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MANAGING PATIENTS

Patients with disabilities: your guide to basic etiquette

For a patient with a disability, an accommodation isn’t enough.

Behind that disability is a normal person, albeit a person with challenges, and the office has to treat the individual as such, says Lydia Ramsey, business etiquette consultant and author of the book, “Manners That Sell.”

Patients come to the office because of the medical services it provides, she says. But it’s the people skills of the staff and physicians that establish relationships with them.

Here are the basic points of disability etiquette the office needs to follow.

Don’t overdo the handshake

Overly warm handshakes and reassuring pats are perhaps the most common area of failure, Ramsey says.

Many people – with the best of intentions – overdo greeting a person with a disability in an effort to convey reassurance and acceptance.

She gives a personal example of being introduced to a blind woman who put out her hand. Ramsey’s first impulse was to respond with a two-handed shake. But she realized that to do so would be demeaning. The woman didn’t want any favors because of her blindness. She expected to get the same handshake a sighted woman would receive.

Any unnecessarily warm wish given because somebody has a disability is offensive. It’s a sign of pity, “and that’s a put-down,” Ramsey explains. The etiquette of handshakes and pats on the back is the same for everybody.

Don’t talk to the interpreter

Another failing occurs when patients with disabilities come in with aides or companions, and the tendency is to direct the conversation to the companion instead of the patient.

That’s a real insult to the person with the disability, because it recognizes the companion as the more capable and responsible of the two, says Ramsey

The misdirected conversation is particularly offensive for the patient who has a hearing or speech disability and has to talk through an interpreter. Talk with the interpreter, but speak to and make the eye contact with the patient. It’s the person with the disability who is having the conversation, not the interpreter.

Search out the hidden obstacles

Then there’s the issue of obstacles in the office.

Look around for things that could be inconvenient or even pose a hazard, Ramsey says. They are easy to miss, because people without disabilities tend to view them as part of the normal environment.

Her advice is to follow the path patients take through the office and watch for things that could get in the way.

She gives the example of a chair placed so as to break up a long hallway. The placement may suit the decor and there may be no inconvenience in walking around it, but someone who’s visually impaired could trip over it. Or a patient in a wheelchair may not be able to maneuver past it and will have to ask someone to move it. Similarly, a deep carpet can be a severe obstacle for a wheelchair user.

Think how the layout of the office could pose difficulties. She gives the example of one client practice where the reception desk was in a corner a long way from the door. To a patient with a disability, the distance from door to desk “seemed like miles,” Ramsey says. The layout was especially unsuited for a medical office, because many patients who come in have disabilities.

Also, she says, be sure the office doesn’t make visits difficult for any patient, and “don’t be short on wheelchairs.” Anybody could come in with a temporary disability, such as a knee injury, and need one.

Plus a few specifics

Ramsey also lists etiquette elements for specific types of disabilities.

  • Hearing impairment.

When speaking about someone who has difficulty hearing, use the term hearing impaired. Use deaf only if the person has no hearing at all. And for a hearing and speech impairment, never use deaf and dumb, which is as bad as it sounds.

Speak slowly and clearly but no more distinctly than is appropriate for people who aren’t hearing impaired.

Don’t raise the voice unless the person requests it. Without a request, the louder voice is just rude shouting.

Speak directly to the individual so that person can read lips, and talk in an area where there’s enough light for the person to see the speaker’s face.

  • Wheelchair.

The correct term is wheelchair user, not wheelchair bound.

As for etiquette, the chair is a physical extension of the individual. Treat it as part of the person. To touch the chair is to touch the person.

Amazingly, that’s violated often, Ramsey says. It’s not uncommon for people to use someone’s chair “as an armrest or a footrest to make themselves comfortable,” she says. Neither is it uncommon for people to lean on a person’s chair.

Ramsey points out that this is “an offensive invasion of the person’s space” and as rude and inappropriate as using the person as a footrest.

Another point of chair etiquette is to talk to the patient at eye level. Standing over the chair makes it difficult for the individual to keep looking up. It’s also intimidating.

Sit down to talk. If there’s no place to sit, stoop down to eye level and then start the conversation.

  • Visual impairment.

Use the term visually impaired, not blind.

Don’t leave a visually impaired person in silence wondering what’s going on. If it’s necessary to turn to the computer to find something or to review a chart, explain what’s going on, perhaps “I’m going to read this document now” or “give me a moment while I write this down.”

With no explanation, the patient may feel ignored or think the other person has walked away.

  • Speech impediment.

If what’s said isn’t understood, ask the patient to repeat it. Everybody wants to be understood, Ramsey says.

Simply say “I’m sorry I did not understand that.” And if it’s impossible to understand the repeat, say “I’m sorry. I don’t understand. May I ask you to write that down for me?”

  • Any disability.

And no matter what the disability, speak to the patient in a normal voice.

Don’t change your tone of voice and don’t simplify the message. No matter how severe the disability, to do that is to treat the patient like a child.


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