Four Tips for Communicating with Patients with Hearing and Vision Impairments

According to data gathered by the Centers for Medicare & Medicaid Services (CMS), seven percent of people with Medicare are blind or have low vision, and nearly 15 percent are Deaf or hard of hearing. Like those with limited English proficiency, the Deaf and blind require specific treatment to ensure they can properly communicate with providers and receive quality health care.

To help providers get the tools they need, the Quality Improvement Organization (QIO) Program held a National Disparities Learning and Action Network (LAN) event in June 2018. This free online training, titled “Effective Communication Strategies for Deaf, Hard-of-Hearing, Blind and Visually Impaired Patients,” informed providers how best to serve these patients in primary care and other ambulatory settings. Presenters included Dr. Michael McKee, assistant professor, Department of Family Medicine, University of Michigan; Padma Taggarse, executive director at Health Services Advisory Group (HSAG); and J. John Pimentel, Diabetes program manager and vision rehabilitation therapist at Insight.

Following are four tips to help providers better communicate with patients who have hearing and vision impairments:

1. Use all the tools at your disposal to ensure quality care.  

   McKee recommended that providers speak clearly, use certified sign language interpreters (when available), flag chart records to identify patients who may need communication assistance, and use personal listening equipment like pocket talkers. He also shared some basic but effective body language strategies like facing patients when speaking, making eye contact and incorporating visual aids.

2. Ask patients how best to help them.

   McKee urged providers to remember that patients are generally the experts on what communication styles work best for them. He cited the Joint Commission’s roadmap for hospitals, Advancing Effective Communication, Cultural Competence, and Patient- and Family-Centered Care, as a strong resource to learn more about caring for patients with hearing and vision impairments. All three speakers advocated for open communication with patients to ensure that care is personalized and customized to their needs.

3. Address challenges head-on.

   Taggarse of HSAG—the Quality Innovation Network-QIN for Arizona, California, Florida, Ohio and the U.S. Virgin Islands—provided an overview of CMS’ Everyone with Diabetes Counts (EDC) program, which is designed to improve health literacy and change behaviors among vulnerable populations with diabetes or pre-diabetes. She explained how some of the key challenges involved with providing diabetes self-management education (DSME) to visually or hearing impaired people include the cost of interpreters, limitations on interpretation, the ability to provide simultaneous translation, and the typically low health literacy level of target populations. To ensure its program was effective, HSAG staff provided materials in several languages and engaged patients individually to check that the lessons were understood.

4. Seek out training opportunities.

   Pimentel of Insight used his personal experiences to delve into the cultural sensitivities of treating blind and visually-impaired patients. He argued that more training is needed, citing studies showing the public’s tendency to over-rate their cultural sensitivity levels. Pimentel said that health care providers often do not have a better understanding of the needs of blind and visually impaired individuals than the general public does.

   The speakers encouraged providers to seek out training and resources like the LAN webinars, so they are prepared to fully engage patients, no matter the circumstance. To learn more about how to effectively communicate with Deaf, hard-of-hearing, blind, and visually impaired patients, listen to the full recording of the LAN event here.

Originally posted in the QIO News July 2018.