Hearing Loss and the Medical Setting

1. Hearing Loss andthe 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 This presentation may be freely used by any SHHH Chapters. It’s available for download from www.nchearingloss.org/programs.htm Presentation Submitted by Beth Wilson, RI SHHH

2. 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 Presentation Submitted by Beth Wilson, RI SHHH

3. Myths and Facts... Hard of Hearing Perspective Beth Wilson Presentation Submitted by Beth Wilson, RI SHHH

4. Myth: “They can lipread me.” Presentation Submitted by Beth Wilson, RI SHHH

5. Fact: Lip Reading is an Art You’re hard of hearing! So you can lipread, right? Only when I want to get myself in trouble... Hollywood Teaches Us: When someone loses their hearing they are able to lipread as compensation Reality Is: Lipreading is a difficult skill that few are able to master Presentation Submitted by Beth Wilson, RI SHHH

6. An Example Can you bowl next week against the Tow Trucks? ? Which Team is it Really? • Navy Department 20 • Navy Department 40 • Navy Department 60 • Raytheon A • Raytheon B • Coast Guard • Army • Marines Sure -- I’ll be there! Presentation Submitted by Beth Wilson, RI SHHH

7. ! I hear the COAST GUARD has a good team! Presentation Submitted by Beth Wilson, RI SHHH

8. Did You Know? Lipreading is only successful when • the speaker never moves • all the words are known • the words are predictable Only 1/3 of speech is visible on the lips An “expert” lipreader is guessing at 66% of what is said! Presentation Submitted by Beth Wilson, RI SHHH

9. How Does Lipreading Work? “f” “s” How air is stopped (teeth, lips, none) Inside the mouth Throat Vocal Chords “s” versus “f” • same except for the highest frequency • sound the same with a high frequency loss • they look different on the lips Presentation Submitted by Beth Wilson, RI SHHH

10. 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” Presentation Submitted by Beth Wilson, RI SHHH

11. Myth: “We don’t need an interpreter, the patient’s insert family member here can do the signing.” Presentation Submitted by Beth Wilson, RI SHHH

12. 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 Example “Can you tell me what this word means?” (word is chemotherapy) “I think I’m dying but they won’t tell me.” Presentation Submitted by Beth Wilson, RI SHHH

13. … Real Life Stories Deaf Perspective Pam Zellner Presentation Submitted by Beth Wilson, RI SHHH

14. 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 Presentation Submitted by Beth Wilson, RI SHHH

15. 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 If I bring someone with me, that doesn’t mean you tell them the details. I want to hear it from my doctor, not my friend or family member. Presentation Submitted by Beth Wilson, RI SHHH

16. Cultural Diversity What is the Difference Between Deaf and Hard of Hearing People? Presentation Submitted by Beth Wilson, RI SHHH

17. Medical Perspective whispering Hearing conversation Hard of Hearing loudness consonants vowels whistle teenager's music Deaf frequency Presentation Submitted by Beth Wilson, RI SHHH

18. 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 Presentation Submitted by Beth Wilson, RI SHHH

19. Technology Options Presentation Submitted by Beth Wilson, RI SHHH

20. Myth: “As long as the patient wears their hearing aid, everything should be fine.” Presentation Submitted by Beth Wilson, RI SHHH

21. 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 Presentation Submitted by Beth Wilson, RI SHHH

22. 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 Presentation Submitted by Beth Wilson, RI SHHH

23. Business Etiquette Presentation Submitted by Beth Wilson, RI SHHH

24. 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 Presentation Submitted by Beth Wilson, RI SHHH

25. 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 Presentation Submitted by Beth Wilson, RI SHHH

26. Communication Strategies Presentation Submitted by Beth Wilson, RI SHHH

27. Myth: “We can’t talk to this patient.” Presentation Submitted by Beth Wilson, RI SHHH

28. 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 Examples • move to quiet room • share computer screen • gestures • sketch a map Presentation Submitted by Beth Wilson, RI SHHH

29. Food for Thought Presentation Submitted by Beth Wilson, RI SHHH

30. “Have a seat, the doctor will be right with you” “First we need you to go to room 456 for the abc work” In the Waiting Room What It Means to the Deaf or HOH Patient What You Say “We’ll call your name and you’ll have no idea it’s your turn.” “Guess where we are sending you and what for” Presentation Submitted by Beth Wilson, RI SHHH

31. 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 Presentation Submitted by Beth Wilson, RI SHHH

32. 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 Ideas in a Hospital Beware of the “Deaf Nod” Presentation Submitted by Beth Wilson, RI SHHH

33. Summary • Communication is not about • what is said • how it is said • Communication is about What is Understood Presentation Submitted by Beth Wilson, RI SHHH

34. Party Favors • Brochures • CDHH • SHHH • RI Relay • “Ear Slash” stickers • Fact Sheets • How to Secure an Interpreter • Suggestions for Communicating • Manual Alphabet cards Presentation Submitted by Beth Wilson, RI SHHH

35. Questions And Answers! Presentation Submitted by Beth Wilson, RI SHHH