Effectively Communicating with Deaf and HoH Patients
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How Not to Communicate with the Deaf & Hard of Hearing Patient Population

By Kathryn Jackson, VP of Language Operations at Stratus Video

Despite popular belief, lipreading is not often an effective form of communication with Deaf and Hard of Hearing (HoH) individuals. Here’s why:

  • 40-60% of English words look similar on the lips when spoken
  • Studies have shown that only about 30 percent of the English language can be understood through lip reading alone


The use of written materials to communicate with Deaf and HoH individuals is not always the most effective method either. Reading levels vary across the U.S. population, including the Deaf and HoH population. The delivery of the message depends on the literacy of the individual. Patients with low health literacy have been shown to experience poorer patient outcome. This is particularly important to keep in mind when treating patients who have limited English proficiency or who have learned English as a second language, as they are more likely to need the assistance of language services to ensure that effective communication is taking place.

For many Deaf and HoH individuals, American Sign Language (ASL) and/or home signs are the individual’s first language. American Sign language grammar and syntax vary significantly from English and could therefore impact the individual’s ability to effectively understand written content. As suggested by the name, “home signs” are a set or system of signs developed by a highly localized group, often within the family home, not necessarily based on the English language.

In addition, writing to communicate is a slow process. People tend to write less than they would say, particularly when using pen and paper. In a healthcare context, this would mean that the patient would not receive a full explanation about his or her healthcare information. This alone yields the mode of communication ineffective, as the message would no longer be complete.

Key written documents in healthcare include informed consent forms, explanation of the patients’ right to support services, hospital discharge instructions, intake forms with clinical consequences and any other written document requiring a response.

When treating Deaf and HoH patients, the provider can ensure that meaningful understanding is taking place with the assistance of a sign language and, if needed, Certified Deaf interpreter. Patients tend to process information differently when in highly charged emotional situations, such as being diagnosed with cancer or having an end of life discussion. Qualified medical interpreters are trained to best navigate these difficult conversations across various healthcare settings.

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