Sight translation by Mary Luczki.
Medical providers care for patients from all walks of life over the course of their careers. Though a provider may understand deafness at a clinical level, they may not be familiar with Deaf culture. However, if a few cultural characteristics are taken into consideration when working with a Deaf patient, it can make the encounter a far more meaningful experience for everyone involved.
The first thing you might have noticed throughout the our “Sign of the Times” blog posts is the use of a capital ‘D’ when talking about Deaf patients. A lowercase ‘d’ represents the pathological view of hearing loss, however, a capital ‘D’ represents the cultural identity of a Deaf patient. To be Deaf is to have an entire culture, language and community that reaches far beyond a medical diagnosis; to be Deaf is to have an unique identity. While not all deaf people identify with the Deaf community, the vast majority of Deaf patients a medical provider will encounter, are proud of their language and being Deaf.
American Sign Language (ASL) is the official language of the Deaf community. It is rich with idiosyncrasies, dialects, regional signs and characteristics that make ASL a complex and legitimate language. It’s important to note that ASL is not universal (for every country with its own spoken language, a signed language exists) and ASL is not a word for word system of English. There are some Deaf people that can speak for themselves or vocalize what they are signing, however, that is unique to each Deaf person. Further, a Deaf person who speaks for themselves, may still need an interpreter because their speech ability does not represent their hearing ability.
Since ASL is a distinctly different language than English, asking Deaf patients to write back and forth in English rather than use an interpreter is asking them to communicate in a second language; a second language that is not their native language. Finally, lip reading is not an effective or accurate way for a Deaf person to communicate and can lead to significantly more misunderstandings.
ASL is a very expressive language. Grammar, emotions and tone are found in the facial expression, body language and manner in which signs are produced. Eye contact is also crucial for Deaf people as it demonstrates engagement and active listening, especially when communicating through an interpreter.
Communicating through an Interpreter:
As discussed in previous blogs, a certified, medically experienced interpreter is necessary when treating Deaf patients. Below are some important tips for working with an interpreter:
- Look and speak directly to the Deaf patient
- Speak at a normal pace as speaking slowly, unless asked by the interpreter, is actually more difficult for the interpreter.
- Stand next to the interpreter (or cart) when possible
- Wait for the interpreter to voice what the Deaf patient is saying; refrain from assuming a head nod or other body language and facial expressions are the accurate answers to a specific question.
- Turn taking is critical for the interpreter; the interpreter is only able to interpret accurately for one person at a time.
- The interpreter will interpret everything being spoken in the room. If private information is being discussed about a patient, the interpreter will interpret it.
- Interpreters are advocates for communication access, they are the linguistic experts on the medical team and should be consulted when working with Deaf patients
Working with Deaf patients is not that much different than working with hearing patients. A few extra steps are necessary to arrange communication, but once that is done, and the suggestions made above are followed, patient care can proceed with ease.
Below is a humorous video clip that illustrates some of the missteps medical providers can avoid when they take a few moments to learn about Deaf culture and how to work with interpreters.