It’s a Sign III—Deaf Access to Health Care

This post is a guest post by Billie Noakes, a freelance writer, storyteller, and children’s author living in Pinellas FL. She also makes lace, is learning to garden, and a blogger in this year’s Word Count Blogathon, aka #blog2011. She blogs regularly at

When my friend “Lily,” who is 78 and deaf, visits her doctor, I go along to interpret. I’m not certified, but even my signing skill is better than having Lily rely on lip-reading.

Someone who relies on lip-reading catches only 30 percent of what’s said, and that’s on a good day.

Comprehension diminishes if the speaker turns away from the deaf person while speaking; uses exaggeratedly slow speech which distorts the appearance of words on the lips; has a beard or moustache which hides lip movement; or himself has a facial, nerve, or speech problem that distorts the lips.

Most deaf people cope by writing notes back and forth to shopkeepers or repairmen, and the development of the Video Relay Service now allows many deaf people to conduct a lot of business by phone.

But what happen in the doctor’s office or hospital, when a misunderstanding can have serious health implications?

Accommodations for Deaf Patients

The Americans With Disabilities Act (ADA) says health care professionals must make reasonable accommodations to ensure that a deaf patient understands what is going on.

The ADA leaves it up to the health care professional to decide whether a deaf person needs a certified interpreter. The deaf person can request one, but it’s the health care provider who decides. The cost of an interpreter can’t be charged to the patient, and not many health care providers are eager to take on this added expense.

Even when a doctor or hospital is willing, it’s not easy to find an interpreter on short notice. I learned this the hard way, when Lily had a medical emergency.

I started by calling our local deaf service center, but they don’t interpret: they provided me with a list of interpreting agencies.

Those agencies all required us to complete paperwork that had to be mailed or FAXed and then returned. They needed about a week’s notice to schedule the interpreter.

I bypassed that hurdle by calling a few friends who knew some interpreters from years back, and one of the guys was available to meet us at the hospital. He had another appointment in the middle of the day, so when we arrived at the hospital we were very clear about the need for someone to step in.

It didn’t matter. Despite Lily’s inability to explain her problems, the inability of nurses and doctors to understand her, and our repeated and emphatic requests, Lily never saw another interpreter for the entire five days she was hospitalized. Not even on a day when she was scheduled for a procedure that scared and confused her.

Nurses and aides couldn’t tell Lily how to reposition herself when they changed her bedding, and Lily couldn’t tell them they were hurting her.

No one noticed the painful lesions on her body, and she went home with an undiagnosed case of the shingles, which all of the expensive tests had not revealed.

Lily is better now, but she tells me that the barricades to competent, compassionate health care that she encountered are repeated every day, all across the country, and deaf people are dying for lack of simple communication.

It doesn’t have to be this way.

Strategies for Improving Access to Deaf Interpreters

Medical buildings across the country house the offices of primary care physicians and a wide range of specialists.

Maybe an enterprising interpreter could partner with the doctors in these medical buildings and establish “deaf friendly days,” days when doctors and interpreters can advertise the availability of a certified interpreter for medical appointments.

Commit to try this for about six months, with lots of information provided on deaf message boards, at deaf clubs, at deaf service centers. It’ll take a little while for the buzz to build.
Hospital emergency rooms can contact colleges with Sign Language Interpreter Programs and keep the names of instructors and recent graduates handy for emergency situations.

Classes in American Sign Language, with an emphasis on medical signs, could be added to the list of required courses for nurses and aides.

ASL students need “contact hours” with deaf people to help them hone their signing skills. They can work with hospital volunteer coordinators and offer their services on patient care floors, visiting deaf patients and letting nurses and aides know what the patients need.
There are many tools available for reducing the frustration that deaf patients encounter when they seek medical help. It would be great if more people made an effort to find and use them.

This entry was posted in Access to care, Americans with Disabilities Act, medical errors and tagged , , . Bookmark the permalink.

2 Responses to It’s a Sign III—Deaf Access to Health Care

  1. Lisa Carter says:

    Thanks for this post, Billie. Raising awareness is so important. I was very saddened by the horrible situation your friend Lily had to face — and so many others like her, every day, whether because they need an ASL or other language interpreter. Hopefully the system will change through advocacy, as well as better recognition of the skills and worth of interpreters.

  2. Well said! I relate to this in so many ways….
    I teach workshops on doctor/patient communication and my daughter is a deaf/hard of hearing teacher for K-12.

    Thanks for giving clear ideas on what might help. You’ve given me something to think about!

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