LETTER TO THE EDITOR
Communication Accessibility in Isolation: The Invisible Factor
May 21st is Global Accessibility Awareness Day. Nowadays, most people are aware of the importance of mobility accessibility, but fewer are aware of the importance of communication accessibility for people with “invisible” disabilities such as hearing, vision or cognitive difficulties.
COVID-19 puts older adults at greater risk, especially those with health problems such as diabetes, chronic pulmonary diseases and heart conditions. What we have not yet realized fully is the invisible factor for those with hearing, vision and/or cognitive impairments. By 75 years of age, half of Canadians have hearing impairments; by 85, half have both hearing and vision impairments. Those with sensory loss are also more likely to have cognitive impairment. It is common for residents in long-term care to have a combination of hearing, vision and cognitive impairments. In other words, those who are at the greatest risk for COVID-19 may also be those with the greatest risk for isolation because of their need for communication accessibility.
Communication challenges have escalated as COVID-19 has altered the ways in which people interact socially because of the need for distancing and wearing masks. People cannot touch or hug. It is impossible to see a face and difficult to hear the emotion in a voice or the words being spoken through a mask. Hearing aids and glasses are not always used when people need healthcare, whether in an ambulance, the ER, or ICU, when receiving palliative care, or even having an elective surgery. While visiting is restricted, people with communication difficulties are often alone when health care decisions are made. The best health care cannot be provided without communication accessibility.
We will all need to find new solutions for communication accessibility as we adapt to the extremely challenging stresses of the pandemic. Hopefully, we will also learn some useful lessons that will improve communication accessibility into a future after COVID-19.
Organizations of people living with hearing, vision and cognitive disabilities, associations of specialized professionals working with them, manufacturing companies, and researchers studying healthy aging are working to find new made-in-Canada solutions. For example, some innovative people who are hard of hearing and audiologists have been making their own do-it-yourself masks with a clear panel and some are using clear face shields so that people can lip-read.
Researchers in the Sensory-Cognitive team of the Canadian Consortium on Neurodegeneration in Aging are pursuing collaborations with industry to produce medical-grade PPE options to improve communication accessibility in healthcare settings. Canadian clinicians who work with individuals who have sensory and cognitive impairments are developing ways to improve clinician-patient communication in a time of physical distancing, including telehealth. Other solutions to improve communication accessibility include the use of video conferencing with personal amplifiers and captioning or speech-to-text apps to help people see and hear better. Communication accessibility for some individuals may require other more specialized technologies or the use of sign language interpreters. But for everyone, simple, tried, tested and true communication tips may be very helpful, including patience, clear and slow speech, good lighting, minimal background noise, taking time to confirm that people understand, and including others who can facilitate communication and help to recall conversations later. We are looking for new ideas and solutions to overcome the invisible factor (ccnateam17.ca).
Everyone can benefit if we all become more aware of the importance of the senses and communication for overcoming isolation. Let’s make a visible difference!
Kathleen Pichora-Fuller, Professor, Psychology, University of Toronto
Members of CCNA Team 17:
Natalie Phillips, Professor, Psychology, Concordia University, Montreal
Walter Wittich, Associate Professor, Optometry, Université de Montréal
Jennifer Campos, Associate Professor Psychology, University of Toronto and Canada Research Chair, University Health Network
Dawn Guthrie, Professor, Kinesiology, Wilfrid Laurier University, Waterloo
Paul Mick, Assistant Professor, Medicine, University of Saskatchewan, Saskatoon
J.B. Orange, Professor, Communication Sciences and Disorders, Western University, London
Marie Y. Savundranayagam, Associate Professor, Health Studies, Western University, London
and colleagues:
Melissa K. Andrew, Associate Professor, Geriatric Medicine, Dalhousie University, Halifax
Inbal Itzhak, Knowledge Translation Specialist, CCNA, Montreal
Chantal Kealey, Director of Audiology, Speech-Language & Audiology Canada, Ottawa
Patricia Kéroack, Communications Specialist, CCNA, Montreal
Marilyn Reed, Audiology Practice Advisor, Baycrest, Toronto
Grace Shyng, Audiologist and Special Advisor, Wavefront Centre for Communication Accessibility, Vancouver
Christopher Sutton, CEO, Wavefront Centre for Communication Accessibility, Vancouver
Lyn Turkstra, Professor, School of Rehabilitation Science, McMaster University, Hamilton
Ruth Warick, President, International Federation of Hard of Hearing People and BC Chapter, Canadian Hard of Hearing Association