Serving Patients Who Are Deaf & Blind: A Practical Guide for Healthcare Professionals
By Kathryn Jackson, Vice President of Language Operations
For healthcare providers to effectively treat Deaf-Blind patients, they need the assistance of qualified medical interpreters. To know what type of language services are needed, it is important to understand how Deaf-Blind individuals communicate.
The largest group of people who are Deaf-Blind in the United States are age 55 and older. According to the American Foundation for the Blind, the most common causes of vision loss in older adults include cataracts, glaucoma, age-related macular degeneration and diabetic retinopathy.
Individuals with Usher syndrome are born Deaf and then gradually lose their sight due to an associated condition known as Retinitis Pigmentosa. Early symptoms include limited peripheral vision, reduced night vision and difficulty adjusting from light to dark. Many Deaf individuals with Usher syndrome use adapted forms of sign language that include forms of touch to communicate such as tactile sign language, tracking, and tactile fingerspelling.
It is important to remember adults who lose hearing and sight later in life may not have any experience using sign language or tactile sign language to communicate. To best serve these individuals, healthcare providers may need the assistance of a Certified Deaf Interpreter. CDIs utilize visual representations of language as well as other nonverbal forms of communication to facilitate meaningful understanding with Deaf individuals who do not use sign language to communicate. A CDI may, for example, make use of a model of the human heart to assist with patient comprehension. Learn more about CDIs and how they facilitate communication with Deaf individuals here.
To ensure Deaf-Blind patients have meaningful access to their healthcare information, as required by Section 1557 among other federal regulations surrounding language access in healthcare, healthcare providers must first identify the patient’s preferred method of communication. The American Association of the Deaf-Blind explains that Deaf-Blind people communicate in a variety of ways including:
- Sign language. Deaf individuals in the early stages of vision loss often use an adapted form of sign language that fits their reduced visual field.
- Tactile sign language. This is a visually based language that is practiced through touch in the air.
- Tracking. Deaf-Blind individuals with some vision who rely on understanding signed information touch the interpreter’s wrist or forearm when signing.
- Tactile fingerspelling. Each word of a message is spelled out in sign language, one letter at a time with the fingerspelling technique. The Deaf-Blind individual touches the hands of the person who is fingerspelling or signing to feel the letters.
- Print on palm. The letters are written on the hand of the Deaf-Blind person so he or she can “read” the message through touch. This is used by individuals who are familiar with written English but not necessarily ASL and/or wish to communicate with someone who does not use sign language.
- Tadoma. The Blind-Deaf individual places his or her hand on the face of the speaker, detecting meaning from movements associated with speech production.
- Braille. Braille is a system of raised dots that can be read with the fingers by people who are Blind or with low vision. Those with vision can read braille with sight.
- Speech. Hard of hearing individuals may utilize elements of speech as part of their communication method.
- Speech reading. Also referred to as lipreading, Deaf or hard of hearing individuals can derive meaning by carefully observing movements of the face, mouth, and tongue.
Healthcare providers can ensure effective communication with Deaf-Blind patients will take place by identifying the need for communication assistance prior to the healthcare encounter. With a team of qualified medical Sign Language and Certified Deaf Interpreters available onsite at the time of the encounter, healthcare providers can ensure Deaf-Blind patients have meaningful understanding of their healthcare information and follow up plans. ASL and CDI interpreters can also be accessed via video remote interpretation (VRI). When using VRI with Deaf patients who have low vision, it is essential to ensure the patient has a clear view of the VRI screen within his or her field of vision. VRI can also be used in conjunction with onsite interpreters to ensure effective communication takes place.
Additional Tips for Providers when Treating Deaf-Blind Patients
Due to the complexity of communication with Deaf-Blind patients, appointment scheduling should be extended to allow enough time for interpretation.
Deaf-Blind patients may use Support Service Providers (SSPs) to assist with mobility to the appointment and within the medical office. SSPs are not typically trained as medical interpreters or contracted for interpretation services and should therefore not be relied on to assist with communication in the healthcare environment.
Learn more about Deaf culture, the importance of using a qualified interpreter when communicating with Deaf patients, and how to best treat Deaf patients in this educational webinar.