Health care system lacks deaf awareness, local study says

The Canadian health care system is lacking deaf awareness for patients with trouble hearing, a new study by a University of Fraser Valley student has found.

Nicole Cusick, a fourth-year nursing student, surveyed 56 deaf and hard-of-hearing people from across the country to try and understand accessibility barriers.

Cusick found health care professionals don’t know how to properly communicate with deaf patients. Deaf and hard-of-hearing patients also found it hard to access sign language interpreters and book appointments through email rather than telephone.

“There are a lot of issues with communication, attitudes of health care providers just being very dismissive or sometimes even discriminatory,” she said.

Cusick became interested in learning American Sign Language three years ago.

At UFV, she never received any formal deaf awareness training and took it upon herself to learn tools that could help deaf and hard-of-hearing patients.

“I just became completely fascinated by the language and deaf culture,” Cusick said. “Deaf culture is just the ways of living of deaf people, the culture of sign language, and a little about the history. I just found it really fascinating.”

While writing an essay on how nurses can support deaf children and families in 2020, Cusick realized that most of her information was coming from the US. She was curious why there weren’t any Canadian-based studies.

“There’s approximately 357,000 deaf people in Canada, as well as 3.2 million [who are] hard-of-hearing. And I just couldn’t understand why such a large population was so understudied.”

To make up for that lack of research , Cusick decided to conduct her own study and shared the results at a symposium in April. Responses were recorded through an online survey where folks shared their answers to a list of questions.

One participant, who is deaf with hearing aids, told Cusick about a time when they went for surgery and were put under general anesthesia. Drowsy, the participant woke up in pain, without their hearing aid, and was anxious about how to communicate.

“They’re in pain, they can’t hear, they can’t communicate, they’re isolated, and this person ended up being labeled as aggressive and being sedated instead of having their concerns addressed,” Cusick said.

Pandemic fallout

The pandemic shined a light on the issues people with hearing problems face in the health care industry. As masks became a tool to protect against COVID-19, they also became a communication barrier.

Last year, the Wavefront Centre for Communication Accessibility in Vancouver released a survey of 641 people that suggested face masks impacted communication for three-quarters of people with moderate hearing loss and 95 per cent with profound hearing loss.

Ruth Warwick, director of programs and services at the Wavefront Centre, has spent her life trying to increase accessibility for deaf and hard-of-hearing people.

Warwick, who is hard-of-hearing, works with businesses to boost their accessibility services. She also advises employment counsellors who give advice to people with hearing problems looking for work, and conducts her own research.

Last year, she co-authored an article that addressed how the health care system could better help people with hearing loss. Warwick said a national strategy that addresses hearing loss and ear care using a three-pronged approach should be the first step to increase accessibility.

Warwick says academia, as a whole, also needs to do a better job providing solutions for deaf people facing everyday problems.

“We want to make sure that we have research projects that are looking at the issues we’re facing more concretely and give us data to advance the need for accessibility,” she said.

Although she did not take part in Cusick’s survey, Warwick has encountered similar challenges while trying to navigate the health care system.

Warwick had to visit the hospital emergency room in the middle of the pandemic. At one point, a staff member asked Warwick the same question three times. Warwick had trouble understanding the staff member, who was wearing a mask that covered their face.

“By the fourth time we got it, we connected,” Warwick said. “But those are situations where some people really feel vulnerable.”

Warwick eventually got the care she needed, but she says measures that make the industry more transparent, open, and clear for folks with communication needs are essential.

How to help the health care industry

Both Cusick and Warwick said hearing loss is different for many people. Some people may need visible oral communication while others require an interpreter. But regardless of one’s needs, Warwick said patients should always be consulted.

“The individual will, of course, be their own expert about the communication and what works and what doesn’t work,” Warwick said.

Cusick believes deaf awareness training could be easily adopted into existing curricula and help the next generation of health care providers understand how to better communicate with deaf and hard of hearing patients.

“It’s not anything that’s super-intense or invasive. I think it’s just some general awareness and thinking: ‘Oh yeah, I never thought about something that way.”