Are Hospitals Letting Deaf People Down?
Deaf people have been going on record about difficult experiences they’ve had in hospitals due to lack of sign language interpreters. See Hear looks at three cases where this trauma could have been avoided had sign language interpreters, or other communication support, been provided.
Deaf couple Nadia and Hulusi Bati were in University College London Hospital for the birth of their child. It was all going fine until the sign language interpreter’s shift ended at 20:00 while Nadia was having contractions and 90 minutes before she went into the final stages of labour.
Despite efforts from the staff, no interpreter was present at the birth which turned out to be a difficult forceps delivery. Nadia only held her baby for a moment before it was whisked away for emergency treatment in another room – they were unable to tell her why.
The child was treated in hospital for several days afterwards though the parents didn’t know what was wrong because sign language support was not forthcoming here either.
Dr Pat O’Brian, Clinical Director, Women’s Health, says the hospital does not comment on individual patient matters but told See Hear they had provided interpreters on-site for 97% of cases. He says: “It’s probably fair to say that of those 3% that we found it difficult to provide a face-to-face interpreter, it is more common in emergency situations.”
If you have a potential life-threatening condition, the priority for medical staff is to assess you and treat you appropriately. Finding an interpreter isn’t always possible at short notice, as Matthew Gurney found when he was rushed to hospital with suspected appendicitis in the early hours of the morning.
On arrival he provided the number of an interpreter he knew. She wasn’t available; its unclear what further steps were taken by North Middlesex University Hospital to find another. Instead Gurney and a deaf friend communicated with hospital staff through pen and paper but important details weren’t communicated effectively. It’s understood widely in the deaf community that detail can easily go astray in all types of conversations.
Gurney signed a consent form for an operation. On waking briefly after the anaesthetic he saw three marks on his stomach which he had understood from the staff meant that he had only had exploratory surgery; he was relieved. ON waking fully later, he learnt that he’d misunderstood and that his appendix had been taken out after all.
He left hospital having had no interpreter support for the duration of the stay.
A spokesperson for the hospital says they attempted to find an interpreter but none were available. Gurney left the next day and the hospital were satisfied he knew how to look after the wound after having been given advice though agree it would have been good to have an interpreter at that discharge meeting.
The Equality Act of 2010 exists to protect people against unfair treatment on the grounds of deafness or disability but, under law, communicating via pen and paper could be considered a “reasonable adjustment”.
A recent report from Signhealth, a deaf charity focusing on the health and wellbeing of deaf people, finds that deaf people are falling behind their hearing counterparts in terms of general health. They’re reluctant to go to their local doctor or hospital, expecting communication to be difficult or impossible.
The report, Sick of It, finds that relatively minor health issues, as well as major ones, are going undiagnosed. The House of Lords discussed the findings last week.
But why is basic communication sometimes failing to materialise?
Dr Andrew Alexander, one of the key people behind SignHealth’s report, thinks it may be a question of perception: “Hospital staff tend to think the interpreter is for the deaf person. They fail to recognise that the interpreter is also for the hearing member of staff. It’s vital in a doctor-patient relationship to have good communication.”
Philip Dixon had “good communication” for an appointment at York Hospital to discuss the results of a scan though, in his case, it was provided by his hearing son Matt who can speak BSL. On discovering an interpreter had not been booked, the two had decided they’d go ahead with the appointment to avoid further delay.
Interpreting the doctor’s words, Matt was shocked that it had been left to him to tell his own father that he had terminal cancer. Not being trained in medical language as an interpreter would have been, the difficulty was further compounded by the fact that Matt didn’t know the signs for some of the medical terminology and had to muddle through.
It happened several years ago, and his father died soon after, but Matt says he relives the experience daily. Looking back he wishes they had pushed for an interpreter and says: “Being put in that situation for me meant, instead of me supporting him, he had to support me because I was so upset. And that’s wrong. If an interpreter had been there I could have sat next to my father and supported him through it and focus on consoling him.”
A spokesperson for York Hospital says they were sorry to hear of Matt’s experiences and says their protocol is to provide interpreters to patients who need them and they’ve been monitoring and improving interpretation services in the last year.
When deaf people feel they aren’t getting the right level of service, they can raise the issue via the Patient Advice and Liaison Service (PALS), their GP, or elsewhere. Change should happen as a result – and if it doesn’t, then The Equality Act gives deaf patients the right to take that complaint further.
On this week’s programme, See Hear raises these stories with Neil Churchill, the Director for Patient Experience for NHS England. He says: “where the NHS has got something wrong and that’s given somebody a poor experience of care, then we need to apologise and we need to learn from that. I think everybody is interested in making sure that if something has gone wrong, it doesn’t happen again.
“My goal really is to put patients in positions of real influence where they can assess the quality of care and identify what improvements Trusts need to make in order to routinely deliver consistently great experiences of care.”
Same Difference 
Age 81 dad went into hospital he’d had inpatient stays in hims 70’s. I went and sat with him many afternoons (I told doctors’ and nurses i would do this). Sometimes I would have to wait at the ward entrance so watched nurses, care staff and sometimes doctors and I only observed one doctor and the Pharmacist introduce themselves to him and the longest stay was 12 weeks. He was blind and had tinnitus which disturbed his already reduced hearing, he was frightened through all of this because he had no idea who was approaching him. Every time I was there I waited as staff approached and when they began putting a thermometer in his ear or lifting his arm for the blood pressure cuff I said “my dad is blind, he has no idea who you are or what you are doing to him, will you please introduce yourself?” There used to be a small laminated label with the sign for partial sight or blindness stuck on the wall behind the bed of someone with reduced sight but I was told it was for infection control it was no longer used that the fact he couldn’t see was in his notes.3rd and longest in patient stay I went to Audiology and said I knew my dad had been for an appointment sometime in the past but dad hadn’t got aids and I wondered why?, the receptionist found his notes and said she remembered him?, he’d had to wait almost all morning 2 years earlier and had gone into diabetic hypo and rushed to A&E and never came back. I asked if he could have his hearing tests on the ward and an Audiologist told me no. He was tested on the ward in a rehab unit weeks later. I asked if he could have a home visit for fitting of the aids as he was discharged home with nursing care, he left hospital 2nd week in January and the home visit was given to him, 3 weeks before he died November.
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Ann, so many similarities here with my late father’s care in hospitals too. He was also virtually blind because of Macular Degeneration, (totally blind in one eye and under 25% vision in the other eye), and was also deaf, (could only cope with one hearing aid, but should have had two).
My father died of cancer, but undoubtedly suffered additionally because his sensory impairments were largely ignored.
His buzzer, white stick, slippers, dressing gown, personal items on his locket would all be moved by cleaners and put in different places – no use to him groping to find things. He’d spill water, spill hot tea, His food would just be set down and on occasion he ate his dessert, (a fruit crumble), with mince and potatoes as he thought it was a savoury oatmeal stuffing we eat here in Aberdeenshire. He’d be reprimanded when he dropped cutlery. When he was given a different ‘clear-out’ medication from he’d previously had in preparation for a colonoscopy, and asked how it would work, (as being almost non weight-bearing he was very anxious he’d not soil himself with such a medication) – the nurse handed him the tiny print leaflet and said “read this” and turned on her heels. He’d be taken for scans/X-rays in a wheelchair by porters, minus his white stick, and of course would then be deposited in unfamiliar surroundings and left with staff who were unaware he was blind. The physiotherapists would come to the ward in an futile attempt to keep him mobile, (the cancer had spread to his spine, hence failing weight-bearing), and ask him to walk to specific points – “the nurse’s station” – he couldn’t even see to the next patients bed, never mind two/three beds along. He was made to feel a total nuisance, and was so often told they hadn’t time to help him. He had at least 6 falls in various wards. He’d be told to use his buzzer, and not try to move himself, but nobody ever came so much of the time, that he’d try moving himself.
I could continue all day with dozens and dozens more incidents, and the shocking thing is that like yourself, we witnessed so much of this ourselves, and my father was certainly not the only frail old gentleman to be treated so poorly.
The awful thing for us was that following successful careers in the army, police, and an oil company, my father had worked for 5 years as a Health and Safety Advisor for our local health board, and actually dedicated himself as part of his work to championing better healthcare and conditions for the very same nurses and staff who failed him despicably 😦
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