Understanding hidden disabilities (Case study)

Tennier is a new patient checking in at the neurology clinic for a follow-up appointment after experiencing a concussion.

Alina, the receptionist, notices Tnier is wearing a sunflower lanyard. She knows that the sunflower is a globally recognized symbol for hidden or non-visible disabilities.

She recalls that wearing the sunflower allows the person to request assistance without having to explain why they need help.

So instead of asking about the disability, Alina focuses her questions on how to support Tennir. Alina Welcome to the clinic.

How can I support you and help make your visit the best experience today? Tennir, thank you for asking.

I seem to be processing things slowly recently, so I may need additional time to fill out the paperwork, and I may have a few questions.

Alina, that's no problem at all. Here's a packet of our paperwork to fill out.

There's no rush, and please let me know what questions you have. I'll also let the clinic staff know if that's OK with you.

Tir, that would be great, thank you. Post-concussion syndrome is one of many hidden disabilities that can cause a variety of symptoms and may fluctuate in severity throughout the day.

Patients may experience headaches and fatigue, as well as cognitive symptoms like difficulty concentrating, confusion, slow mental processing, impaired ability to filter distractions, and decreased comprehension.

These symptoms reflect how an injured brain processes information and can make it harder for a person to communicate, making timely decisions, remember details, or complete paperwork or electronic forms accurately.

They are also typically not visible to those around them, which can cause others to think the affected person isn't paying attention, is ignoring them, or simply doesn't understand.

So although Tir doesn't have any visible symptoms to alert Alina that she may require additional assistance, wearing the sunflower symbol is a way to start a conversation about what support she needs.

Mario, the patient care technician escorts Tenier to the exam room. He asks Tenier questions about their history and notes that Tenn is slow to reply.

He also notices that Tenn appears fatigued after answering multiple questions in a row. He collects Tennier's vital signs, which are P 80 BPM, respirations 26 breaths per minute, BP 126/72 millimeters of mercury, and oxygen saturation of 99% on room air.

Tinnier also says they have a headache with a pain level of 3 out of 10. Mario documents the information in the electronic health record, or EHR.

Before entering the room, Hibba, the nurse practitioner reviews the progress notes from Tennir's previous emergency room visit, their current vital signs, and Mario's notes.

While examining Tennir, Hibba asks questions clearly and slowly, providing ample time for Tir to respond. As the visit continues, Hibba notices that Tir seems confused at times, which requires Hiba to repeat information.

Based on these findings, Hibba suspects post-concussion syndrome. She lets Tir know that Mario will bring her a tablet so she can complete a questionnaire today and again at each follow-up visit to monitor her symptoms over time.

Next, Mario returns with the tablet, shows Tenni how to use it, and asks her if she needs any assistance completing the form.

Tennir shares that it's difficult to focus on the screen since Mario recognizes that difficulty concentrating can be a non-visible symptom.

He offers to read the questions aloud and enter the responses for her. After reviewing the questionnaire, Hibba returns to the room.

She explains that Tir will need weekly follow-up appointments to monitor symptom improvement and recommends Tennir start vestibular physical therapy to help with recovery.

Given Tir's dizziness and difficulty concentrating, Hibba also confirms that she has a safe ride to and from physical therapy.

And because a common symptom after a concussion is difficulty remembering, she also suggests that Tir write down questions for her next visit to ensure that all Tir's questions are answered at the next visit.

Next, Susan, the nurse enters the room to go over Tenni's treatment plan. She provides Tenni with educational handouts and takes time to go over each handout individually, making sure to answer any questions Tenni has.

She shows Tenn how to scan the QR codes embedded in the handouts that link to patient education videos. These videos were created to support accessible communication, using consistent design features and easy to read fonts can improve digital accessibility.

All right, as a quick recap, the sunflower symbol is a worldwide indicator that an individual has a hidden disability. It's a way for people with hidden disabilities to communicate that they may need additional accommodation or support.

The health care team's awareness and knowledge of hidden disabilities informed the accommodations they made for Tnir, which limited her stress and confusion, fostered a sense of trust, promoted safety, and improved patient outcomes.

When Alina saw this symbol, it prompted her to ask Tir if she could provide additional assistance, which opened the lines of communication and made Tennir comfortable asking for support.

Mario observed Tenni's slow responses and fatigue and accurately documented the symptoms in the medical record. The accurate documentation of non-visible symptoms allowed Hibba to be prepared when talking with Teni, who supported them by asking questions clearly and slowly and allowing ample time for her to respond.

Susan ensured that patient education was accessible to Tir both through written and video communication. She explained the information step by step and allowed time for follow-up questions prior to ending the visit.