Clinical

The Approach Formula: Accommodating Patients with Disabilities on the Spot

Dr. Sarah Elizabeth Moreman
Published on Jun 3, 2020. Updated on Sep 15, 2020.

In response to the novel coronavirus pandemic, an ideal on-the-spot approach in accommodating patients with disabilities is being shared. All-inclusive communications strategies can be used right now when interacting with a person, no matter the background nor (dis)ability. In this article, Dr. Sarah Elizabeth Moreman discusses the Approach Formula and how it can improve communication across the board.

COVID-19-imposed chaos has fundamentally shifted how health professionals care for their patients. The question of how to meet the needs of people with disabilities in these new circumstances makes it clear how marginalized this demographic can be. The sobering fact is that the ratio of people with a disability to people without is significantly small. According to the CDC, 1 in 4 adults in the United States have some type of a disabling condition, and the ratio is likely to be similar in other countries. Now is the time to remind current and future health professionals about the efforts and laws already in place to protect the civil rights of people with disabilities

Most people are at least vaguely aware of these laws and efforts, but that simply isn’t enough. We need to be acutely aware of how the healthcare needs of people with disabilities may be overlooked while the healthcare industry undergoes an abrupt, yet necessary transformation in response to COVID-19. Even before the outbreak, figuring out how to communicate with each individual with a disability could be exhausting and overwhelming, especially for people experiencing communication barriers. 

Osmosis illustration of text stating that the needs of people with disabilities may have been overlooked while the healthcare industry responds to COVID-19.

The Approach Formula

When it comes to figuring out how to communicate with any person, no matter the background or ability of that person, the important thing is to focus on relating with the person first before relating with the disability or issue the person may have. In other words, the crucial first step of establishing a connection with any patient with a disability is to acknowledge the person first and the disability second. 

Considering the unlimited range of disabling conditions and personalities of each person, a communications strategy that promotes connection within the practitioner-patient relationship is necessary. In pursuit of the seemingly unrealistic goal of developing an all-inclusive communications strategy, Dr. Sarah Elizabeth Moreman created a simple visual using three words: Attention—Adjust—Absorb. These words are meant to be a quick reference for medical professionals to remember and apply on the spot when communicating with persons with disabilities. This three-step formula in the form of an upside down triangle illustrates the importance of narrowing one’s focus down to the needs of the person by giving attention and adjusting communication styles before absorbing the most beneficial communication strategy with the other person. 

Osmosis illustration emphasizing the importance of recognizing the person first and the disability second.

Attention

Preconceived notions about people with disabilities are discouraged, as they hinder the relationship-building aspect of getting to know the patient as a person first. For instance, medical professionals should not immediately assume that a person with hearing loss uses sign language to communicate, nor does a person who is visually impaired necessarily use braille. When starting a conversation or entering into any type of interaction with a person with a disability, it is safe—and recommended—to do these two things first: 

  1. Maintain eye contact.

  2. Speak normally.

In addition to maintaining eye contact and speaking normally, pay attention to the other person’s body language and reactions. 

Adjust

Adjustment happens when the medical professional allows the interaction with the patient with a disability to evolve while looking out for audible or verbal cues the patient might rely on.  A person with visual impairment may want to be given audible cues to identify who is talking, whereas a person with hearing impairment may want to be given visual cues, like facial expressions, to understand the context of the conversation.  

Absorb

After recognizing the medical professional’s efforts to connect while communicating, the patient will feel validated and understood. At this point in the interaction, the medical professional and patient have connected by reaching a mutually beneficial communication strategy. 

Applying the Approach Formula on the spot

This Approach Formula serves as a quick, simple visual to help medical professionals discern how to empathize with feelings of uncertainty and self-conscious thinking in the patient. This is particularly useful during the time of COVID-19, which is anxiety-inducing and can easily fluster any person, especially those with communication barriers. It is crucial to help maintain the dignity of the person with disability.  

Using the traffic light concept, we must exercise caution when offering assistance to any person with a disability. The first step is to be cautious about offering assistance, rather than immediately foisting the proffered assistance upon the person. What if that person with a disability does not want assistance? Or, for whatever reason it may be, what if that specific offer of assistance offends that person? 

If the person says “no,” the medical professional may need time to process what kind of assistance will best fit that person’s needs. In other words, the person with the disability now takes the responsibility to request assistance. Once the person either accepts the offer for assistance or requests it, we can then ask for instructions and listen.  


Intensified Communication Barriers

Shelter-in-place and mask-wearing protocols exist to help flatten the curve so medical professionals can provide adequate healthcare during the pandemic. However, these protocols also intensify communication barriers, especially for those who rely on lipreading, touching, and sign language. Some—not all—people with disabilities have smartphones with at least one or two automatic speech recognition apps downloaded to help with the practitioner-patient interaction. Yet there are others who may not have smartphones or any other assistive technology when they enter the hospital or private practice. Apart from smartphones, iPads, and even laptops, medical professionals can still proactively provide technological assistance, like updating their websites with accessible instructional pages, ensuring that SmartTVs in reception areas display voice guidelines, and lowering music to help those who rely on audible cues. 

In situations where technology cannot be used to overcome the communication barriers, medical professionals can still use the Approach Formula to foster connection with patients and/or colleagues, even while wearing a face mask. Non-technological techniques include but are not limited to the following: 

  • Eye contact

  • Paper and pen

  • Questions (asking and listening)

  • Purposeful talk (some hearing devices help people better recognize words when spoken clearly)

  • Universal-friendly body language and gestures (not necessarily formal sign language)

  • Facial expressions (smiling does make a difference behind the face mask and helps with being approachable!)

  • Pictures/safety signage  

Osmosis illustration of a clinician smiling through her mask to help her patient feel at ease.

The focal point of the Approach Formula

The Approach Formula can be applied in any situation and is not limited to patients. The main takeaway from using the Approach Formula is to acknowledge the needs of the other person no matter what background and/or (dis)ability, especially in the area of preferred communication methods. This creative communications strategy serves as a reminder that we need to slow down by adjusting our communication methods to connect with others rather than defaulting to our typical communication standards.  

About Dr. Moreman 

As Creative Communications Consultant, Dr. Sarah Elizabeth Moreman, originally of Auburn, Alabama, shares her expertise on matters of creative communication strategies, disability awareness, compliance, DEI training, student-teacher interaction, and writing. Dr. Moreman serves as English Instructor at Jefferson State Community College of Birmingham, Alabama. When not teaching, public speaking, consulting, or doing marketing projects, she enjoys traveling to reconnect with friends and family, along with keeping healthy and fit taking Pure Barre and dancing classes. More information can be found via her website. 

  

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