating because
communication still not there
reasonable request simply ignored
Listen to your patient -- they have some experience here …
Hearing losses are different -- what worked for your last Deaf patient may not work for me
I’m Still Here
Talk to the Deaf patient
what is going to happen next
what does all this mean
Ask the Deaf patient about their symptoms
avoid “does she …” and ask “do you…”
don’t let this become a vet exam
talk to the patient, not about the patient
Cultural Diversity
What is the Difference Between Deaf and Hard of Hearing People?
Medical Perspective
Cultural Labels
Deaf
part of Deaf culture/community
deafness is an identity
deaf
cannot hear well even with hearing aid
culturally hearing (translation: isolated)
Hard of hearing
may hear some with hearing aid
too deaf to be hearing and to hearing to be Deaf
My spouse thinks I can’t hear
Technology Options
Myth:
Hearing Aid Facts
Hearing aids do not “fix” hearing loss
not like glasses
external amplifier has to go through “bad” ear
Problems with hearing aids
amplify background noise
can have interference from equipment
Kinds of hearing aids
conventional
programmable
in-the-ear
behind-the-ear
body aid
Beyond Hearing Aids
Variety of Technology
loops
assistive listening devices
CART
Useful Additions to a Hospital Room
light for phone
phone amplifier
TTY
captioning for TV
Business Etiquette
Interpreter Setting
Be conscious about setting communication mode
where is interpreter located?
Can everyone understand each other?
Maintain eye contact with patient
talk to patient, not interpreter
pretend interpreter is not there
Translation takes some time
be patient waiting for response
only one person can talk at a time
Relay
Identify yourself (machines don’t recognize voices)
Pretend there is no Relay operator
avoid “tell him”, “ask her” phrases
speak normal like talking to a hearing person
Remember that someone is typing what you say
speak at normal pace (not an auction)
can be like dictation
GA means go-ahead, it’s your turn
SK means stop keying, I’m hanging up soon
Communication Strategies
Myth:
Fact:  It Doesn’t Have to Be So Hard
Ask the patient with a hearing loss for ideas
they can best describe their loss
they have some experience accommodating it
Get the critical information conveyed with
pen and paper
how long will the wait be
what are they waiting for
Be creative
Food for Thought
In the Waiting Room
“Have a seat, the doctor will be right with you”
“First we need you to go to room 456 for the abc work”
I Never Thought of That...
Patients With Hearing Loss Cannot Hear:
 their name called
 a knock on the door
 instructions in the dark
 a conversation through glass
 observations made through a mask
 a response over the intercom
Ideas in a Hospital
Parade of staff will try to talk to patient:
put a note on chart
put up a sign in the room
Put tape over an intercom to prevent temptation to verbally communicate with that patient
Make sure they understand everything
ask them to repeat for confirmation
provide as much as possible in writing
Summary
Communication is not about
what is said
how it is said
Communication is about
What is Understood
Party Favors
Brochures
CDHH
SHHH
RI Relay
“Ear Slash” stickers
Fact Sheets
How to Secure an Interpreter
Suggestions for Communicating
Manual Alphabet cards
Questions
And Answers!