Deaf Elderly Misdiagnosed with Dementia

Miss-Delectable · 08-21-2008, 02:33 AM

http://www.ivanhoe.com/channels/p_ch...?storyid=19511

Elderly deaf adults may score lower on mental health tests because of a language translation issue, new research shows.

David Feldman, Ph.D., a licensed psychologist and assistant professor of psychology at Macon State College in Macon, Ga., and colleagues looked at scores on the nationally used Mini Mental Status Exam. The exam is given by doctors to detect early signs of dementia and Alzheimer’s disease.

The researchers found deaf patients scored an average of 3 to 5 percent lower on the exam. They then examined the types of questions that brought down the scores of deaf patients. The investigators found those questions used complex language and language hard to translate into sign language.

“One of the reasons was, it’s language or communication issues rather than a cognitive impairment issue,” Dr. Feldman told Ivanhoe.

Dr. Feldman stresses the importance of hiring an experienced sign language interpreter, especially when seeing a health care provider or counselor.

“One of the problems is that when an older deaf adult is being tested by somebody, they’re automatically going to look like they’re demented even though they’re not -- and they’re going to look like [that] because of a language issue,” he said.

Since most of sign language involves body language, it’s easy to misinterpret what is being said, Dr. Feldman explained.

“There are a lot of people that think they can interpret because they know a couple signs, and you really have to be careful of that,” Dr. Feldman said. “There are a lot more nuances than if you are just translating from Spanish to English.”

The Gallaudet Research Institute estimates 29 percent of those over 65 are hard of hearing or deaf.

jillio · 08-21-2008, 09:12 AM

We find this occrring not just in dementia, but several other mental health issues as well. It is the topic of my dissertation. Status exams need to be revised to be more culturally/linguistically relevent.

Byrdie714 · 08-21-2008, 11:17 AM

There is a popular deaf nursing home outside of Columbus, Ohio that has a lot of deaf senior citizens.

Anyway I have to agree that the criteria for diagnosing dementia needs to be adhered to one's culture and language as I have meet many deaf senior citizens who were labelled, "dementia" patients--when they have no memory problems.

The sad part is that the hearing individuals that work there convinces themselves that the residents do suffer from dementia when in fact they don't.

Royale · 08-21-2008, 11:52 AM

The hearing medical and nursing staff members at the nursing homes and hospital need to be EDUCATED about the norms that the Deaf people tend to use and access such as sign language interpreters and VRI that the Deaf people require for better facilitation between them and the hearing medical and nursing staff.

jillio · 08-22-2008, 09:46 AM

Quote:

Originally Posted by Byrdie714

There is a popular deaf nursing home outside of Columbus, Ohio that has a lot of deaf senior citizens.

Anyway I have to agree that the criteria for diagnosing dementia needs to be adhered to one's culture and language as I have meet many deaf senior citizens who were labelled, "dementia" patients--when they have no memory problems.

The sad part is that the hearing individuals that work there convinces themselves that the residents do suffer from dementia when in fact they don't.

That particular place has been expanded to include not just a nursing home, but an independent seniors only apartment building. Its a wonderful place. A great community within a community. And the criteria for working with the deaf patients in the full nursing care faciltiy has been revised so that they are requiring knowlege of the culture. St. Vincent's has done the same. ADAMH has begun to recognize the implications of cultural considerations, but I agree with you that we need to keep pushing because we have not reached equity as of yet.

One of the things that I think is important is the use of an individual on staff that is not just fluent in ASL and knowlgeable in cultural considerations, but an actual Deaf communication specialist.

jillio · 08-22-2008, 09:52 AM

Quote:

Originally Posted by Royale

The hearing medical and nursing staff members at the nursing homes and hospital need to be EDUCATED about the norms that the Deaf people tend to use and access such as sign language interpreters and VRI that the Deaf people require for better facilitation between them and the hearing medical and nursing staff.

That, and much more.

Byrdie714 · 08-22-2008, 09:58 AM

Quote:

Originally Posted by jillio

That particular place has been expanded to include not just a nursing home, but an independent seniors only apartment building. Its a wonderful place. A great community within a community. And the criteria for working with the deaf patients in the full nursing care faciltiy has been revised so that they are requiring knowlege of the culture. St. Vincent's has done the same. ADAMH has begun to recognize the implications of cultural considerations, but I agree with you that we need to keep pushing because we have not reached equity as of yet.

One of the things that I think is important is the use of an individual on staff that is not just fluent in ASL and knowlgeable in cultural considerations, but an actual Deaf communication specialist.

Well knowing that it is 98% hearing staff and 2% deaf--still has a long ways to go. (I am referring to the nursing home part.)

fredfam1 · 08-22-2008, 10:00 AM

Jillio, I would like to do volunteer work with my kids at any nursing home that had Deaf residents. (I am a CNA and have worked in nursing homes facilities) How would I find ones closest to me? (Due to gas prices?) Would be great practice for me and kids and I could be an extra set of eyes for the Deaf.

Byrdie714 · 08-22-2008, 10:02 AM

Quote:

Originally Posted by fredfam1

Jillio, I would like to do volunteer work with my kids at any nursing home that had Deaf residents. (I am a CNA and have worked in nursing homes facilities) How would I find ones closest to me? (Due to gas prices?) Would be great practice for me and kids and I could be an extra set of eyes for the Deaf.

There is one in Gresham, Oregon and it's on the TriMet!

fredfam1 · 08-22-2008, 10:14 AM

COOL! Thanks Byrdie!

jillio · 08-22-2008, 10:22 AM

Quote:

Originally Posted by Byrdie714

Well knowing that it is 98% hearing staff and 2% deaf--still has a long ways to go. (I am referring to the nursing home part.)

Oh, I agree. A long way to go. Progress unfortunately, seems to be slow and painful.

jillio · 08-22-2008, 10:24 AM

Quote:

Originally Posted by Byrdie714

There is one in Gresham, Oregon and it's on the TriMet!

Thanks, Byrdie! You are quicker on the draw than I am this morning!

Gemma · 08-22-2008, 10:25 AM

Quote:

Originally Posted by Byrdie714

There is one in Gresham, Oregon and it's on the TriMet!

Actually it is on MAX - the light rail

Fred feel free to PM me

fredfam1 · 08-22-2008, 10:28 AM

I'll call the facility and ask which bus number goes there. I've never ridden Max before should be fun.

Gemma · 08-22-2008, 10:35 AM

Quote:

Originally Posted by fredfam1

I'll call the facility and ask which bus number goes there. I've never ridden Max before should be fun.

Look up trimet.org and it will give you very specific directions

Byrdie714 · 08-22-2008, 10:39 AM

Quote:

Originally Posted by jillio

Thanks, Byrdie! You are quicker on the draw than I am this morning!

That's what happens when one has 2 big mugs of coffee this morning!

jillio · 08-22-2008, 10:41 AM

Quote:

Originally Posted by Byrdie714

That's what happens when one has 2 big mugs of coffee this morning!

Ahhh....the Hazlenut Latte, huh?

Byrdie714 · 08-22-2008, 10:43 AM

Quote:

Originally Posted by jillio

Ahhh....the Hazlenut Latte, huh?

I wish! I prefer Almond latte instead. It was just a basic black coffee with cream and sugar.

Opps! We are having a conversation in the thread!

But back to your comment about progress at this particular nursing home, it just seems that the hearing staff is a little slow to accomodate the residents.

Byrdie714 · 08-22-2008, 10:47 AM

Quote:

Originally Posted by fredfam1

COOL! Thanks Byrdie!

Your welcome!

Here is more information on it: Seek Geo - Chestnut Lane - Nursing Home for Deafies

jillio · 08-22-2008, 10:48 AM

Quote:

Originally Posted by Byrdie714

I wish! I prefer Almond latte instead. It was just a basic black coffee with cream and sugar.

Opps! We are having a conversation in the thread!

But back to your comment about progress at this particular nursing home, it just seems that the hearing staff is a little slow to accomodate the residents.

Dang...I forgot about the "no conversation" rule!

And yes, I agree that accommodation has been slow in coming. Because the facility is overseen by ADAMH, it takes a change in the Board of Directors that results in a change in attitudes and perceptions. We have to keep up with a constant stream of advocacy.

fredfam1 · 08-22-2008, 11:26 AM

Quote:

Originally Posted by jillio

Dang...I forgot about the "no conversation" rule!

And yes, I agree that accommodation has been slow in coming. Because the facility is overseen by ADAMH, it takes a change in the Board of Directors that results in a change in attitudes and perceptions. We have to keep up with a constant stream of advocacy.

I asked my previous boss if I could volunteer to teach his staff 50 basic signs and he said they would have to volunteer to take the class on their own time as they could not afford to pay them to sit and take the class. They had one deaf person living there at the time.

Byrdie714 · 08-22-2008, 05:35 PM

Quote:

Originally Posted by jillio

Dang...I forgot about the "no conversation" rule!

And yes, I agree that accommodation has been slow in coming. Because the facility is overseen by ADAMH, it takes a change in the Board of Directors that results in a change in attitudes and perceptions. We have to keep up with a constant stream of advocacy.

I need some clarification please.....

ADAMH is Agency on Disabilities and Mental Health of central Ohio, correct? (Refresh my memory please.

)

Secondly--when you are talking about the Board of Directors--are you referring to ADAMH or the deaf nursing home???

jillio · 08-22-2008, 07:41 PM

Quote:

Originally Posted by Byrdie714

I need some clarification please.....

ADAMH is Agency on Disabilities and Mental Health of central Ohio, correct? (Refresh my memory please.

)

Secondly--when you are talking about the Board of Directors--are you referring to ADAMH or the deaf nursing home???

ADAMH is Adena Mental Health. It is now under the auspices of Adena Hospitals. And I was referringto their Board of Directors.

08-21-2008, 02:33 AM	#1 (permalink)
Miss-Delectable Capt Tony Nelson, Jeannie Join Date: Apr 2004 Location: No.1 Shopping Capital in Australia Posts: 9,692 Blog Entries: 3	Deaf Elderly Misdiagnosed with Dementia http://www.ivanhoe.com/channels/p_ch...?storyid=19511 Elderly deaf adults may score lower on mental health tests because of a language translation issue, new research shows. David Feldman, Ph.D., a licensed psychologist and assistant professor of psychology at Macon State College in Macon, Ga., and colleagues looked at scores on the nationally used Mini Mental Status Exam. The exam is given by doctors to detect early signs of dementia and Alzheimer’s disease. The researchers found deaf patients scored an average of 3 to 5 percent lower on the exam. They then examined the types of questions that brought down the scores of deaf patients. The investigators found those questions used complex language and language hard to translate into sign language. “One of the reasons was, it’s language or communication issues rather than a cognitive impairment issue,” Dr. Feldman told Ivanhoe. Dr. Feldman stresses the importance of hiring an experienced sign language interpreter, especially when seeing a health care provider or counselor. “One of the problems is that when an older deaf adult is being tested by somebody, they’re automatically going to look like they’re demented even though they’re not -- and they’re going to look like [that] because of a language issue,” he said. Since most of sign language involves body language, it’s easy to misinterpret what is being said, Dr. Feldman explained. “There are a lot of people that think they can interpret because they know a couple signs, and you really have to be careful of that,” Dr. Feldman said. “There are a lot more nuances than if you are just translating from Spanish to English.” The Gallaudet Research Institute estimates 29 percent of those over 65 are hard of hearing or deaf. __________________

08-22-2008, 10:00 AM	#8 (permalink)
fredfam1 Cathe Join Date: Sep 2007 Location: Oregon Posts: 1,024	Jillio, I would like to do volunteer work with my kids at any nursing home that had Deaf residents. (I am a CNA and have worked in nursing homes facilities) How would I find ones closest to me? (Due to gas prices?) Would be great practice for me and kids and I could be an extra set of eyes for the Deaf. __________________ http://mommasarmyboots.wordpress.com/

08-22-2008, 10:14 AM	#10 (permalink)
fredfam1 Cathe Join Date: Sep 2007 Location: Oregon Posts: 1,024	COOL! Thanks Byrdie! __________________ http://mommasarmyboots.wordpress.com/

08-22-2008, 10:28 AM	#14 (permalink)
fredfam1 Cathe Join Date: Sep 2007 Location: Oregon Posts: 1,024	I'll call the facility and ask which bus number goes there. I've never ridden Max before should be fun. __________________ http://mommasarmyboots.wordpress.com/

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08-21-2008, 09:12 AM	#2 (permalink)
jillio Banned Join Date: Jun 2006 Posts: 29,484	We find this occrring not just in dementia, but several other mental health issues as well. It is the topic of my dissertation. Status exams need to be revised to be more culturally/linguistically relevent.

08-21-2008, 11:17 AM	#3 (permalink)
Byrdie714 Banned Join Date: Feb 2005 Posts: 8,946	There is a popular deaf nursing home outside of Columbus, Ohio that has a lot of deaf senior citizens. Anyway I have to agree that the criteria for diagnosing dementia needs to be adhered to one's culture and language as I have meet many deaf senior citizens who were labelled, "dementia" patients--when they have no memory problems. The sad part is that the hearing individuals that work there convinces themselves that the residents do suffer from dementia when in fact they don't.

08-21-2008, 11:52 AM	#4 (permalink)
Royale Eek Doggah! Join Date: Feb 2008 Posts: 1,396	The hearing medical and nursing staff members at the nursing homes and hospital need to be EDUCATED about the norms that the Deaf people tend to use and access such as sign language interpreters and VRI that the Deaf people require for better facilitation between them and the hearing medical and nursing staff.