Communication for people with sensory loss during the COVID-19 pandemic

People with sensory loss face extra barriers to accessing healthcare which can put them at risk of missing out on the care they need, and avoidable death. In addition, due to the increased risk of adverse outcomes from respiratory conditions for many disabled people, they may be more likely to need to access healthcare services. At this time, it is vital that health and social care workers can still make the reasonable adjustments required by law that these patients need – this document will help you identify the most important things you need to do to communicate effectively with your patient to support their health needs.   

Communicating effectively can help your patient to:   

• Understand advice about how to deal with the symptoms of COVID-19 and keep themselves, and others safe; 
• Comply with treatment such as medicine dosage;  
• Keep to appointments and engage with healthcare professionals;  
• Give you the information you need about their symptoms;  
• Recall the information you have given them;  
• Make their own decisions and give valid consent to treatment;  

Remember communication is both about giving and receiving information.   

• Where possible, always talk directly with the person;  
• Always ask for the individual’s preferred language and communication method;  
• Remember that noisy and busy environments can make communication difficult for many disabled people;   
• People may have more than one disability;   
• Do not assume just because someone has a mobile number that they can receive important communications via text;  
• National and local charities, and self-advocacy groups, or companies like www.a2i.co.uk and www.ecomdda.com, can provide communication support and solutions. It may also be appropriate to ask the individual which organisation they recommend consulting. A wide range of third sector groups can also offer support, including:  

• www.royalblind.org/accessible-media  
• https://www.aliss.org/   
• https://deafscotland.org/  
• https://dbscotland.org.uk/ 
• https://signlanguageinteractions.com/  
• https://www.rcslt.org/policy/scotland  
• https://www.alliance-scotland.org.uk/  
• www.rnib.org
• www.actiononhearingloss.org.uk
• https://www.sensescotland.org.uk/
• https://contactscotland-bsl.org/  
• https://www.guidedogs.org.uk/  

Patients who are blind or partially sighted  

• Let the individual know you are there or if you are leaving the room;  
• Make sure you have large print, electronic, audio version and Braille versions of information available;  
• If the person is in a hospital bed, have you told them when and where you have placed food or drink near them (e.g. 12 o’clock, 3 o’clock etc) so they do not go hungry or thirsty? Have you told them about the location of important items such as the emergency call button and checked that they have understood and can reach them?   
• More communication tips can be found here: https://www.rnib.org.uk/sites/default/files/10%20tips%20sight%20loss%20Communication_0.pdf    

Patients who are Deaf or who have hearing loss

Older people are at higher risk of becoming severely ill due to coronavirus. More than 40% age 40, 60% age 60, 70% of people over the age of 70 and 90% over 75 have hearing loss. It is important to: 

• Establish the communication needs of the patient. The pillars of deafness and language preference describe Deaf, Deafblind, Deafened and Hard of Hearing as people with different levels of deafness. 
• Many people with hearing loss rely on visual cues such as lipreading and facial expressions. Communication can become more difficult or impossible on the telephone or when you are wearing a mask or using the wrong language, be that a sign language or verbal language. When wearing a mask, speak clearly, check understanding by asking them to repeat, speak to a friend or relative if absolutely necessary. Alternatively, use paper and pens, laptops or tablets, or visuals and symbols to communicate.   
• Telephone based services are inaccessible. Do you provide email, SMS text, Text Relay, textphones or British Sign Language (BSL) video relay or remote interpreting services? Deaf and deafblind BSL users in Scotland can use the contactSCOTLAND – BSL service to contact anyone, anytime.  
• For patients in a hospital bed, have you checked if they have hearing aids and that they are working? If they do not have hearing aids but need them, check with audiology locally to see if a personal listener can be supplied.  
• Comply with the British Sign Language (Scotland) Act 2015, NHS and medical guidance.  
• Are your hearing loop systems working? Are they regularly tested? Do you have a portable facility? 
• More communication tips can be found here: https://www.actiononhearingloss.org.uk/how-we-help/health-and-social-care-professionals/communication-tips-for-health-professionals/   
• https://www.hearinglink.org/living/partners-children-family-hearing-people/how-to-communicate-with-a-hearing-impaired-person/  

Patients who are deafblind  

• There is no single way that someone who is deafblind will communicate – it depends on their levels of sight and hearing as well as when acquired.  
• People who are deafblind may communicate using clear speech, adapted forms of sign , including tactile BSL orother methods such as braille or deafblind manual.    
• People who are deafblind may also need information available in different formats such as Braille or BSL video dependent on their individual needs.  
• More communication tips can be found here: https://www.sense.org.uk/get-support/information-and-advice/communication/ and herehttps://deafblind.org.uk/information-advice/living-with-deafblindness/communication/
• An Inclusive Communication Guide for Engaging with Deafblind People has been developed by Deafblind Scotland: https://dbscotland.org.uk/resources/publications/

Other useful links: 

Scotland’s Inclusive Communication Hub gives additional useful resources. Search ‘Top Tips’ for information on other communication support needs, such as learning disability or autism: https://inclusivecommunication.scot

Clinical guidance has been published for front line staff to support the management of patients with a learning disability, autism or both during the coronavirus pandemic: https://www.scld.org.uk/wp-content/uploads/2020/03/Managing-patients-with-ID-FINAL.pdf

Advice on Augmentative and Alternative Communication:https://www.aacscotland.org.uk/home/

Advice from the Scottish Accessible Information Forum:

www.saifscotland.org.uk/information-and-advice/#sthash.eXppa6lA.dpbs  

During the current COVID-19 pandemic Deafblind Scotland is sending out regular information to keep deafblind people updated on the developments and support that is available to them during this crisis and is extend this supporting to people with a visual impairment as well. The charity is providing the following services which are open for referrals from partner agencies/services: 

• Regular briefings for deafblind blind and visually impaired people, in alternative formats (large print, extra large print, braille, moon, audio cd). These will provide up to date information on the crisis, benefits information and any other developments. 
• 1:1 telephone support to access advice on welfare and benefits including hardship grants, food funds, access to shopping etc. 

Contact [email protected] for more information.

The Scottish Government has launched a new helpline for peoplewho are at high risk from coronavirus and do not have a support network at home, including disabled people. The phone number is 0800 111 4000.This communication guidance has been produced by the following organisations. We are extremely grateful for all that health and social care staff are doing in these unprecedented times.