Better patient outcomes usually come down to great communication.
Not assuming anything, being clear, empathetic, and speaking in layman's terms.
But, the challenge increases for eye health practitioners.
With 55 per cent of meaning communicated through body language, and only seven per cent through spoken word[1], it is imperative health professionals maximise their communication skills for blind and low vision patients.
Psychologist Courtney McKee, who herself has low vision, regularly sees clients who have had bad experiences in consulting rooms.
“Health professionals know their specialty so well, they can tell you the ins and outs of a condition, but sometimes forget how important good communication can be,” she said.
“Give the patient the control in a situation; address them, not their carer or family member; explain the examination process before you touch them; and provide good verbal instructions that they can understand.”
Caption: Psychologist Courtney McKee.
Here are simple tips to communicate better with blind and low vision patients:
- Identify yourself
Don't assume the person will recognise you by your voice.
Eg. “Hi Donna, it’s Dr Smith. How’re you?”
Similarly, say goodbye when you finish a conversation and indicate when you are leaving the room. Eg. “Hi Donna, I’m heading off now. See you soon.”
- Talk to the patient, not their carer or family member
Remember, they’re not deaf. Address the patient, and if they’re over 18, they should be the one making the decisions on their healthcare.
- Continue to use body language
This will affect the tone of your voice and give a lot of extra information to the person who is blind or has low vision.
- Use everyday language
Don't avoid words like "see" or "look" or talking about everyday activities such as watching TV or videos.
Also use accurate and specific language when giving directions. For example, "the door is on your left", rather than "the door is over there".
- Always ask first to check if help is needed
Don’t assume you know better. Ask the patient if they would like some assistance. Don’t grab their arm, announce what you’re doing first.
Eg. “Would you like to take my arm and follow me to the consulting room? I’ll walk you to the chair.”
- Avoid situations where there is competing noise
This is a good general consulting tip for sighted patients too. Noisy rooms are particularly distracting to patients as they can’t give their undivided attention. Tip: in particularly noisy environments, get the patient to repeat any directions you give so you are confident they have understood.
- Announce what you are going to do
When examining the patient, announce what they should expect.
Eg. “Mrs Smith, I’m just going to use my hand to have a look at your left eye.”
- Modify instructions to match the lived experience of the patient
For example, if the person has no central vision, they may not understand how to “look straight ahead”. So they may prefer you to direct them to move their eyes left, right, up and down until they are positioned correctly for the assessment.
After speaking to many patients going through consultations, Ms McKee said the best piece of advice she could give is refer people to support services early.
“Many say they wish their doctor had connected them with vision rehabilitation services early, either by speaking to them about these services directly, by training their reception staff to have this conversation, or by simply having written information (e.g. brochures) available in the waiting area.”
For more advanced help, the sighted guide technique is a good skill to learn when you greet people and assist them to move between the waiting room and your clinic room.
Vision Australia provides training in this skillset and can work with you and your reception staff.
Contact Vision Australia on 1300 84 74 66
For more tips in assisting patients with a vision condition, visit Vision Australia’s website information section.
[1] Mehrabian, A., & Wiener, M. (1967). Decoding of inconsistent communications. Journal of Personality and Social Psychology, 6, 109-114 & Mehrabian, A. (1968). Inference of attitudes from the posture, orientation, and distance of a communicator. Journal of Consulting and Clinical Psychology, 32, 296-308.