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Tips on How to Interact with Patients Who Have Mental Health, Intellectual, Learning Disabilities or Language/Speech Impairments

disability
The Accessibility for Ontarians with Disabilities Act ( AODA) is a law in Ontario that allows the government to develop specific standards of accessibility and to enforce them. Recognizing the history of discrimination against persons with disabilities in Ontario, the purpose of this act is to benefit all Ontarians by:

1. Developing, implementing and enforcing accessibility standards in order to achieve accessibility for Ontarians with disabilities with respect to goods, services, facilities, accommodation, employment, buildings, structures and premises on and before January 1, 2025
2. Providing for the involvement of persons with disabilities in the development of accessibility standards

The Patient Service Standard is the first to come into effect under the AODA. The standards require that all public and private sector businesses identify, remove and prevent barriers for people with disabilities in key areas of daily living. Barriers keep people with disabilities from fully participating in activities that most of us take for granted

When we think of people with disabilities, we tend to think of people who use wheelchairs and who have physical disabilities that are visible and obvious. Disabilities can also be invisible.
Any degree of physical disability that is caused by bodily injury, birth defect or illness. The AODA defines a disability as :

Physical reliance on a guide dog or other animal or on a wheelchair or other medical appliance or device. A condition of mental impairment or developmental disability

A barrier is anything that keeps someone with a disability from fully participating in all aspects of society because of their disability.

This week we will be presenting tips on how to interact with patients who have disabilities related to mental health, intellectual disabilities, learning disabilities and speech impairment.

Mental Health Disabilities

Mental health disabilities are not as visible as many other types of disabilities. You may not know that your patient has a mental health disability unless you are informed of it. Examples of mental health disabilities include schizophrenia, depression, phobias, as well as bipolar, anxiety and mood disorders. You also should not directly ask the patient if he/she has a mental health disability.

A person with a mental health disability may have difficulty with one, several or none of the following:

• Inability to think clearly, poor concentration, difficulty remembering
• Hallucinations (example: Hearing voices, seeing or feeling things that aren’t there)
• Depression or acute mood swings (e.g. From happy to depressed with no apparent reason for the change)
• Apparent lack of motivation

If someone is experiencing difficulty controlling their symptoms, or is in a crisis, you may want to help out. Be calm and professional and ask your patient how you can best help. Treat a person with a mental health disability with the same respect and consideration you have for everyone else
Be patient, confident and reassuring. Listen carefully and work with your patient to try to meet their needs.

Intellectual Disabilities

People with intellectual disabilities may have difficulty doing many things most of us take for granted. These disabilities can mildly or profoundly limit the person’s ability to learn, communicate, socialize and take care of their everyday needs. Here are some tips on how to interact with patients who have intellectual disabilities:

• Don’t assume what a person can or cannot do
• Use plain language and speak in short sentences
• To confirm if your patient understands what you have said, consider asking the person to repeat the message back to you in his/her own words
• If you cannot understand what is being said, simply ask again
• Provide one piece of information at a time
• Speak directly to your patient, not to their companion or support person

As much as possible, treat your patients with this type of disability like anyone else. They may understand more than you think, and they will appreciate that you treat them with respect.

Learning Disabilities

The term “learning disability” describes a range of information processing disorders that can affect how a person acquires, organizes, expresses, retains, understands or uses verbal or non-verbal information. It is important to know that having a learning disability does not mean a person is incapable of learning. It means that they learn in a different way.

Learning disabilities can result in different communication difficulties for people. They can be subtle, such as difficulty reading, or more pronounced. They can interfere with your patient’s ability to receive, express or process information.

You may not know that a person has a learning disability unless you are told. They can be subtle, such as difficulty reading, or more pronounced. They can interfere with your patient’s ability to receive, express or process information. You may not know that a person has a learning disability unless you are told

Tips on How to Interact with a Patient with a Learning Disability

When you know someone with a learning disability needs help, ask how you can help.

• Speak naturally, clearly, and directly to your patient

• Allow extra time if necessary – people may take a little longer to understand and respond

• Remember to communicate in a way that takes into account the customer’s disability

• Be willing to explain something again, if needed

Some people have problems communicating because of their disability. Cerebral palsy, hearing loss or other conditions may make it difficult to pronounce words or may cause slurring or stuttering. They may also prevent the person from expressing themselves or prevent them from understanding written or spoken language.

Interacting with Patients Who Have Speech or Language Impairments

Don’t assume that because a patient has difficulty speaking that they have an intellectual or developmental disability. Also don’t assume that a speech impairment means that they cannot hear you. Ask your patient to repeat the information if you don’t understand. Ask questions that can be answered “yes” or “no” if possible. Try to allow enough time to communicate with your patient as they may speak more slowly. Don’t interrupt or finish your patient’s sentences. Wait for them to finish.

How to Interact Over the Telephone

Speak naturally, clearly and directly. Don’t worry about how the person’s voice sounds. Concentrate on what they are saying. Don’t interrupt or finish your patient’s sentences. Give your patient time to explain or respond. If you don’t understand, simply ask again, or repeat or rephrase what you heard and ask if you have understood correctly

If a telephone patient is using an interpreter or relay service, speak naturally to the customer, not the interpreter. If you encounter a situation where, after numerous attempts, you and your patient cannot communicate with each other due to the patient’s disability, consider making alternate arrangements

Staff Training

Your dental team must be trained on your policies, practices and procedures relating to the provision of your services to people with disabilities. Compliance with ADOA begins with training all team members to learn how to interact with guide dogs or other service animals, learn how to interact with people with disabilities who are accompanied by a support person, to know what to do if a person with a disability is having difficulty accessing your services.

All patients deserve access to dental services. Dentistry is a relationship business built on trust. In order to build a trusting relationship with all of your patients, communication is key. Removing barriers to communication is the best way of building and sustaining a positive long term relationship with all of your patients. For more information about how to interact with patients with disabilities or if you would like to receive a copy of past articles, please send an email to sandie@dentalofficeconsulting.com with the subject line AODA past articles. The previous articles were:

1. Accessibility for Ontarians with Disabilities Act Patient Service Standard
2. Interacting with Patients who Have Hearing Loss
3. Interacting with Patients who Have Vision Loss

The next article will be – Interacting with Patients with Assistive Devices and/or Service Animals

Source: Public Services Health and Safety Association

About author
Sandie Baillargeon is a leading authority on how to increase the effectiveness of medical and dental business systems. Ms. Baillargeon is author of two text books, Dental Office Administration and The Canadian Dental Office Administrator, published by ITP Nelson Canada. Sandie is the owner and operator of Dental Office Consulting Services, which specializes in dental business planning, staff development, consulting and continuing education seminars. Visit her website at www.dentalofficeconsulting.com or contact her directly at (905) 336-7624.
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