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Deaf Health Care

By Andrea Hadley-Macias,
Monday, April 6, 2009

Deaf People and Health Care System

Patients are dependent on nurses for the delivery of safe and effective health care and communication is key for success. How does a nurse accomplish this important task with a person who is Deaf or Hard of Hearing?

In communication people who are deaf use American Sign Language (ASL) which is a language of its own, few people realize ASL is different from English. There are other methods of communication such as writing, lip reading, and auxiliary aids but most people who are deaf or Hard of Hearing (HOH) chose to use ASL as their method of communication. Besides the rules and guidelines the federal government sets for the health care system in regards to people who are Deaf/HOH there is an underlying moral sense and cultural identity that needs to be addressed. Deaf culture is "a social, communal, and creative force of, by and for deaf people based on American Sign Language.

Deaf culture, however, is not restricted to deaf people; families, friends and advocates of the deaf community may also be a part of deaf culture…It involves deaf people partaking in "visual literature" (for example, ASL poetry, plays, story telling, or humor) as well as, sports and many other physical and visual activities. As a result, the psychosocial basis of deaf culture is understood to mean that deaf people…regardless of mode of communication taught in the school will seek out other deaf people and use sign language as a primary mode of communication." [1]

In this awareness of Deaf culture, nurses and other health care providers need to develop a sensitivity to the patient's preference of communication in order to be effective and administer proper care. According to federal law, nurses and their employers have important responsibilities to be accessible to deaf and hard of hearing patients.

"Failing to provide interpreters and adapted equipment may be discrimination on the basis of disability. In addition, failure to establish effective communication with a deaf patient may expose a health care provider to liability for medical malpractice…This right is established under two federal laws." [2]

The Rehabilitation Act of 1973 and the American Disability Act set the rules and guidelines Hospitals or medical care facilities and its employees must follow to adhere to the patient's rights. Under section 504 of the Rehabilitation Act of 1973 which "requires federal financial recipients' programs to be equally accessible to handicapped persons…provision of qualified sign language interpreters is critical to ensure that deaf persons are able to benefit from and participate equally in the program. The office for Civil Rights of HHS has consistently required hospitals to provide qualified interpreters and TDDs to deaf clients…" [3]

How can nurses provide proper care and improve relationships with patients who are Deaf or HOH?

By following ADA guidelines and the Rehabilitation Act of 1973 regulations and taking the initiative to become certified ASL interpreters or be able to work with interpreters and to be aware and respectful of Deaf culture and the fact that many  "…deaf people do not view their deafness as a disability..."[4] but as an identity.

[1] http://www.enotes.com/nursing-encyclopedia/american-sign-language accessed 4/4/2009
[2] http://www.nad.org/hospitalsnursinghomes accessed 4/4/2009
[3] http://www.nad.org/hospitalsnursinghomes accessed 4/4/2009
[4] McAleer Moncia, Communicating Effectively with Deaf Patients. Nursing Standard. 52. (2006) accessed 4/42009


 


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