Communication access the great equalizer
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Communication Access: The Great Equalizer. Marie Koehler, Regional Manager , DHHS ~ Metro. Focus of presentation…. Addressing and identifying ways to meet the communication needs of individuals who are deaf, deafblind and hard of hearing in nursing homes and long term care facilities.

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Communication Access: The Great Equalizer

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Communication Access: The Great Equalizer

Marie Koehler, Regional Manager, DHHS ~ Metro

Focus of presentation….

  • Addressing and identifying ways to meet the communication needs of individuals who are deaf, deafblind and hard of hearing in nursing homes and long term care facilities.


  • Мы заяц рад видеть вас здесь. Мы встретимся с вами в 2: 00 сегодня представить краткий ориентацию на повседневной жизни.

Start with humor

  • The story of Morris…..


  • Residents lack information related to their medical care and participation is limited

  • Involvement in activities is impeded

  • Interaction with staff & residents is obstructed

What’s the big deal?

  • More than 1 out of 10 Minnesotans has a hearing loss

  • 1 out of 3 people over the age of 65 has a hearing loss

  • 1 out of 2 people over the age of 75 has a hearing loss

Background of identified needs

  • DHHS statewide staff

  • Consumers who are deaf and hard

  • From family members

  • From social workers

Information from dhhs staff

  • DHHS staff had to intervene with a nursing home in Greater MN to ensure that the facility provided interpreter services. The DHHS office provided a loaner TTY.

Information from dhhs staff

  • Facilities in Northwestern MN were serving deaf and hard of hearing consumers without interpreters and ALDs until DHHS intervened.

Information from dhhs staff

  • In the St. Cloud area, staff have not visited a single nursing home where captions were displayed on televisions in the community rooms.

Information from dhhs staff

  • One particular nursing home in Central MN told a DHHS staff that it is the responsibility of the resident who is hard of hearing to provide the assistive listening device.

Information from dhhs staff

  • Assistance with hearing aid care and maintenance is extremely poor to non-existent (typically staff has received no formal, or informal training related to this topic).

Information from A Consumer

  • One deaf person was placed at a Metro LTC facility for 10 days and did not have an interpreter for any part of his stay.

Information from Family Members

  • One daughter shared that her deaf father was refused access to a Greater Twin City Care Center solely because he was deaf. The facility admitted that they did not want to pay for interpreting services

Information from Family Members

  • A daughter's mother was provided an interpreter for the intake process and for one health care conference. Her mother waived her rights to interpreters beyond this for fear of ramifications.

Information from SERVICE PROVIDERS

  • Hospital social workers have reported that when they call facilities for placement information for deaf patients, some of the facilities say that they will accept the patient, but will NOT provide interpreters.


  • ADA is an unfunded mandate!

  • Many nursing homes/TCF have financial struggles

  • For signing deaf residents, the accommodation is not necessarily a “one time fix”

Obstacles/CHALLENGES (Cont.)

  • Skill level & availability of interpreter

  • Regional sign variations

  • Medical words that do not have a specific sign, or the patient or interpreter may not be familiar with the sign

Obstacles/CHALLENGES (Cont.)

  • Providing ALDs for residents can be cost effective, but requires staffs attention

  • Late deafened individuals may rely on CART services.

Obstacles/CHALLENGES (Cont.)

  • Fear factor

  • Don’t want to be a “bother”

  • Deaf seniors (family members) often do not “advocate” for access

  • Family member can “interpret”

  • Residents wants to live near family

Obstacles/CHALLENGES (Cont.)

  • Challenges of writing notes

  • Multiple health issues

  • Combined vision and hearing loss

  • Cognitive issues

  • Immigrant/refugee

Obstacles/CHALLENGES (Cont.)

  • Staff/residents: Cultural differences

  • Staff/residents: Dialect challenges

  • Skill level of interpreter

  • One or a combination of any of the aforementioned challenges results in significant COMMUNICATION BARRIERS


  • There are effective measures that can be taken and some “one-time” costs that can help to open up communication access to a large percentage of residents with hearing loss.


  • Staff can learn and implement effective communication strategies

  • Captioning can be turned on community TVs & resident’s TVs

  • Staff should ask resident with hearing loss how to best communicate with them

“one-time” Costs

  • Purchase ALDs

  • Put a white board in residents’ room with bold black markers

  • Purchase portable laptop computer with a swivel stand to type messages to residents

One-Time Costs (Cont.)

  • Picture Boards/Communicators

  • Set up web cam or videophone for residents (Video Relay Services)

  • Have a few staff enroll in a sign language class

Interpreter services


  • You can either go through an interpreter referral agency or call the independent interpreters directly. Fees apply.

No Cost HELP

  • Amplified telephone, at no cost, through the TED Program (for resident):

  • ALDs may be covered under CADI or Elderly waiver programs

training goes a long way

  • FREE Training offered by DHHS (Find schedule at

  • FREE online training available through Hearing Loss Association of American at

FREE Resources to the Rescue!

  • Deaf Community Health Worker:

  • Deaf Hospice Program:


  • Grant dollars received to hire a ¾ Ombudsman

  • Development of a DVD on “Hearing Aid Care”

  • Speech Gear, Inc.

CONTACT Information


  • 651/431-5964



End with some levity

questions and answer

  • General questions and comments related to hearing loss/other


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