Working with patients who are deaf, hard of hearing or deafblind

The resource provides practical guidance for staff in Victorian hospitals on working with patients who are deaf, hard of hearing or deafblind, and working with Auslan interpreters to provide services to hospital patients. Information contained in this resource has been adapted from resources developed by Vicdeaf.

This resource is to be read in conjunction with Information for public hospital staff: legal obligations when working with patients who are deaf, hard of hearing or deafblind, which outlines the legal obligations of public hospital staff under the Equal Opportunity Act 2010 and the Charter of Human Rights and Responsibilities Act 2006.

Information on Auslan and other sign languages

What is Auslan?

Auslan (Australian Sign Language) is the sign language of the Australian Deaf community. Auslan is composed of precise hand shapes, facial expressions and body movements with its own syntax and grammar. Auslan has a different grammatical structure to spoken and written English.

What other sign languages do people use?

Tactile signing

Auslan can be tailored to a tactile version for people who are deafblind or people who are deaf or hard of hearing who also have low vision. Tactile sign uses additional signs to convey information about facial expressions and other emotional information. Tactile sign is not a different sign language, it is a modified version of Auslan.

Other Sign Languages

Around the world, deaf communities use different sign languages. Sign languages used in different countries are different languages. For example, New Zealand Sign Language and American Sign Language are different languages to Auslan.

It may be possible to find an interpreter who uses the sign language of other countries, however interpreters are not available for all international sign languages. A deaf interpreter may be helpful as an alternative.

Are deaf interpreters different to Auslan interpreters? What are deaf interpreters used for?

Yes, deaf interpreters are different to Auslan interpreters. Deaf interpreters are specifically trained sign language interpreters who are able to convey meaning in the form of a highly visual form of gesture.

Some patients who are deaf or hard of hearing are not fluent in Auslan. This may be because they became deaf or hard of hearing later in their life or they are fluent in a sign language of another country.

Patients who are not fluent in Auslan may benefit from a deaf interpreter.

How do I book an Auslan or other sign language interpreter?

Contact the Language Services Unit or equivalent service in your hospital.

Why do some patients prefer to work with particular interpreters?

There are a number of reasons why a patient may request to work with a particular interpreter. Some of these reasons include:

  • the patient has worked with an interpreter in the past and the interpreter is familiar with their individual interpreting needs
  • the patient prefers to only share their medical or personal information with particular interpreters
  • the patient prefers to use different interpreters in different settings, for example, different interpreters for health and work settings
  • the patient has gender or cultural preferences for their interpreters. These may depend on the nature of the health care appointment and topics to be discussed.

Why may a patient refuse to work with an interpreter?

In some situations, a patient may refuse to work with a particular interpreter. The patient is not obliged to provide a reason for this decision. In addition to the reasons outlined above other reasons may include that:

  • the patient and the interpreter are not well matched in the way that they sign
  • the patient has had a previous bad experience with the interpreter
  • the patient has an association with the interpreter outside of professional services

Tips for working with patients who are deaf and hard of hearing

Effective communication is critical to ensuring patients can access high quality health services. It enables them to understand all relevant information, ask questions and give informed consent for any medical treatment they receive. It is also important to avoid potential discrimination or other complaints.

Below are some important considerations when communicating with patients who are deaf, hard of hearing or deafblind:

  • Talk directly to the patient, not the interpreter, throughout the consultation.
  • Ensure that the patient and the interpreter are in the best position for them at the start of the consultation, such as having a clear line of sight with each other.
  • Allow time for interpreting. This may include speaking at a moderate pace, breaking up the delivery of information and extended appointment times. Be mindful that additional time is often required for tactile interpreting.
  • Ensure your face is visible to the patient while you are speaking to them.
  • Conduct your consultation in a well lit room with lighting on your face. Avoid glare behind you.
  • For consultations with patients who hard of hearing, use a quiet room with minimal background noise, for example, rooms that are not adjacent to a main corridor.
  • Allow the patient personal space so they can use Auslan.
  • Adjust communication to meet individual patient needs. This may include taking time, explaining information in different ways, using diagrams, anatomical models and other visual representations and asking yes/no or open questions where appropriate.
  • Provide health information in a variety of formats, for example, written formats, recorded Auslan videos on your website, Easy English and diagrams.

Methods of communication for patients who are deaf, hard of hearing or deafblind

This section outlines some forms of communication when working with patients who are deaf, hard of hearing or deafblind.

Auslan interpreting (including tactile interpreting where needed) is the best way to obtain informed medical consent and convey important information about treatment and prognosis for patients whose first language is Auslan. In exceptional circumstances, such as a medical emergency when an Auslan interpreter is not available, other communication methods may be considered pending the arrival of an interpreter for people whose first language is Auslan.

Other communication methods might also be preferred by patients whose first language is not Auslan.

This is intended as a guide only. Each patient has their own individual needs and it is important to tailor service provision accordingly.

COMMUNICATION METHODDESCRIPTIONAPPROPRIATE SITUATION
Auslan and other Sign Language Interpreters Auslan, tactile sign and deaf interpreters and interpreters for other sign languages. All medical appointments for patients whose first language is Auslan or another sign language.
Video Remote Interpreting (VRI) and other Off-site Interpreting Auslan and other sign language interpreting through videoconferencing using professional conferencing equipment or desktops,laptops and tablets. Videoconferencing software can include ClearSea, Skype, Blue Jeans and other similar programs. In exceptional circumstances, such as a medical emergency, where an on-site Auslan or other sign language interpreter is not available.

Hearing loops (audio loop)

International Deafness Symbol

A listening device that amplifies sound directed into a microphone, sends an auditory signal via wires installed the room and the hearing aid picks up the signal. This greatly improves sound reception of words spoken into the microphone.

The International Deafness Symbol is displayed in venues that have hearing loops installed.

All medical appointments for patients who are hard of hearing.
Writing This involves writing using a pen and paper or electronic word processing. Keep sentences and questions brief and in Plain English.

May assist to obtain basic information (for example name, address, medicare number).

Writing is not a substitute for an interpreter.

Communications board A communication board is a laminated sheet that may include words, phrases, questions, symbols and/or the alphabet. People can point to items on the board to convey a message. May assist to relay basic information (for example, pain levels, toilet requests). A communication board is not a substitute for an interpreter.