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Deaf community

Network meeting with a DHB Interpreting Service

An alarming response to an emergency

Wrong shuttle to check cochlear implant

Hearing aids make all the difference

The importance of interpreters

Ignoring the needs of a Deaf consumer

Problems with a Deaf Mental Health Service

Specific communication needs

Using interpreters to promote dignity and independence

Communication in a diagnostic medicine setting

Network meeting with a DHB Interpreting Service

An advocate contacted a DHB Interpreting Service coordinator by email to arrange a network meeting.  The advocate was aware that the interpreting service had had a few staff changes as well as the local Deaf Community having concerns on how to access the interpreting service.  

The advocate went to the meeting with a prepared list of questions and met the new interpreting service coordinator. The coordinator had only been in the role for one month.  

The advocate and coordinator discussed how the service would work and what the requirements were for the Deaf when requesting an NZSL interpreter. The advocate was also keen to see who was on their list as an NZSL communicator or interpreter. The advocate told the coordinator that there were two Interpreting Services they can use to book NZSL interpreters. 

The advocate had a clearer idea of how the service would work and passed on her findings to the Deaf community. 

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An alarming response to an emergency

Ambulance Service ~ Lifelink System ~  Right 1 ~ Respect and privacy ~ Deaf ~ NZSL interpreter

A Deaf consumer alerted emergency services using his Lifelink system, which he wore around his neck. He lived on his own at home and after collapsing from his bed, pressed the button on his system.

He waited for the ambulance which arrived 80 minutes later. He was not satisfied with the ambulance crew's communication. They had also recorded their notes in his home carers' communication book, resulting in him feeling that he had no privacy. He was not asked for permission to do this. 

The consumer had previously used the advocacy service, so emailed the service again with a request to meet and discuss this particular complaint.  After considering the options he requested a resolution meeting. His preference was to have a face-to-face meeting; instead of correspondence, as face-to-face he could communicate in NZSL via a NZSL interpreter. His issues were summarised in NZSL, which were put in a letter of complaint. 

His request for a face-to-face meeting was accepted. Those present were a regional manager for the ambulance service, a colleague to take notes, an advocate and a NZSL interpreter. The manager explained how their "pecking order" worked in terms of call-out priorities, which had resulted in a long wait on this occasion for the consumer. They acknowledged his concern about his carer's communication book. The ambulance crew had intended to give their log book to him.  The consumer stated that he had not seen any flashing lights at home to indicate that there was a call coming through. 

The manager examined the alert call between the consumer's home and the call centre. It was discovered that the centre declined to call the complainant's fax number because they knew he was Deaf, but they did not realise about the flashing light system. They updated their system to advise the staff to use his number during an emergency call. 

The manager advised him that the transmitter was to be moved to the bedroom from another room in order for the centre to be able to hear his movements during critical periods, for example his breathing. He informed the consumer that the contact line between the centre and his place remained open prior to the arrival of the ambulance.  He also organised an appointment for a technician to visit to check the Lifelink system to ensure it was operating properly.

The consumer was very satisfied with the result of this resolution meeting, and was extremely happy with the ambulance regional manager's careful consideration and explanation.

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Wrong shuttle to check cochlear implant

Right 1 ~ Respect ~ Right 5 ~ Effective communication ~ Right 6 ~ Fully informed ~ Cochlear implant device

A consumer was upset with the shuttle service she received during her annual visit to have her cochlear implant device checked and mapped. Her trip to the venue was arranged by the local DHB. In the past, she had received a very good service. Her flight was meet by a shuttle driver at the airport, she was taken to the venue on time and her return to the airport was carried out in a timely manner.

On her most recent trip, she was not met at the arrival gate and since the airport had been revamped she did not know where to go.  Once meeting up with the shuttle service, she notified the driver of her appointment time.  She found the driver rude and abrupt and was late for her appointment.  

On the return trip, the driver had other passengers to pick up and drop off along the way to the airport. The consumer was late arriving at the airport and had three minutes to spare to catch her flight.  She had to sprint to the gate which at her age was not easy to do.  

The consumer found the experience very upsetting and stressful. The treatment of the shuttle service driver put her off from wanting to return to the region for her next annual check up.  

She contacted the advocate for support to write a letter. She wanted an apology, better information on how and where to meet the shuttle, and to get to her appointments on time.  

The DHB and shuttle service were apologetic. It turned out the consumer had used the wrong shuttle service so did not receive the appropriate one. The shuttle service advised the DHB of the services they had available.

The DHB told the woman that following her complaint their 'Travel and Welfare Team' were provided with information so they were aware of the different types of shuttle services available and would book the most appropriate one for their patients in the future.  Maps of where to meet the shuttle would be included in the consumer's travel itinerary.   

The consumer was very happy with this response and outcome.

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Hearing aids make all the difference

Right 1 ~ Respect ~ Right 4 ~ Cooperation between providers

A mother approached the advocacy service as she had done everything suggested by her providers for her daughter. She had attended the audiology department for nine years and was told that her daughter's hearing needed to be monitored but was at an acceptable level. Her daughter was not progressing at school and her mother was very concerned. The daughter was to begin college and was behind in her studies. She was told she could see a private audiologist if she wished. 

The mother did this and was told her daughter needed hearing aids. This had never been mentioned in the past.  The aids were fitted and both the school and the family noticed improvements in the child. 

The mother had received conflicting views from both providers and remained confused as to what was best for her daughter. She was also concerned that the audiology department would remove the hearing aids as they did not agree with them being issued. 

The advocate assisted the mother to write about her concerns. The answers received were unsatisfactory as both parties did not agree with each other.  The mother was angry and upset at the loss of schooling opportunities for her daughter and felt she had been "robbed and the years of struggle could not be replaced". 

At her request, the advocate arranged a resolution meeting between the parties.  An agreement was drawn up with the following plan put in place.

• The aids would be adjusted as the child found them too loud for the movies. An appointment was made to do this the following week. 
• The DHB would pay the cost of two more visits to the private audiologist.
• The audiology department would then take over the management as they had upgraded their equipment and could offer testing and follow up on a par with the private provider.
• The hearing aids would not be removed.

The mother was very satisfied with the outcome of the meeting. 

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The importance of interpreters

Deaf Advocacy ~ Right 1 ~ Respect ~ Right 5 ~ Effective communication ~ Booking interpreters

The consumer's preferred method of communication is NZSL. On a recent visit to his GP he advised he required an interpreter, but one was not provided. Instead, a staff member from his home was used as a communicator during the consultation.

The consumer made his initial contact with the advocate by text and through this media it was agreed they would set up a Skype video call to discuss his concerns.

Having previously used the advocacy service, the consumer was aware of the Code and the assistance an advocate could provide. He advised the advocate he would like a meeting with the operations manager at his residence and requested the advocate arrange and accompany him to the meeting.

The consumer asked that the operations manager and house leader be present and advised he would be accompanied by a family member. The advocate requested the organisation arrange an interpreter to be present. 

Prior to the meeting the consumer and advocate met to discuss in detail his concerns, and the format of the meeting. At the meeting the consumer advised of his disappointment that an interpreter had not been organised and said he had been uncomfortable with having a staff member of his residence present during the consultation. The staff acknowledged his concern and explained it was hard to obtain an interpreter immediately during the emergency.

The operations manager agreed to ensure that residential staff would receive training on how to book an interpreter as the consumer did not believe they knew the procedure for booking through an agency. The meeting presented an opportunity for the consumer to also explain that he felt left out during the house meetings when no interpreter was present. The organisation staff acknowledged the consumer's concerns and agreed to book interpreters for house meetings and appointments. 

The operations manager reiterated residential staff would learn basic NZSL and more about Deaf culture. The consumer's key workers would be given additional training to improve their NZSL skills so that in the event of any emergency they would be able to communicate effectively while awaiting the arrival of a NZSL interpreter. 

The consumer was very happy with the outcome of the meeting; he felt that he had been heard. 

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Ignoring the needs of a Deaf consumer

DHB ~ Right 5 ~ NZSL interpreter

A consumer, who is Deaf, was taken to hospital with abdominal pain. She was accompanied by two support people, both of whom were Deaf. Upon entering the Emergency Department the staff were advised a NZSL interpreter would be required to enable the consumer to understand any information being given to her. Despite the request no interpreter was supplied that evening.

The following morning a doctor, accompanied by a NZSL interpreter, advised the consumer she would need to remain in hospital over the weekend. 

During the weekend, no interpreter was provided, with hospital staff instead electing to communicate in written English which the consumer found very difficult as it is a completely different language. She was discharged after the weekend and as no interpreter had been provided the consumer still did not know what was wrong with her.

The consumer contacted her support worker, who as a result of an earlier education session by the advocacy service referred the consumer to an advocate.

After discussing whether a letter or a meeting would be the best approach, she decided she wanted a letter sent. The advocate assisted by writing her letter in which she described how she had felt about not being informed or able to communicate with those caring for her. 

The hospital responded in writing. Their letter contained an apology, empathising about the lack of information and generally poor communication that the consumer had experienced while in hospital. The letter also contained information about her diagnosis, which she was pleased to receive. The hospital also acknowledged that an interpreter should be provided for patients during the discharge process to ensure information was understood, and they offered to meet with her. 

After considering the response the consumer advised that she was happy with the letter and that at that stage she did not consider a meeting necessary but she might take up the offer in the future. 

Problems with a Deaf Mental Health Service

Deaf Mental Health Service ~ Right 4 ~ Consistent with needs ~ Right 6 ~ Fully informed

A Deaf consumer, who spoke fluently as well as using NZSL, required the assistance of Advocacy. When her regular support worker from the Deaf Mental Health Service (DMHS) left she was advised that someone would take over until a new support worker was appointed. Three months later she still had not seen anyone, was concerned that she may become unwell without any support, and accessed a counsellor at her own expense. She had already attempted to contact the temporary support worker by fax and text as well as visiting the office, leaving numerous messages requesting contact. Her GP also tried to contact the support worker without success and in the end referred the consumer to the general Community Mental Health Service.

The consumer had attended an advocacy education session so was aware of her rights. After making contact with HDC and advocacy, she received an immediate response from the manager of the mental health service. The manager explained they had encountered great difficulty recruiting a suitable person for the role and apologised for the delay. Although she claimed to have responded to the GP's voicemail message, the GP had not received any messages from the manager.  The consumer found the response from the manager unacceptable and decided to discuss the situation with her GP, and use the support of the advocate to pursue her complaint.

Although the consumer accepted the apology, she wanted to meet with the manager to discuss the delay in receiving a response to her concerns.  The manager agreed to meet and to organise an interpreter for the meeting. In the meantime the consumer continued to receive support through the team organised by her GP.

Before the agreed date for the meeting a new support worker was appointed and made contact with the consumer. The consumer chose to continue with her complaint as she was concerned about how other Deaf consumers had been affected and felt the provider needed to address how the service is provided when they are short staffed. Prior to the meeting the manager contacted the consumer to seek permission for the two new support workers to attend as she felt they could learn something from the process. The consumer denied the request on the basis she wanted to discuss issues pertaining to previous staff and management.

At the meeting the consumer began with a prayer and went on to speak of her experience of not having support; how she felt she was left in the dark not knowing what was going on. She said they had failed to update her despite repeated messages requesting information. The consumer said she was surprised that the standard of care and management were not the same as for other health services.

The manager apologised for the lack of support and said she ought to have more actively supervised the team throughout that period. She was based at a different location to the Deaf Mental Health Service. As a result of the complaint she had advised her Manager that she was finding it difficult to effectively manage the two services. She also acknowledged the difficulty dealing with the sudden resignation of the former support worker. The consumer accepted what the manager had said and was happy and relieved that she had finally been heard. She ended the meeting with a prayer.

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Specific communication needs 

A woman with a hearing impairment had an outpatient appointment at her local hospital which she needed to postpone. Because of her hearing impairment she was unable to use a telephone. The appointment letter only supplied a phone number, so she looked in the phone book and used the hospital's multi-purpose fax number to notify them that she could not attend the appointment.

The woman wrote to the CEO pointing out that deaf people are disadvantaged by communication such as this. She received a letter from the outpatient department advising that they intended to include a fax number on all their appointment letters in the future, and advised her that if she experienced any similar communication difficulties in the future she should contact one of four named people. Unfortunately, only the phone numbers of the people had been provided.

The woman asked the advocacy service to contact the hospital to check that the fax number was operational, and to reiterate that phone numbers were of no use to someone who could not use a telephone.

The provider advised the multi-purpose fax was still operational, and that a further letter was being sent to the woman apologising for the error and advising that a systemic change would be made within the organisation ensuring that fax numbers would be included on all written information.

The woman received the letter from the provider and was happy with the outcome.

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Using interpreters to promote dignity and independence

A Deaf consumer requested advocacy assistance to address his concerns about the loss of dignity and independence in the rest home where he lived. He asked the advocate to arrange a meeting with the manager, organise an interpreter and to support him at the meeting.

Using the interpreter, the consumer was able to communicate his concerns to the manager. These included the manager communicating with his family instead of him. The meeting proved useful in that it provided an opportunity for the consumer to raise his concerns and discuss other matters such as medication and activities. It also provided an insight for the manager into interpreters, how they work, how to make a booking and how to access funding when an interpreter is required.

Following the resolution meeting the consumer told the advocate that he felt very empowered and said 'Just because I have a disability, it doesn't mean I have something wrong with my brain.'

As a result of the meeting the advocate identified there was a need to have information available about interpreters in the area, how to book them and information about funding. The advocate worked with local interpreters to develop a pamphlet which is currently being piloted.

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Communication in a diagnostic medicine setting

A Deaf consumer, who uses NZSL, went for a breast screen. Having been for a breast screen previously, she did not organise an interpreter. However, she had questions about the form she had to fill in and asked the technician to write her explanation down. Despite this request, the technician continued speaking, and the consumer left without having her mammogram.

The consumer contacted advocacy by text message, and asked for contact via Skype. Having heard the possible options for support, the consumer elected to request a resolution meeting with the support of an advocate, and emailed a request for a meeting. The meeting was agreed to and an interpreter was booked to attend.

The manager of the service advised that the technician had asked that an apology be put forward on her behalf. The consumer was able to get answers to her queries and an appointment for a breast screen was scheduled for her.

As a result of the meeting, the consumer was invited to a staff meeting to discuss the communication needs of Deaf consumers. Staff were instructed to ask Deaf consumers if an interpreter is required prior to their appointment, and if an interpreter is not present, information needs to be written down. The consumer was happy with the outcome of the meeting.