Have you ever entered the home of a patient only to find out they and/or a family member are deaf or hard of hearing and use sign language as their primary mode of communication? How will you be able to convey the necessary information and provide needed healthcare services if you are unable to communicate with your patient and/or their family?

Unfortunately, this is a common situation that both healthcare professionals and deaf or hard of hearing patients and/or family members often face with home healthcare services. The lack of understanding regarding deafness and methods of effective communication results in both parties becoming frustrated with the inability to communicate effectively and achieve desired healthcare outcomes. Studies have found miscommunication occurs often between deaf patients and healthcare providers, which can lead to misunderstanding about the diagnosis and therapeutic measures that must be taken. Many healthcare providers are unaware of the cultural differences and language needs of this population and how this can influence their receiving appropriate healthcare services.

For example, practitioners often believe that lipreading/speechreading and note writing provide effective health communication. Deaf people who have practiced lipreading/speechreading for many years and who are familiar with spoken language are able to understand at best only 30% to 45% of spoken English! Writing back and forth requires knowledge of medical terminology and the ability to accurately describe symptoms. This is a significant challenge for many deaf individuals when they are healthy, let alone when they are sick or under the influence of pain medication. Furthermore, written communication requires more time and this can be very frustrating for healthcare professionals who are already stressed because of a heavy patient workload.

Research has shown that a lack of adequate interpreter services compromises the quality of care for patients who are deaf or hard of hearing. Using family members or friends can compromise many aspects of patient care. These well-meaning people are more likely than professional (certified) interpreters to make errors of potential clinical consequences, such as omitting or misunderstanding questions about drug allergies or instructions on prescription dose, frequency, and duration. Patient privacy can also be compromised when family and friends are used as interpreters.

Do you know that medical professionals are obligated to pay for sign language interpreting services? Title VI of the Civil Rights Act obligates medical caregivers to provide interpretation and translation services so deaf patients can have access to healthcare services equal to that of hearing patients. The American Disability Act has provisions that spell out obligations of providing clear, effective communication for deaf or hard of hearing individuals seeking medical services. Deaf patients with certified interpreters will ask more questions, have better overall information recall, and are more comfortable discussing sensitive or embarrassing issues. They will also have better physical functioning, psychological well-being, and higher patient satisfaction.

First ask the patient if they have a preferred interpreter. If not, contact a local reputable interpreter agency. They will require interpreters contracting with them to have appropriate interpreter certification, background checks, and signed confidentiality agreements as well as an agreement to maintain appropriate professional behavior while interpreting for the agency. Local agencies often know the communication preferences of many deaf individuals in the area and are better able to provide the most appropriate interpreter to achieve effective communication between patient and the healthcare professional.

Certified medical interpretation services result in improved quality of care, better outcomes, lower costs, and greater patient satisfaction. Advocate for your deaf or hard of hearing patients-insist that a certified interpreter is present for all home healthcare visits.