The deaf and hard of hearing may have increased risk for having complications from COVID-19. Read about cochlear implant recipient JP’s story whose story was seen here and expanded by the LA Times.

In the hospital, COVID-19 creates unique challenges for those with hearing loss. COVID-19 patients are separated from other other patients into “respiratory isolation.” This means that masks and noisy air purifiers are widely used. Masks that muffle the voice and prevent lipreading. Unlike other medical settings, masks will not be lowered so that you can lipread. Masks are being rationed, so doctors and nurses are limited when they can enter a room. This disrupts normal methods of using communication strategies such as video remote interpreting and even personal speech recognition apps.

Normally, hospitals are able to provide accommodations. However, some are overwhelmed and their ability to provide accommodations may be limited.

This guide is meant to provide the information that most people need to know. For more in depth needs, consult the guidelines produced by Dr. Ruffin and other deaf and hard of hearing leaders. These guidelines have been adapted for people who primarily use oral and spoken language and for those who communicate in sign language. The NAD has also released guidelines for hospital personnel. You may also see our recorded webinars for oral and spoken language or sign language users.

About Clear Masks

Clear masks are useful in any situation where a regular surgical mask or a homemade mask is used. It is not appropriate for use in the hospital COVID-19 setting. They are a reasonable accommodation for hearing loss.

Clear masks do not have the same level of filtration that N95 masks provide. Thus, they do not protect healthcare workers from catching COVID-19. The only clear mask solution that we have used and recommend is the Communicator Mask from SafeNclear (we have no financial connection). Other commercial solutions such as The Clear Mask is currently on backorder and we have not evaluated its product.

Your Communication Rights in the Hospital

Know your communication rights in the hospital.

You have the right to communication access whether you speak or hear. Options can include:

• a live ASL interpreter and if not available, quality video interpreting services. Ask that the following information be posted in your room and on your medical chart: Your need for and the name/number of the interpreting service.
• Access to real-time captioning.
• An assistive listening device such as a remote microphone or a Pocket Talker.

• See below for apps such as Google LiveTranscribe and Microsoft Translator which can provide backup communication aids that with captions for speech.  
• Use a personal whiteboard or a boogie board.
• For help obtaining communication-friendly equipment, ask for the charge nurse of your ward or hospital nursing supervisor.

Communicating at the Hospital

Three steps to being prepared for a COVID-19 hospital admission. Keep in mind that these may be used for any hospital admission.

1. Plan ahead with a backup plan. Hospitals may not always have the capacity to accommodate you. Please note, this doesn’t absolve them of that responsibility.
2. Practice communication strategies prior to going to the hospital.
3. Teach your advocate how to implement these strategies. Your advocate is your significant other, family member, or friend who knows you well. They can communicate your needs with the healthcare team.

Low-Tech Hospital Survival Tools

Consider printing these useful signs to place in your hospital room. They work well on the door and above the head of your bed to remind people that you have hearing loss. See if your hospital has assistive technology or a hospital kit for those with hearing loss.

Download these placards so hospital staff can operate your cochlear implants and hearing aids.

Use a personal whiteboard or a boogie board.

App-Based Communication Scenarios to Master

Apps that provide captions can be classified into two categories:

• Human based stenographers convert phone calls to captions for hard of hearing users. It is illegal to use these apps as interpreter. In other words, these apps cannot be used in the same room as another speaker. Examples include InnoCaption and Hamilton CapTel.
• Automatic speech recognition (ASR) apps automatically convert speech to text. Examples of these apps are Google LiveTranscribe (Android), Otter (Android, iOS), and Ava (Android/iOS).

For the latest on apps, check out the Connect-Hear resources created by my colleagues, Dr. Tina Childress of See Hear Communication Matters and Catharine McNally.

Make sure that your healthcare providers and advocates know your login and passwords.

Scenario #1:

The speaker is in the same room as you, and you hare having difficulty hearing because of distance or a mask.

• Use an ASR app listed above (e.g. Google Live Transcribe or Otter).
• Provider holds a portable device under their chin, facing out so you can read the captions. See Dr. Tina Childress demonstrate this in the video right.

• Provider talks into your portable device from a slight distance while you're holding it (see second video). Wired or wireless lavalier microphones can increase accuracy with social distancing. Wired mics are easier and less prone to being lost in the hospital.

Scenario #2

Communicating when the speaker is outside the room. Treat this as a phone call.

• InnoCaption (Android, iOS) and Hamilton CapTel (Android, iOS, Web) use human stenographers to caption conversations live.
• For group conversations, Google Hangouts/Meet (Android, iOS, Computer) provides free group video calls with automated captions.

For People who use Sign language or are deafblind

Please see the NAD resources for a list of video remote interpreting and text-enlargement apps.

If you are not getting what you need…

Ask to speak with the nursing supervisor for the hospital or ask for an ethics consult. You can also contact ConsumerGroups@DHHCAN.org for help.