A Hearing Loss & Late Deafened Blog

Posts Tagged ‘Hospital Accommodations’

Please Face Me – And Make it a Double (part two)

In Accommodations for Deaf, Hospital Accoommodation on August 1, 2008 at 12:12 pm

7/28/2008 – Skirmish Lost – War Declared!

The following transcript of a conversation I had today is not complete or perfect – it’s from my best recollection upon arriving home in rather profound emotional turmoil and disappointment. I had to scribble it on paper as fast as I could, while it was fresh in my memory. I now more calmly and patiently transcribe it here for the edification of those who believe in the Happiness-care tooth fairy. At the outset, know that this is NOT OVER.

This is a conversation between myself and my “official” case manager (CM) at St. Goofy’s Bombastic Happiness (SGBH), an arm of St. Goofy’s Medical Center, a facility of Goofy Happinesscare North (GHN).

Recall from part one that I had a discussion with my “fill in” case manager about my ongoing outpatient treatment, during which I requested and explained CART accommodation. The following conversation was with my actual case manager, Susanne, with whom I’ve had pretty good rapport in general.

Susanne: What can I help you with?

Paul: I need to find out if my insurance will cover the Partial [outpatient group therapy] program.

Susanne: I spoke with Judy [temp CM I talked to Friday], and she had information for you, but you left.

Paul: Apparently she wasn’t aware I was already discharged, and had to leave.

Susanne: Ok, let me go look and find the information for you – it’ll just take a couple minutes.

Paul: OK

Susanne: You’re eligible for our CCDI program.

Paul: One important thing I need to tell you – I can’t do the full 10 days [assuming this acronym refers to their 10 day Partial program]. I’ve got to get back to work.

Susanne: It’s not a 10 day program – it’s 3 times a week, in the evenings; it starts at 5:30 on Mondays, Wednesdays, and Fridays.

Paul: That’s not what Judy and I talked about!

Susanne: That’s what your insurance specifies, the CCDI program – and we can provide an interpreter for you. [Note that I had not asked for an interpreter – I had requested CART]

Paul: I can’t use an interpreter – I don’t speak ASL! I need CART!

Susanne: We’re not set up for that. All we can do is provide an interpreter.

Paul: By law, you have to accommodate me! I have information on how to do this easily with remote CART. All you need is a computer with Internet, Skype, and a microphone.

Susanne: So don’t you lip-read?

Paul: Yes, I can lip-read a bit, but I’m not totally deaf – just hard of hearing, so if you’re facing me, I can both lip-read and hear some of what you’re saying. But in a group conversation, I can’t follow.

Susanne: So you’re telling me the CART people can follow a conversation where 3 or 4 people are talking at once?

Paul: No – I couldn’t do that when I could hear!

Susanne: I can’t do that now (smiles).

Paul: What I’m saying is that when someone isn’t facing me, I can’t understand them, and that’s what happens in a group setting. But the CART person can hear and transcribe any single speaker in the room.

Susanne: So what happens with this setup? People talk, and you do what… read?

Paul: Yes, on the computer screen.

Susanne: I don’t even know if there’s a computer available in the room we do the groups in – and I doubt there’s Internet. It would take at least several days for us to set this up, and I don’t see how the program could benefit you given that you can’t go past this week. The only thing I can recommend to you is AA meetings – we do have one that meets here, Tuesday nights, 7:30 p.m.

Paul: I guess you’re right.

[Much prognostication (by me) of future encounters of this sort follows, but is omitted here – and I insisted that Susanne make photocopies of the material (and postcard) provided by our (SWC) Gayl to give to “them” for the benefit of future patients – which she did.]

[Pleasantries, goodbye, etc.]

[Note that the suggestion of the AA meeting completely sidesteps the HOH/CART issue – what elephant? I don’t see an elephant!]

So now what?

Well I haven’t formulated my plan of attack yet, but do trust me, THIS IS WAR. I am absolutely determined that these people will enter the 21st century and start accommodating late-deafened/HOH folks, or they will PAY in real dollars for their ignorance and dismissal of this issue.

This isn’t even about me anymore. This is about everybody who comes to them for help and is turned away because their hearing loss can’t be accommodated in one of the simplest, cheapest (most “reasonable”) ways.

Can you tell I’m pissed? ūüėČ

And what of my recovery? Well don’t worry, I’m not about to throw the baby out with the bathwater. I’ve still got determination to keep my LIFE, and I’ll find what I need out there (if I have to, I’ll START a late-deafened/HOH AA meeting! – I have plenty of experience with 12-step).

Wish me luck as I dive into my new role as the HOH Radical. ūüôā

Paul S

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What Accommodations Should A Hospital Provide?

In Deafness, Hearing Loss on February 14, 2008 at 2:31 am

After two back to back trips to the hospital that ended in two surgeries, I began to wonder about hospital ADA requirements.  YeahРI knowРbetter late than never. 

I read lips well enough that I didn’t need an interpreter. . . I thought.¬† I can’t use one anyway, since I’m not fluent in ASL.¬† My hard-of-hearing husband was able to help in most cases where I misunderstood a question.¬† His familiar voice and lips are easy¬†to read, so¬†he acted as an oral interpreter when he could.¬† That said, he is also somewhat hard-of-hearing.¬† It crossed my mind that in years to come we might not fare as well in an emergency.¬† We both have progressive hearing losses.¬† In a few more years his hearing might be bad enough, he might not be able to hear any better than me.¬† OR– if it were ME interpreting for HIM, we’d be in big trouble.¬† Still– because both times I¬†entered the hospital through the ER, I thought it¬†might be too much trouble to ask for . . . what??¬† What could I ask for???¬† Would they know about CART??¬† Oral interpreter???¬† What???¬†¬†

Here’s an ADA Business Brief put out by the Federal Government on what kind of accommodations to reasonably expect.

ADA Business Brief/Hospitals

I’m sure the reality is far different from the ideal.¬† A few of you have already mentioned you’ve had less than satisfactory experiences in hospitals after requesting accommodations.¬† It¬†wouldn’t hurt to have something like this Business Brief¬†in hard copy on hand, just so you can carry it around with you and wave it in someone’s face next time they fail to follow up on your requests for reasonable accommodations.¬†¬†

What is reasonable you might ask? 

The Business Brief¬†tells all–

1)  Is it reasonable to request an oral interpreter or CART for medical emergencies when a deaf/Deaf family member is receiving emergency medical treatment? 

Yes.  The hospital should be prepared to accommodate in emergencies regardless how the D/deaf/hh person communicates.  Reasonable accommodations include:  CART, Oral interpreter, Cued speech interpreter and ASL interpreter, and YESРhospitals should be prepared to provide these in emergencies.  Dang!  I should have asked! 

2)  Should family members be counted on to interpret for other D/deaf/hh family members?

No–Family members may be too upset and caught up with the emergency themselves to interpret accurately.¬† Dang again!!¬† So true!!¬†¬†While I’m a good lip-reader, I was in pain.¬†¬†After the pain meds¬†were administered,¬†I developed a bad case of tinnitus and my ability to¬†think/lipread became fuzzy.¬†¬†Both times I was in the ER six to eight hours.¬†¬†After I zoned out in a peaceful morphine-induced sleep,¬† my husband¬†paced hospital corridors calling relatives and talked to doctors until the wee hours of the morning.¬†¬†He stayed up and sat with me til 3am twice, then he went home and came back again at 6am.¬† Naturally by the next day he couldn’t keep details straight.¬† He was sleep-deprived and stressed.¬† Was it this or that?¬† Did the doctors say this??¬†Or did¬†this one¬†say that???¬†¬†And another one say. . .?¬†¬†With an interpreter present my husband could have allowed me to answer at least some of the initial questions before they shot me full of drugs.¬†¬† Instead it ALL fell on him, including the history of my symptoms, which he was unclear about– because it was¬†MY body, not his.¬†¬†

3)  When is it OK to rely on simply passing notes back and forth? 

When medical treatment, information or diagnostic options aren’t¬†being discussed.¬† For example– when d/Deaf/hh visitors where the restroom or coffee shop is, or when “interactive communication” isn’t expected such as giving a patient his/her bill, then a piece of paper is fine.¬† If the communication is “interactive,” like when¬†a patient may have questions or may need to make decisions based on information a nurse or doctor is giving him or her, then an interpreter or CART should be provided.¬† We didn’t do much passing of notes, since my husband was there most the time and I read lips fairly well while awake.¬† Still, I am ashamed to admit there were times I “faked” it because I was tired and full of drugs and too lazy to bother with another nurse flapping her lips at me.¬† I depended way too much on my husband who sometimes didn’t think to ask the questions I¬†had about side-effects and symptoms I was having.¬† Because again– it was MY body, not his.¬† An oral interpreter really should have been present and I didn’t ask for one– because I didn’t know I could!!¬† Dang AGAIN!!!

4)  What kind of interpreter or accommodations should a d/Deaf a person expect? 

Hospitals should be prepared to provide ASL interpreters, Cueing interpreters, oral interpreters and computer-assisted relay transcription, (CART) as stated above.¬† I answered this above, but it should be stated again, because this is too often ignored.¬† Too many hospitals are not prepared for these types of emergencies.¬† WHY aren’t they?¬† What can we do about it?¬† I don’t know the answer.¬† I’m asking.¬† Dang it– why do people have trouble getting accommodations in hospitals sometimes?¬† Is it because they don’t ask, or don’t know what to ask, or don’t know how to ask, or maybe the hospital doesn’t know what to provide because most don’t ask. . .?

5)  What kind of accommodations should a d/Deaf/hh patients expect in his/her hospital room?

If there is a television, it should have captioning.¬† Mine had that.¬† All hospitals¬†should provide TTY or relay.¬† My hospital had this, and my room was fully wireless, so if you had your SK or blackberry,¬†it would have worked.¬† My SK was stolen last Dec. and I STILL haven’t replaced it!¬† My¬†laptop worked¬†so I could have made a relay call if I had wanted to.¬† Phones should be hearing aid compatible.¬† Mine was.¬† I was surprised how well I could hear with it, despite the fact I can rarely hear on a phone these days.¬† I only used¬†it to talk briefly with relatives, but still it was amazing I could hear on it at all.¬† My dad even called later to find out what kind of phone the hospital had because he was so surprised I could use it.¬† He wants me to have a phone like THAT one.¬† We’re going to check into it.¬† Additionally alarm systems¬†should have visual alerts so that D/deaf people will¬†know when there’s an emergency.¬† I never got a chance to check out the visual alarm system¬†in my hospital.¬† I wish I did.¬†

I guess it’s’ important to¬†point out¬†the Business Brief emphasizes¬†a hospital’s¬†prerogative to offer “reasonable” accommodations.¬† Just because you ask for one thing doesn’t mean you’ll get exactly what you ask.¬† They may accommodate you differently.¬† The point is they will try to accommodate you in a reasonable way.¬† It doesn’t hurt to ask.¬† Even if you don’t get exactly what you want, it’s better than nothing.¬† So don’t be like me.¬†¬†ASK!!