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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 1 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 2 Presentation Submitted by Beth Wilson, RI SHHH Myths and Facts... Hard of Hearing Perspective Beth Wilson Presentation Submitted by Beth Wilson, RI SHHH 3 Myth: “They can lipread me.” Presentation Submitted by Beth Wilson, RI SHHH 4 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 5 Presentation Submitted by Beth Wilson, RI SHHH An Example Can you bowl next week against the Tow Trucks? ? Which Team is it Really? Sure -I’ll be there! Presentation Submitted by Beth Wilson, RI SHHH Navy Department 20 Navy Department 40 Navy Department 60 Raytheon A Raytheon B Coast Guard Army Marines 6 ! I hear the COAST GUARD has a good team! 7 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! 8 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 “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 9 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 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 10 Myth: “We don’t need an interpreter, the patient’s can do the signing.” insert family member here Presentation Submitted by Beth Wilson, RI SHHH 11 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.” 12 Presentation Submitted by Beth Wilson, RI SHHH … Real Life Stories Deaf Perspective Pam Zellner Presentation Submitted by Beth Wilson, RI SHHH 13 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 14 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 15 Cultural Diversity What is the Difference Between Deaf and Hard of Hearing People? Presentation Submitted by Beth Wilson, RI SHHH 16 Medical Perspective loudness frequency Presentation Submitted by Beth Wilson, RI SHHH 17 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 18 Technology Options Presentation Submitted by Beth Wilson, RI SHHH 19 Myth: “As long as the patient wears their hearing aid, everything should be fine.” Presentation Submitted by Beth Wilson, RI SHHH 20 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 21 Beyond Hearing Aids Variety of Technology loops assistive listening devices CART Useful Additions to a Hospital Room light for phone phone amplifier TTY captioning for TV 22 Presentation Submitted by Beth Wilson, RI SHHH Business Etiquette Presentation Submitted by Beth Wilson, RI SHHH 23 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 24 Presentation Submitted by Beth Wilson, RI SHHH Relay 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 GA means go-ahead, it’s your turn SK means stop keying, I’m hanging up soon 25 Presentation Submitted by Beth Wilson, RI SHHH Communication Strategies Presentation Submitted by Beth Wilson, RI SHHH 26 Myth: “We can’t talk to this patient.” Presentation Submitted by Beth Wilson, RI SHHH 27 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 Get the critical information conveyed with pen and paper how long will the wait be what are they waiting for Be creative Presentation Submitted by Beth Wilson, RI SHHH Examples move to quiet room share computer screen gestures sketch a map 28 Food for Thought Presentation Submitted by Beth Wilson, RI SHHH 29 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” 30 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 Presentation Submitted by Beth Wilson, RI SHHH 31 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 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” 32 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 33 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 34 Presentation Submitted by Beth Wilson, RI SHHH Questions And Answers! Presentation Submitted by Beth Wilson, RI SHHH 35