“I was furious, upset and a bit traumatized. I felt really alone,” said Thielman, who lives independently but needs a service dog to hear even her own doorbell.
Thielman wasn’t misdiagnosed, mistreated or given improper medications. Still, in two emergency room visits and subsequent hospital stays this year at Mercy General Hospital in Sacramento, she said she frequently felt isolated and unsure why she was getting certain injections or exactly what her medical status was. Both times, she said, it took three to four hours for a trained interpreter to arrive in the emergency room. Later, in the hospital, she was unable to schedule an interpreter to meet with her doctors.
During her multi-night hospital stays, her primary means of conversation was to scribble back-and-forth notes with her nurses and doctors.
The struggle to communicate with medical providers is a common complaint among the deaf and hard of hearing and has resulted in dozens of legal settlements nationwide in recent years. Since 2012, when the federal Department of Justice launched its Barrier-Free Health Care Initiative, it has concluded investigations in about 36 cases – including several in California – involving lack of interpreter services.
An estimated 37 million U.S. adults have hearing trouble, ranging from partial loss to complete deafness, according to a 2006 study by the Centers for Disease Control and Prevention. That’s up from 31.5 million in 2000.
“We get complaints weekly, if not daily,” said Sheri A. Farinha, CEO of NorCal Services for Deaf & Hard of Hearing in North Highlands, a nonprofit that represents individuals in 24 California counties.
Hospitals, medical centers and doctors’ offices top the list of U.S. entities deemed the “worst in failing to provide effective communications to deaf and hard of hearing individuals,” Howard Rosenblum, CEO of the National Association of the Deaf, said in an email………………………………..Last year in San Bernardino County, Arrowhead Regional Medical Center, a surgical hospital in Colton, agreed to pay $100,000 to settle claims by two deaf patients who said they were denied adequate sign language interpreters. In the August settlement, Arrowhead agreed to set up video communication services with an off-site interpreter within 20 minutes after a patient’s request, or provide an in-person interpreter within two hours of an emergency, if possible.Written notes or asking family members to interpret are considered the least effective ways to communicate with doctors, according to federal guidelines. The Department of Justice, for instance, said family members may lack a medical vocabulary or don’t want to deliver a doctor’s bad news.The use of medical interpreters varies by hospital. Some, like the UC Davis Medical Center in Sacramento, have a sign language interpreter on staff. Others, such as Mercy General, contract with outside agencies, whose interpreters are on call and travel to the hospital as needed. In addition, some use video remote interpreting, where a patient is linked to an off-site interpreter via a laptop or tablet screen.
Tina Contreras, whose parents are deaf, said she tries to accompany her 58-year-old mother on doctors’ and hospital visits, but with a full-time job and two kids, it’s not always feasible. As a freelance interpreter for deaf individuals, Contreras finds it dismaying that hospitals haven’t kept up with technology.Her mother, who has kidney disease and heart issues, was recently hospitalized at Mercy San Juan Medical Center, where Contreras said there was no interpreter readily available. Instead, staffers brought her mother a TDD phone, essentially a phone with a keyboard where messages can be typed, that isn’t widely used anymore.“It’s like bringing in a rotary phone for a hearing person,” she said. “They’re using 20-year-old technology.”Without an interpreter, Contreras said her mother often tries to follow instructions or confers by written notes with medical providers, but frequently she doesn’t understand what’s being said. “It’s mentally draining,” she said. “You have to fight so hard and bark so loud to get interpreters.”
Clear communication in health care settings is critical to avoid “misdiagnosis and improper or delayed medical treatment,” according to the ADA. The issue affects not only those who were born deaf, but also older Americans dealing with age-related hearing loss.
Compared with all U.S. adults, those who are deaf or have significant hearing loss are nearly three times as likely to be in fair or poor health, according to a 2006 study by the CDC. They also have higher rates of smoking, diabetes, high blood pressure, excessive alcohol use, physical inactivity and obesity.