Transcript Tips for Travelers with Hearing Loss

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
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
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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
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Presentation Submitted by Beth Wilson, RI SHHH
Myths and Facts...
Hard of Hearing Perspective
Beth Wilson
Presentation Submitted by Beth Wilson, RI SHHH
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Myth:
“They can lipread me.”
Presentation Submitted by Beth Wilson, RI SHHH
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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
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Presentation Submitted by Beth Wilson, RI SHHH
An Example
Can you bowl next
week against the
Tow Trucks?
?
Which Team is it Really?

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Sure -I’ll be there!
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Presentation Submitted by Beth Wilson, RI SHHH
Navy Department 20
Navy Department 40
Navy Department 60
Raytheon A
Raytheon B
Coast Guard
Army
Marines
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!
I hear the
COAST GUARD
has a good team!
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Presentation Submitted by Beth Wilson, RI SHHH
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!
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Presentation Submitted by Beth Wilson, RI SHHH
How Does Lipreading Work?
“f” “s”
How air is stopped
(teeth, lips, none)
Inside the mouth
Throat
Vocal Chords

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“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
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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

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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
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Myth:
“We don’t need an
interpreter, the patient’s
can do the
signing.”
insert family member here
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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.”
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Presentation Submitted by Beth Wilson, RI SHHH
… Real Life Stories
Deaf Perspective
Pam Zellner
Presentation Submitted by Beth Wilson, RI SHHH
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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
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Presentation Submitted by Beth Wilson, RI SHHH
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
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Cultural Diversity
What is the Difference Between
Deaf and Hard of Hearing People?
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Medical Perspective
loudness
frequency
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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
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Technology
Options
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Myth:
“As long as the patient
wears their hearing aid,
everything should be
fine.”
Presentation Submitted by Beth Wilson, RI SHHH
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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
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Beyond Hearing Aids

Variety of Technology
loops
 assistive listening devices
 CART

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Useful Additions to a Hospital Room
light for phone
 phone amplifier
 TTY
 captioning for TV
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Presentation Submitted by Beth Wilson, RI SHHH
Business
Etiquette
Presentation Submitted by Beth Wilson, RI SHHH
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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
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Presentation Submitted by Beth Wilson, RI SHHH
Relay

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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

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GA means go-ahead, it’s your turn
SK means stop keying, I’m hanging up soon
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Presentation Submitted by Beth Wilson, RI SHHH
Communication
Strategies
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Myth:
“We can’t talk to this
patient.”
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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

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Get the critical information conveyed with
pen and paper
how long will the wait be
 what are they waiting for

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Be creative
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Presentation Submitted by Beth Wilson, RI SHHH
Examples
move to quiet room
share computer screen
gestures
sketch a map
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Food for Thought
Presentation Submitted by Beth Wilson, RI SHHH
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In the Waiting Room
What You Say
What It Means to the Deaf
or HOH Patient
“Have a seat, the doctor will “We’ll call your name and you’ll
be right with you”
have no idea it’s your turn.”
“First we need you to go to
room for the work”
456
abc
“Guess where we are sending
you and what for”
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Presentation Submitted by Beth Wilson, RI SHHH
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
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Presentation Submitted by Beth Wilson, RI SHHH
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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
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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

Beware of the “Deaf Nod”
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Presentation Submitted by Beth Wilson, RI SHHH
Summary

Communication is not about
 what
is said
 how it is said

Communication is about
What is Understood
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Presentation Submitted by Beth Wilson, RI SHHH
Party Favors

Brochures
 CDHH
 SHHH
 RI


Relay
“Ear Slash” stickers
Fact Sheets
 How
to Secure an Interpreter
 Suggestions for Communicating

Manual Alphabet cards
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Presentation Submitted by Beth Wilson, RI SHHH
Questions
And Answers!
Presentation Submitted by Beth Wilson, RI SHHH
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