Barriers to Healthcare

Patients who have disabilities that do not affect their communication, frequently report serious challenges interacting with healthcare practitioners because of prejudice, perceptions of reduced quality of life experiences, ableism, discrimination, lack of knowledge and familiarity about their disability, as well as language and cultural differences.

In addition to these barriers, patients who have disabilities that impact on their communication, report that practitioners often do not consult them about healthcare decisions that affect them.  They report that practitioners may not understand how they communicate and restrict their communication to answering “yes” and “no” type questions.  There are numerous examples of practitioners either under estimating or over estimating the capacity of patients with communication disabilities to give consent.  In addition, the majority of practitioners have little or no training about the provision of communication accommodations and supports and often defer decision-making to family members or in some cases caregiving staff who do not have power of attorney to make these decisions and in some cases, have conflicting interests.

Barriers may include:

• Healthcare professionals not knowing how we communicate, or being able to understand our messages
• Healthcare professionals not having the time to communicate with us
• Healthcare professionals not giving us information in ways we can understand
• Hospitals not having appropriate communication tools and methods available for us to use in emergencies
• Hospitals not having trained communication assistants to support us to effectively communicate throughout our hospital stay
• Patient Intake and Admissions Services not being able to get accurate information from us
• Healthcare professionals not knowing how to obtain our informed consent to treatment and advance care directives
• Hospital not knowing their obligations to provide communication supports for people with communication disabilities as required by the law (Eldridge v. British Columbia (Attorney General) [1997] 2 S.C.R. 624)
• Hospitals not providing access the nurse’s call bell to get attention in an emergency