Deaf Awareness in Healthcare

Additional Information

Statistics.

From Office for National Statistics population data (2018) , British Deaf Association and The British Tinnitus Association

  • There are 12 million people in the UK with some form of hearing loss. That equates to 1 in 5 people. 
  • It is estimated that there will be 14.2 million people with hearing loss (greater than 25 dBHL) across the UK by 2035. 
  • Approximately 151,000 people use British Sign Language in the UK 
  • On average it takes 10 years for people to address their hearing loss. 
  • 1 million adults in the UK live with tinnitus

Levels of hearing loss.

Adapted from British Society of Audiology 

There are four different levels of hearing loss, defined by the quietest sound that people are able to hear, measured in decibels (dB).

Mild hearing loss:  Hearing loss between 20 - 40 dB. This can sometimes make following speech difficult, particularly in noisy situations.

Moderate hearing loss: Hearing loss between 41 - 70 dB. People may have difficulty following speech without hearing aids.

 Severe hearing loss: Hearing loss between 71 - 95 dB. People will have severe difficulty following speech.

 Profound deafness: Hearing loss over 95dB+. People usually need to lipread and/or use sign language and/or use cochlear implants/hearing aids.  

However......It's not just about volume

Deafness is rarely spread evenly across the range of frequencies used in speech. So deafness is not simply a matter of volume.

One of the most common types of deafness is the loss of high frequencies, which makes it difficult to hear consonant sounds like S T K P and female voices.

Vowel sounds (A E I O U) have low frequency. So if someone has low frequency deafness vowel sounds will be difficult to hear as well as male voices.

Defining deafness.

Adapted from Wright Communication Learning Material

  • deaf (lowercase d): This term is usually refers to the auditory condition of hearing loss. It can also refer to people who are deaf but do not use sign language.
  • Deaf (Capital D): This term usually refers to someone who was born Deaf (but not always), uses British Sign Language as their first and preferred language and identifies with the Deaf community. They are very proud of their language, culture, history/ similar shared experiences and therefore may view deafness as a cultural and linguistic affiliation rather than a disability.
  • deafened: This term usually refers to someone who was born hearing and has lost any useful hearing. They can become deafened very quickly or over a period of time. They will normally lipread. Their first language will be English.
  • Hard of Hearing (HOH): This term usually refers to people with different levels of hearing loss and many of them benefit from using hearing aids. The majority of this group may also have to rely on lipreading.
  • Tinnitus: Tinnitus is experiencing noises in the head/ear. The majority of people with some degree of hearing loss will suffer from tinnitus. However some sufferers do not necessarily have a hearing loss.

However… remember that all of these ‘labels’ are flexible and depend on how someone identifies themself. They may also change their preferred terminology and communication preference over time.

Medical information.

D/deaf and HoH patients often leave a consultation confused about their treatment and/or medication and many find communicating with healthcare professionals problematic. Such difficulties lead to high rates of missed appointments and the avoidance of healthcare services leading to poorer mental and physical health when compared to hearing people.

Follow the links below to find out more about deaf and hard of hearing health:

Deafness May Damage your Health (The Lancet): 

National Deaf Services provides a range of comprehensive mental health services for deaf adults, children and their families: 

Sick of It Report (about the Deaf communities health) 

Coronavirus Impacts Report (about how the pandemic has impacted D/deaf people)  

Key communication points.

Important fact - Around only 30% of English is lip readable on the mouth.

Making it easier for people to lip-read you. 

  • If a window is behind you close the blinds or adjust your seating .
  • .Avoid looking at your computer or turning around while speaking. 
  • Be sure light is on your face and that you are at eye level 
  • Make sure nothing is obstructing your mouth (paper, objects, hands). 
  • Use your normal pace of speech.
  • If you speak very quickly you may need to slow down slightly. 
  • Do not over enunciate or speak very slowly as this distorts lip patterns. 
  • Shouting isn’t helpful; it lacks confidentiality and distorts lip patterns. 
  • Speak directly to the patient (not family members or interpreters). 
  • You may need to repeat, rephrase and /or write down what you say. 
  • Communicating visually (pointing to objects/pictures, miming, hand gestures) may help. 
  • Remove masks or use clear ones. 
  • Be sure the patient has his/her glasses on if they need these. 
  • You may need to move to a quieter space without background noise. 

Checking understanding. 

  • Double checking that the patient has understood is often helpful. 
  • For patients confident with English, it may be helpful to type a summary letter (especially with medication or treatment changes) 

Examination.

  • If the patient is facing away from you visual methods may be useful. 

Additional points when communicating with BSL user.

  • Book qualified BSL interpreter registered with the NRCPD. 
  • Avoid using family members as interpreters; especially children. 
  • Some BSL users may struggle with written English. 
  • If written notes are unavoidable use basic terms. 
  • It may be helpful to contact the Speech and Language Department for communication aids 

Language service professionals.

Types of Language Service Professionals.

Interpreter: an interpreter has an advance level of signing and receptive skills and interprets British Sign Language into spoken English and vice versa.

Communication support worker (CSW): a CSW is similar to an interpreter but with a lesser degree of Sign Language qualifications and training. Communicators usually work in schools, colleges and universities but shouldn’t be used in a medical environment.

Lipspeaker: a lipspeaker silently repeats all that is being said in a clear manner to the lipreader, and sometimes uses fingerspelling.

Speech to Text professional: An STTR professional translates spoken English into written text using a small laptop screen which can also be relayed to a large screen for the deaf person to read.

Notetaker: a notetaker manually writes the spoken word into an understandable note form for Deaf/deaf people.

Points to Consider when Working with a BSL Interpreter. 

  • Arrange to meet the interpreter 5 minutes prior to meeting the patient to prepare. 
  • Check that the interpreter is qualified and registered with an NRCPD badge. 
  • Be prepared to rearrange seating. 
  • Address the patient directly and look at the patient (not the interpreter). 
  • The patient will look at the interpreter, but will look back to you for your facial expressions/body language. 
  • The interpreter may need to stop the consultation at some point to clarify language. 
  • A brief concluding meeting with the interpreter may clarify any necessary communication points. 

If your interpreting provider cannot locate a qualified interpreter try: 

Example of qualified interpreting badge

Additional links.

Charities.

Technology and assistive devices for deaf people.

Communication Support/Language Service Professionals.

Learning British Sign Language.