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DOING IT RIGHT EVERY TIME - PROVIDING ACCESSIBLE SERVICES TO THE DEAF IN ACUTE CARE AND PALLIATIVE CAREMONICA ELAINE CAMPBELL: Good morning. We, Monica Elaine Campbell, Christine Wilson and Monique Dozois, are pleased to be making this video which is a replica of a presentation we have made at several national conferences and to numerous community organizations. Who are we? We are current or past members of Ottawa Deaf Health Care Team serving the Deaf community in palliative care, long term care and acute care. We are volunteers and participants on many boards, committees, advisory boards and organizations. We received numerous awards for advocacy and active citizenship. Monica Elaine Campbell. I was born with profound deafness at birth. I attended Prince Edward Island Oral School for the Deaf. Then in mainstream at both senior high school and university, I received a Bachelor of Science degree, honors in mathematics. I was employed by provincial and federal governments for 11 years. I received an honors certificate in multidiscipline palliative care at Algonquin College. Monique Dozois. She was born profoundly deaf. She attended an oral deaf class in Ottawa from ages four to 12, and Sir James Whitney School for the Deaf for six years. She worked for the Deaf Outreach Project, providing services in the Deaf community for HIV/AIDS clients and at Bob Rumball Center for the Deaf as a life skills staff for two years with clients with a developmental delay. She’s an American Sign Language instructor at Algonquin College.Christine Wilson. She is an ASL English interpreter. Her first language is ASL, as her parents were Deaf. She is a registered nurse by profession and works with special needs populations and established a non-profit organization in 1979 to provide group homes for individuals with multiple disabilities and deafness. For more information. If I have to enter a hospital for treatment as a Deaf person relying on both speech reading and sign language, I would want to know who will take care of me and what the staff know about how to accommodate my needs. The staff at the hospital should ask themselves how they can manage a Deaf patient’s needs and where to get qualified information to fully accommodate the patient’s needs. For example, it is the right of a Deaf person to have access to qualified interpreting services. Christine will speak about that shortly. To facilitate your understanding the remainder of this presentation, I wish to quickly explain the distinction among the Deaf with the letter “D” in upper case upper case, hard of hearing, deafened and oral deaf, and the languages used by these groups.The term “hearing impaired” is sometimes used by people to describe those with partial hearing loss. It is a medical or audiology term. But the term is considered by many people, especially in the Deaf community, to be politically incorrect, because the word “impaired” seems derogatory and implies that something is wrong with the person. The more accepted terms used to identify distinct groups of people with hearing loss are Deaf with the letter D in upper case refers to members of a socio-linguistic and cultural group whose language is sign language. The culturally Deaf share a common sense of pride in their language and culture. They seek each other out for social interaction and emotional support. Deafness is natural to them – it is a positive identity NOT a disability.Hard of hearing refers to those whose hearing losses range from mild to severe and who use their voices and residual hearing and occasionally sign language. Deafened refers to individuals who have lost most or all of their hearing, usually as teens or adults. They use spoken language and rely on visual forms of communication, such as speech reading, text and occasionally, sign language. Oral deaf are those who were born deaf or became deaf pre-lingually, but do not use sign language. I identify myself as oral deaf and learned sign language as an adult. All of these groups may use hearing aids, cochlear implants or other assistive devices, but more rarely so in the culturally Deaf group. During the presentation, we will be talking mostly about the culturally Deaf. However, you can apply most of the content of the presentation to the other groups of persons with hearing loss. CHRISTINE WILSON: You may remember the ceremony that was held as a commemoration of Nelson Mandela's life after he died. This was obviously, the former President, Barack Obama, speaking. And the gentleman in the middle, if you were watching it on TV, was the interpreter. This was in South Africa. I was watching it and the gentleman signed away. I had no idea whether he was signing correctly or not, because each spoken language has its own sign language. Well, it turns out this gentleman is a fraud. He is not a sign language interpreter. He is used many, many times in South Africa and people have complained. Who have complained? The Deaf community. They knew he was not a sign language interpreter, but nobody listened to them. So, it's very important to know that you have a professional, qualified interpreter. And when you watch somebody signing, I guess you have to ask yourself, do I know whether this person is qualified? Is it a qualified interpreter? Does this person really know what they're signing? So, ignorance is a liability, if you do not have a professional, qualified interpreter. Some providers of health care and police services here in Ottawa are doing the same thing. They're using non professionals to provide interpreting services. The presentation today is going to give you the knowledge about accessibility for the Deaf community and where to go and get the answers about truly accessible services. We need those kinds of services in hospitals, hospices, medical clinics, the Champlain LHIN Home and Community Care, which used to be the former CCAC. All of these have to provide interpreters when they have a Deaf client (consumer) coming for services. Canadian Blood Services are a good example of having accessible services. For many years, Deaf people in Ontario could not give, could not donate blood. And the reason was, that when you go to donate blood, you are asked to have an interview. And you have to fill out an extensive questionnaire about your sexual practices, your history, et cetera. And it was felt by the Blood Services that they would not accept the answers through a third party. And an interpreter was considered a third party. Deaf individuals fought this. And the Canadian Blood Services needed to know how they could fix this situation. So, there's quite a simple solution. In fact, if you make sure that when you are hiring an interpreter, that the interpreter is a professional and is a member of AVLIC (now, CASLI), which is the Canadian professional organization for interpreters in Canada. We are all strict followers of a very strict code of ethics. We are professional interpreters. And we take our ethics very seriously. And so basically, Canadian Blood Services will bring in an interpreter who is a member of AVLIC (now CASLI), who signs the documents that are needed for confidentiality, et cetera. And since then, Deaf Canadians have been allowed to give blood. And if you go to the Canadian Blood Services website, it's very clear in terms of how to go about doing this. And I think it's a real success story, because they just went to the people who had the answers and got the right answer. And it was to them, quite simple to institute. Having a qualified professional interpreter is a right. It's not an extra, it's a right. And I would say any organization that doesn't bring in a professional, does have a liability if it's proven that the interpretation was faulty. It's expensive. There's no other way around it. Interpreting services are expensive. But it takes a long time to become a truly well-trained professional. In excess of 10 years, I would say, because first you have to learn the fluency of the language. And then secondly, all the professional skills of being an interpreter. MONICA ELAINE CAMPBELL: The goals of the presentation are to learn about the experiences of the Deaf when they access services. In other words, to have you walk in our shoes. To gain a Deaf perspective if a patient or a family member is Deaf. To understand how service providers can communicate with the Deaf effectively to enable them to make well informed health care decisions. To look at the crucial role of interpreters, Deaf interpreters and Deaf volunteers in palliative care and long term care and acute care. To raise awareness of questions to ask to ensure accessible services for Deaf patients. These are Deaf volunteers with a deaf patient in a long term care home. CHRISTINE WILSON: I'm going to speak a bit about the Canadian political landscape, in terms of accessibility to care. In the year 2000, the Canadian Senate issued a report which demanded better access for all Canadians to hospice palliative care. This was a landmark, because at the same time, Senator Sharon Carstairs had this report translated, interpreted into an ASL version of it. And the Deaf community really appreciated that. And for the year 2000, that was a real start to providing accessibility in video formats. In 1997, the Supreme Court of Canada ruled in a case that's known as Eldridge versus British Columbia. It was a huge landmark ruling, which we'll speak about a little bit later in our presentation. In 2005 in Ontario, the Ontarians with Disabilities Act was passed, and it will come into full force by the year 2025. You might think 20 years is a long time to have an act come into full force, but it's going to take a while for businesses, institutions, organizations to become fully barrier-free. And barriers exist for many groups. And if you happen to be a person with a disability or you happen to be an aboriginal or part of a visual minority, then you would face different barriers. But if you happen to have intersectionality between one, two or three of these or more, then the barriers are compounded. It's not just an addition, it's compounded, it's a multiplying effect. MONICA ELAINE CAMPBELL: Accessibility. Ramps, automatic door openers, Braille on public elevator buttons and accessible washrooms define accessibility for many. For the Deaf community professional, qualified interpreters DEFINE accessibility. SACHA: We had to argue with people at the hospital. It would've been so much easier to just bring in an interpreter, so my mother could understand what was going on. SACHA: As a hearing child with two Deaf parents, you can imagine how hard life growing up can be. At 21 years old, I became very ill and we went to a local hospital. My mom met me there. We had an MRI scan done. At that time, we requested an interpreter be brought in, so my mom could understand what was going on with the situation. As I was on medications, I couldn't interpret for her properly. They fought with my mother, saying it wasn't a big deal. They would try, but no promises. The results came in. And they told me I had brain cancer and I needed to be rushed to the next biggest hospital. With an IV intact in my arm, we rushed over to the next hospital. Beforehand, my mother had profoundly expressed how she wanted to have an interpreter present. When we arrived, the people at the hospital had no idea what we were talking about. We argued with the front door staff. Here I am, being the patient, having all these medications inside me, not knowing what's going on, thinking I have brain cancer, interpreting for both my parents, not even being a qualified interpreter at the time. And all along, just thinking, what am I going to do with the situation? It would be so much easier if they would just bring an interpreter and have communication for my mother, who during his time, needed to know what was going on. MONICA ELAINE CAMPBELL: The Deaf community. What is different? These are Deaf people's experiences, not what hearing people would experience. Several factors impact how Deaf people deal with health care, illness, hospitalization, death and dying. These factors include primary language, whether they had residential and/or mainstream experiences. Whether they had Deaf parents or hearing parents. When hearing loss was acquired, et cetera. 90% of Deaf children are born to hearing parents. Some families may learn basic sign language or develop home signs or gestures. Many Deaf children do not have access to, or the chance to learn, ASL as a first language. Some Deaf children may not develop much language at all. Where there is lack of language, we see “supper table syndrome”. because parents, siblings and peers cannot interact with the Deaf. To better understand this syndrome, think of family members sitting around sharing about each of their days. They discuss positive and negative experiences, tell jokes or have light hearted conversations. All these interactions at the supper table are opportunities to learn language, appropriate social etiquette and behaviors. But if Deaf children or even Deaf adults miss out on such conversation, they do not have the opportunity to learn vital skills. Family members tend to bounce back and forth between who is talking. They talk over each other, resulting in the Deaf person feeling lost. Most of their time is spent trying to figure out what is going on. Perhaps they cannot even participate in the conversation. When a Deaf person truly wants to know what is going on, he may tap on a family member's shoulder and ask questions through gesture or some ASL like, “What is everybody laughing about?" There is a tendency for a family member to respond “Oh, it’s not important.” or “I’ll tell you later.” as repeating the information the Deaf person is seeking is time-consuming. Other factors that impact the Deaf in health care are negative attitudes and stereotypes towards people with disabilities in general. There remains among some professionals a lack of understanding about Deaf culture and access needs. Also, there is a limited pool of interpreters, intervenors and Deaf interpreters. Although I am a very good speech reader, it is important to remember that only about 30% of the English language is visible on the lips. Generally, the best lip readers on average get about 50% of what people say. So, I benefit greatly from using sign language in addition to speech reading. MONICA ELAINE CAMPBELL; It is hard to describe the feeling of having full access. It put me on a level playing field and helped me better deal with my grief.MONICA ELAINE CAMPBELL: Two and 1/2 years ago, my oldest brother died rather unexpectedly. I flew home to Charlottetown to attend his wake and funeral. In that area, there are no interpreting services available. I've been profoundly deaf since birth and never heard a word. Although I am an adept speech reader, how much I can speech read depends on many factors. For that reason, I really prefer to have the use of interpreting, sign language interpreting services to ensure that I have full access to information. Much to my relief and delight, two interpreters who were also friends traveled to Charlottetown to interpret at the wake and funeral. It's hard to describe the feeling that I experienced in having full access to information being communicated. I could not help but think about the time of my dad's wake and funeral, how isolated I felt, because I did not have access to interpreting services. A few months ago, my mother passed away. And again, I was provided with an interpreter who was also a dear friend. That really put me on a level playing field and helped me to better deal with grief.MONIQUE DOZOIS: This picture is a group of women, and they're all Deaf. They went to the same school for the Deaf. Usually, they would stay together as close friends after graduating. This group of ladies are supporting Betty-Ann, who's in the middle with glasses and bald head. She's not well, and her friends were there to support her. After graduation from a school for the Deaf, friends stay in touch. They stay in touch forever. They are as strongly connected as family members. I often ask hearing people, when you graduated from school, did you keep in touch with your classmates? The last time I made this presentation at a conference I asked the audience and very few people said they had kept in touch. It's very interesting, the differences. I'd like to speak a little bit about American Sign Language, the culture of the Deaf and their language. It's not the same as English. It depends very strongly on facial expression, body language. It has its own syntax and grammar. It's almost like an enhanced 3D. Hearing people learn language through hearing words. For Deaf people, they learn language through their eyes. They pick up words through their eyes and what they see. Here are all the people you might find on an interdisciplinary team. You can see the list is extensive. For example, dietitians, cancer therapists, long term care staff. If a person is sick and they need services, these are the type of people who would be giving them service. But if a Deaf person comes for service, you need to be sure you have certain things to meet their needs. Are there interpreters? Are there intervenors if you are Deafblind? Do you include those named here that are in red? Interpreters, intervenors, Deaf team members on the Deaf Palliative Care Team, Deaf volunteers or Deaf interpreters? If you don't have them in your service, we encourage you to please include them, so that when a Deaf person comes, trying to access service, their frustration will be much less, because you will be providing accessible services to meet their needs. MONIQUE; Volunteers stayed with her at the hospital and were with her when she died, and supported her Deaf husband to help him understand what was going on. Claire, who was Deafblind, went to the hospice as she got closer to the end of her life. The Deaf Palliative Care Team supported her there and helped the staff to communicate with her. Claire had to learn who people were. And to identify them, she would find a marker, such as one doctor, who had a lovely long braid, and Claire would touch the braid and know who it was. Another staff member had a beautiful bracelet. Claire would touch it and would know who the person was. And it helped her, and it helped the staff understand how to communicate with her. Claire's family, her granddaughter and daughter, were estranged, and had been for many years. We were thankful that there was a member of our team who found the family and were able to reunite Claire with her family. It was lovely. The team had a birthday party for Claire and brought her favorite apple pie and shared it with Claire. As Claire neared the end of her life, there were two volunteers who stayed with her and with her husband, who was also Deaf, to support them as she neared the end of her life. It was beautiful. This is a picture of Claire, who's in the middle. Remember, she was Deafblind. On her left is her daughter and on her right is her granddaughter. CHRISTINE WILSON: Communication is a very important part of care delivery. Whether you have your discussion in person with a doctor, a therapist, whether it's in private, in comfort of your own home or in a health care institution, a hospital, a clinic, whatever, importance of clear, simple language and telling the truth in terms of getting your medical information and your treatment options. I think everybody who listens to this presentation will say, yeah, I require that. When I'm sick or I have a problem, I require to be told very clearly what my issues are and what my care options are. And it's exactly the same for Deaf people. But in order to get that truth and full message, they need access through an interpreter. And that's basically what the Eldridge decision in the Canadian Supreme Court in 1997 was all about. I referred to it earlier. In their ruling, two people, two Deaf people in British Columbia had taken their case to the British Columbia Supreme Court. And they argued that they had been denied appropriate care in a hospital setting for very complicated cases because they were denied sign language interpreters. They took the case far as they could, right to the Supreme Court of Canada. And the Supreme Court of Canada sided with them and said, yes, of course they should have had full access through a sign language interpreter to all of the information they needed in order to have full information for what was necessary for their care. You can imagine how scary that must have been to be in hospital facing communication difficulties in a complicated medical situation. What surprised all of us who were there that day, I was interpreting for the Deaf people who were there to hear the decision from the Supreme Court, was the Supreme Court went on to say, and I'm going to read, that each of the appellants in this case were born deaf. Their preferred means of communication was sign language. They contended that the absence of interpreters impaired their ability to communicate with their doctors and health care providers, and thus, increased the risk of misdiagnosis and ineffective treatment. The Supreme Court of Canada ruled that sign language interpreters must be provided in the delivery of medical services where doing so is necessary to ensure effective communication. Well, that was 20 years ago, more than, well, yeah, 20 years ago. And it isn't even fully actioned across Canada. In a recent study that went across Canada to see if sign language interpreters truly were provided, it was found that, no, they were still lacking in many areas. And so, the battle goes on and the need for services continues. The court also went on to say that in many circumstances, the government would have to take action or special measures to ensure that disadvantaged groups are able to benefit equally from all government services. People were surprised with that. It was basically the court was saying, not just health care, but ALL services that governments provide. And so, we're still a long way from that. We also talked earlier about the Ontarians with Disabilities Act, which ensures that decision-makers at all levels of service are going to provide appropriate services to the Deaf as A right, not just oh, you're here, wait, I'll do you a favor, I'll get you an interpreter. It's a RIGHT!MONICA ELAINE CAMPBELL: In this photo, the Deaf women are sharing experiences in education on palliative and acute care needs of the Deaf. Acute care volunteer support. Our Deaf team members not only provide support and serve as advocates in hospice palliative care and long term care, but also in acute health care settings, such as emergencies, inpatient units, psychiatric units, medical clinics, et cetera.Partnerships in health care for the Deaf. To achieve effective services in health care, we must have partnerships. The members of our Ottawa Deaf Health Care Team are volunteers who are trained to help. Qualified interpreting services are provided by Sign Language Interpreting Associates Ottawa, and Canadian Hearing Society's Ontario Interpreting Services. CNIB provides intervening services for the Deafblind. We need full access to ASL or LSQ. Qualified interpreters and intervenors, qualified Deaf interpreters who usually work in tandem with hearing interpreters. Deaf interpreters are particularly useful if communication by a Deaf patient is unique, such as having minimal or limited communication skills or use signs that a hearing interpreter may not be familiar with. These signs can be non-standard signs, “home” signs, foreign sign language or signs unique to a region the Deaf patient came from. A Deaf interpreter may have a better understanding of what the Deaf patient is communicating than a hearing interpreter. We also need cultural facilitation and trained Deaf workers and volunteers. CHRISTINE WILSON: So, it's very important, I think you've all gathered, to include professional, qualified interpreters and intervenors to ensure clear communication. And remember, it's a conflict of interest if you have a family member or a friend do the interpreting. Because they may very well have their own needs and be very affected by the situation. Earlier you saw a movie with Sacha, who was talking about her issues in the hospital. Her parents were demanding an interpreter. She was undergoing tests for a possible brain tumor. And her parents were denied an interpreter. She was a teenager at the time, and she was being expected to interpret for herself. MONIQUE DOZOIS: A Deaf person upon finding out that they had HIV/AIDS, wasn't quite sure what to do. But they knew there was the ACT, the AIDS Committee of Toronto, and decided to go there for some support. But they had never served a Deaf client there. And so, they wondered what to do, but they got together with the mental health services of the Canadian Hearing Society, some Deaf persons with HIV/AIDS, interpreters, representatives of the Deaf community and themselves, the ACT. After some discussion, they decided they would establish the Deaf Outreach Program, the DOP. That was in 1987. By 1998, it was decided that it was time to transfer the DOP to the Ontario Association of the Deaf, OAD. It's still in operation today. What did the Deaf Outreach Program do? It was very beneficial. There were two Deaf staff, one interpreter and one hearing staff member, all who could sign. The program is four days a week. And the role included supporting Deaf clients with HIV/AIDS to access services to meet their needs. Educating service providers, such as long term care homes, cancer treatment centers, et cetera, on how to accommodate the Deaf community and provide accessible services. It facilitated the information and knowledge for accessible services. It included workshops, training, training of volunteers, events, et cetera. There was a real team approach. The benefit for hearing people was that they could work as part of an interdisciplinary team with Deaf people. For example, at the Casey House Hospice, with the ACT staff and other health care professionals working together with the DOP, shared information and worked together. It was wonderful. Here are three examples of service provided by the DOP. A hearing person, who was deaf as a result of illness, contacted the ACT staff, who in turn, contacted the DOP for information on how to communicate, making use of the TTY, how to access services. It was great. Another story. A Deaf person, who was in hospital, seriously ill, partially paralyzed, experienced difficulty communicating. It was quite a challenge. He was signing “green”, “green” over and over. The Deaf interpreter came and said, “Do you want ginger ale in a green can or a green apple?” The patient answered with a slight no, pointed down with a head motion. The DI looked, following the patient's eyes, saw a green blanket and the Deaf patient went, YES, he was cold. A horrific situation also came about when a Deaf person, who was very stubborn and breaking the rules in hospital and frustrating the staff, but the nurse, in frustration, tied this Deaf person's hands to his wheelchair. He was very upset and paranoid. This was physical abuse and denying the patient's rights to communication. It's as if a hearing person was being forced to wear headset that was soundproof and having duct tape over his eyes and ears and mouth. How would you feel? MONICA ELAINE CAMPBELL: Why Deaf professionals and volunteers? Because we are sensitive to the social and cultural issues of the Deaf. We share the same language. The involvement of a patient's family members is variable. As I mentioned earlier, 90% of Deaf children are born to hearing parents, of whom very few are fluent in ASL. As Monique explained, many Deaf consider their Deaf peers to be their family too. We can educate health care professionals and serve as advocates for the Deaf patient and their families. MONIQUE DOZOIS: An interpreter from the Deaf Palliative Care Team helped me spend quality time with my aunt, so I could have a final conversation with her before she died. It was a blessing.My aunt Terry, who was very special to me, we were very close. She was like my second mom. She was hearing, I'm Deaf. She couldn't sign, although she could finger spell and gesture. But mostly we wrote back and forth. When she was very ill and nearing the end of her life, she couldn't write as much as she would like to. An interpreter from the Deaf Palliative Care Team came with me, so that I could spend some time with my aunt and have that final conversation interpreted by the interpreter. It was wonderful to spend time together with my aunt before she died. It was a blessing. MONICA ELAINE CAMPBELL: Here are some members of the Deaf Palliative Care Team and friends with a Deafblind patient at Elizabeth Bruyere Palliative Care Unit. We formed a great working relationship with EB's staff. Professionals had great confidence in our resources serving the patient. Our goal, mission. To enable Deaf patients to make well-informed decisions in their health care. It is essential that communication, cultural and institutional barriers are removed. The KEY is to treat the Deaf patient as the centre of care to fully involve him or her in decision-making. MONIQUE DOZOIS: In 2001, for the first time ever, three Deaf people took the hospice training course at the May Court Hospice in Ottawa. It was a 13-week program. In 2009, a larger group, six deaf people and one interpreter, took the training, the same training, in fact. And again, in 2015, six Deaf people, six ASL interpreters and two LSQ interpreters enrolled for the 13-week program. Classes began with a lecture. There were hearing people and Deaf people. After each lecture, we would divide into discussion groups and the Deaf group would meet together and look at issues through their experiences and decide what was good to do, what wasn't good, et cetera. After the course, team members were able to support Deaf people who needed help in hospice, in hospitals, long term care, acute care or therapy. CHRISTINE WILSON: So, you've heard a lot about interpreters and intervenors and how it's important to have professional sign language interpreters when needed. But communication is two ways. And so, if Monique and Elaine and I were standing here in front of you right now communicating in sign language, it would be you who need the interpreter, not us. Because we would understand what we were talking about, but you wouldn't, unless you were fluent in sign language, and maybe some of you are, I don't know that. So, it's a two-way street. We're all responsible for making sure that interpretation, and communication is clear. And so, you need to be ready when a Deaf person comes to access your services. Interpreters are professionals. They're not volunteers. So, you have to budget for the possibility of needing to have interpretation. Sign Language Interpreting Associates, SLIAO, has a philanthropy arm to their business, and the efforts have always been directed to long term care and palliative care work and initiatives within the Deaf community, to ensure that some services are provided, whether the organization has an ability to pay or not. And that has been very helpful. For example, in the hospice palliative care course at the May Court, the first time interpreters were provided by SLIAO, there was no charge to the organization. But of course, the interpreters were paid. And the second time (SLIAO was), Hospice Care Ottawa was able to apply for some funding and they got a grant in order to pay for the interpretation. So, we are all responsible. We need to be ready when the Deaf person comes. It's not the day that the Deaf person shows up that you start finding out what you need. You need to find out beforehand. Chances are, as a professional, you may only meet a Deaf person once in your whole professional career. But you really need to know where to go to get the information you're going to need. So, at the end of this presentation, you'll see the contact information for us. We're happy to mentor groups. We're happy to answer questions, whatever we can. All children of Deaf adults do not sign as their first language I did, because my parents didn't actually use their voices to speak. They used their voices to make sounds. As children, my siblings and I knew when our parents were mad at us, because we could tell by the tone of their voice. There are three of us in the family. My younger brother is a doctor. And he would often ask the older two to interpret for him to my mom. And yet, the Deaf community loves to go to him as a doctor, because he does sign. And so, you feel like you're being provided some access. But he would always bring in a professional interpreter if he was going to provide services to a Deaf patient. So, I guess the final message is that we all need to be ready. We're all responsible to provide accessible services. At least if you have some knowledge, like you hopefully got from this presentation, you'll be able to at least know I have to go and figure out where I can get the professional help through an interpreter or an intervenor or whatever it is you may need for the situation you're faced. MONIQUE DOZOIS: In this lovely picture, we see Betty-Ann, who as she neared the end of her life, decided to go to the May Court Hospice. Her daughter, who is a professional interpreter, was encouraged to put aside her role in order to spend quality time as a daughter with her mom. When interpreters were needed, professional interpreters were brought in. The little boy with Betty-Ann in the picture is her grandson. She enjoyed time with her family. The Deaf palliative care team volunteers provided care and support in ASL to Betty-Ann. If you have any questions or have anything you'd like to share or have any discussion points you'd like to bring up, please feel free to get in touch with Elaine or Christine. Here are their email addresses. We also have a website, which you can see here. If you access the website, you will see photos, videos, pictures from the conference, this video of this presentation today, and the PowerPoints. There is a link you can click on and print it if you would like. We hope you've enjoyed today and that you've learned something. Please feel free to share. We have so many people to thank who have supported us through all our work. ................
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