Deaf people's experiences in hospital
Clear communication between patients and medical staff is critical to have a positive interaction and successful health outcomes. Many people who are Deaf or hard of hearing have experienced difficulty in a hospital or medical setting predominately around communication.
Due to gaps in understanding and/or awareness on both sides, Deaf patients may not be fully informed as to their treatment or their options.
A 2020 community survey conducted as part of the Deaf Regional Health project asked the Deaf community about their experience of the health service. It found:
- 45% indicated they do not receive sufficient information to self-manage their health.
- 95% identified an interest in learning more about health care.
- 43% were confident to request access support.
- 20% received access support in a timely manner.
- 25% indicated that services met their cultural needs.
- 75% would have liked advocacy support.
- 41% felt confident providing feedback.
A previous research piece by the advocacy body Deaf Victoria (An inquiry into access to Auslan interpreters in Victorian Hospitals) cited the following typical examples:
- At a post-operation check-up at a Victorian hospital, a Deaf patient learned that they had emergency surgery a week prior, but had no idea what had happened, as no interpreter had been provided at any time in the past week.
- A patient presenting to emergency with a migraine requested an interpreter, but the request was denied. Despite a subsequent stay of six days and repeatedly asking for an interpreter, one wasn’t provided resulting in much confusion and a lack of informed decision making.
- A woman having her first child, unable to access an interpreter, had her mother sleepover to communicate to her so she would not miss what was happening. Relying on family members can be distressing for patients, who may not want to share their information and removes independence for the patient.
It’s important to understand that Deaf patients can miss out on a lot of contextual or implied information. Surrounded by people using a different language, they can miss the incidental conversations and lessons others are privy to. That can mean that even when directly talking to a nurse or doctor, things might get missed due to a level of assumed knowledge and contextual familiarity the patient may not have.
For these reasons, it is vital to provide accessible information to the patient, to ensure proper informed consent.
As a health practitioner, you can make a real difference by acting in a culturally safe and inclusive way. That means putting yourself in their shoes and making sure you’re considering their unique situation.
Establish a Deaf person’s preferred and most appropriate mode of communication as quickly as possible. This could be:
- Writing messages with their phone or with a pen and paper
- Using an Auslan interpreter and/or a Deaf interpreter
- Utilising visual aids
- Reading lips and speaking
Whatever it is, be guided by your patient as to the best way to communicate.
Consider the unique impact a diagnosis may have on a Deaf patient and act accordingly and sensitively.
- A bandaged hand or arm in a sling will severely hamper an Auslan user’s ability to communicate.
- Similarly, an IV drip in the arm or other intervention - even heavy blankets on a bed long term - can make it difficult to sign and be understood while in hospital.
- A condition expected to affect someone’s eyesight will impact their ability to communicate and navigate their day to day life.
- Explaining procedures before they occur, not during, is really important to reduce anxiety.
- Anxiety about what is happening can present as anger, and frustration and fear can drive behaviour that appears aggressive, like shouting or vocalisation.
Also, consider that hearing loss impacts one in six people in our community. Especially older people. Simple strategies like getting someone's attention before speaking to them can make all the difference. People with a hearing loss may also have a disability, or other factors impacting their communication. Taking the time upfront to ascertain individual needs can make all the difference.
- Deaf people communicate visually. Auslan relies on the use of the eyes, hands, arms and good movement. Consider how an injury or medical interventions may impede communication.
- People who are Deaf and hard of hearing are at their most vulnerable in a hospital setting. Be aware there may be acute anxiety around access to information and communication, in addition to anxiety around their health issues.
- People who are Deaf and hard of hearing have different communication strategies, it is always preferable to ask the person how they want to communicate, via notes, an interpreter or orally through speaking and lip-reading.