Having some time on my hands during my 2-week quarantine, I was able to reflect on my recent experience of being hospitalized in Paris. As you can imagine, the language barrier between myself and my medical team made my stay long and difficult. No one wanted to use the Google Translate app pulled up on my phone so we spent 10 minutes trying to charade our way into the word "contraindications". With the help of my medical background, I was fortunate enough to piece together enough information before leaving the hospital exhausted from the exchange.

My experience gave me a personal glimpse into my patient's struggles and how these may be especially magnified during the COVID-19 pandemic. Having now been on both sides of the communication barrier, I wanted to provide information to our medical community in hopes to reduce some of the struggles the Deaf and Hard of Hearing (DHH) may experience during medical care.

Effective communication is crucial for successful diagnosis and treatment of any patient. Have you ever had to repeat information to a patient several times? Did you notice that each time you shortened and simplified the message? Were you ultimately successful in the exchange or did things fall apart? Many of the DHH work against assumptions of their intellect when communication is misheard. They may bluff understanding or become frustrated with an unsuccessful exchange. The following tips can help enhance understanding:

-              Get the patient's attention and minimize background noise

-              Face the patient and take care not to talk toward a computer, chart, or the floor

-              Speak up slightly and at a moderate pace

-              Rephrase your question or answer when repeating

Everyone consciously and subconsciously uses visual cues to aid in understanding. These cues are even more imperative when communicating with DHH patients.  Many DHH patients rely on lip-reading to clarify spoken language, but visual cues also include facial expressions and gestures.

With the current universal need for face coverings, a key aid to communication has been eliminated.  However, there are some solutions. One solution is purchasing surgical masks with a fog-resistant clear window (an example of such can be found at safenclear.com). This allows for lip-reading and better transmission of messages even among other medical team members (something to consider for use during surgeries).  For those of you who are handy and are not required to wear medical grade masks, I've attached instructions on how to make your own face view mask.  

Another solution is to utilize an interpreter or electronic translation. There are video interpreting services available for those who rely on American Sign Language (ASL). Speech to text apps like Google Translate and a pen and paper or keyboard can decrease misunderstandings. Being ill or in isolation is already extremely stressful. Picture yourself in the room trying to communicate in an unknown language, but also being afraid for your health and wellbeing. Individuals may miss out on having a familiar talker nearby due to necessary restrictions, straining an already stressful situation.

You will also encounter individuals with a variety of hearing solutions including hearing aids, cochlear implants, and bone anchored hearing aids (BAHA). You may not even see that this person is wearing amplification at first glance.  It is imperative to ensure the function of these devices, especially if the patient is in isolation. Patients who rely on family members for maintenance tasks like changing batteries or cleaning the device could be without effective communication in a scary situation.

Please know that your JBSA Audiologists are here to assist in any way we can. We have at DHH Hospital Packets (see below) at the ready that will provide information to the patient on ways to effectively advocate medical professionals for their communication needs. The packet includes a communication plan, tip cards, international symbol placards, and reminders for keeping assistive listening devices safe during their stay.  It also contains information from the Hearing Loss Association of America and a great video source for the patient:

If you need our assistance with any DHH patients or would like packets for your patients, please call the WHASC Audiology clinic at 210-292-5420. These packets would be an excellent resource for patients during in-patient registration or at a pre-op appointments. 

Thank you,

Your WHASC Audiology professionals.