How to serve clients with disabilities

When we exited a taxi at the airport with our golden retriever guide dogs, Keebler and Latrell, we were dismayed to hear the skycap ask the cab driver, "How many bags do they have and where are they going?" The skycap's disregard for our abilities and feelings brought back unpleasant memories of similar experiences: A restaurant waiter once asked our sighted friend, "What would they like to eat?" And after paying a hotel bill, the customer service representative returned our credit card to a stranger next to us in line.

Feeling infantilized and disempowered is one of the most upsetting and universally encountered experiences for people with disabilities. Waiters, skycaps, hotel personnel, and even veterinary professionals can affect people with disabilities this way—without realizing it. Incorporating the people first concept—a movement that promotes inclusion, freedom, and respect for people with disabilities—will help your team members build stronger relationships with disabled clients. Simply put, remember these clients are people first. They are not their disabilities. Use these guidelines to follow the people first approach in your practice.

What you can do

Disabled clients' needs vary by disability. Even those sharing a disability may use different adaptive techniques. Catering to these adaptive techniques makes your practice a friendlier, more comfortable place. It also shows you appreciate the extra effort it takes them to schedule, attend, and follow up with veterinary visits.

To start, some disabled clients might commute to or visit your practice differently from other clients. Blind clients might arrive with a designated driver or take a bus. Deaf clients might drive themselves and meet an interpreter at your practice. Physically disabled clients might visit with a personal attendant.

When Ms. Iverson arrives with her interpreter and iguana in tow, remember she's the client and communicate with her. Rather than tell the interpreter, "Ask her what Oreo's symptoms are," face Ms. Iverson and ask for Oreo's symptoms.

Since some disabled clients depend on public transportation or a taxi service to meet appointments, consider a flexible scheduling policy. And when they call to schedule appointments, ask whether there are any special accommodations you can provide.

When you meet disabled clients for the first time, maintain eye contact, offer to shake hands, and relax. Ask if they need any additional accommodations. This empowers your clients to express their needs so you can meet them.

Blind and visually impaired clients

For blind and visually impaired clients, verbal communication is essential. First, introduce yourself by name and title and indicate if and when you're leaving the room. Avoid using the four most dreaded words for the visually impaired: here, there, this, and that. These words give visual clues and don't provide the direction needed. Rather, give audible clues by tapping a chair or the exam table where you would like a blind client to settle.

And remember, Mr. Thomas can't see you nodding in agreement or pointing to the open chair. In these situations, we often joke, "Would you please point a little louder?" Generally speaking, giving directions using measurements like, "Mrs. Jefferson, the chair is 3 feet to your right," is a less effective approach because these directions can get confusing. Some blind clients might appreciate you offering your elbow and walking a half a step in front to guide them. But others prefer to use their guide dogs or white canes to maneuver around your practice. So always ask clients how they can best be guided.

In the exam room, explain each step as your team examines the patient, including weighing the pet, taking its temperature, and making notes in the medical chart. Your continuous commentary will relieve Mrs. Moore's anxiety, especially if Max wiggles or yelps.

Blind clients may need hands-on demonstrations of at-home treatment procedures, such as cleaning ears, administering medication, and changing dressings. If the doctor prescribes several medications with similar containers, use rubber bands or tape to differentiate them. And you can notch syringes to indicate the proper level of liquid medication to administer. Because adaptive techniques differ, ask clients about their preferred accommodations.

Deaf and hard-of-hearing clients

These clients may communicate through sign language interpreters, by speech reading, and with writing. If clients speech read, face them directly and speak clearly and expressively, using gestures, facial expressions, and eye movements to provide context. Note: Raising your volume with Mrs. Williams generally isn't helpful.

When you need to call a client who's deaf or hard of hearing, use the phone relay service—simply dial 711 to connect to a trained operator who transcribes your spoken words into type that appears on a screen or on paper on the deaf client's phone. The client then types a response on the text phone, which the operator translates orally. Clients who speak can use the voice-over system. Your spoken words are transmitted as typed text, but the client replies orally.

We also recommend e-mail for clients who are comfortable with this format. Remember, written instructions are essential for those with hearing difficulties.

Clients with speaking difficulties

You may struggle to understand clients with cerebral palsy or physical disabilities from a stroke or brain injury. In these cases, don't pretend to understand what these clients say. You won't embarrass Ms. Mitchell by asking her to repeat or write down Molly's exercise schedule. And for phone conversations, remember the 711 relay service.

Give your full attention when communicating with Mr. Brown. Be patient, and avoid completing his sentences or speaking for him. When necessary, ask short questions that require short answers or a nod or shake of the head, such as, "Do you feed Buddy once a day?" And, "Do you leave his food out all day?"

The well being of your patients and your relationships with your clients depend on clear communication. Repeat what you think you heard, and look for clarification from the client. Remember, impaired speech isn't synonymous with impaired cognitive ability.

Clients with physical disabilities

Physically disabled clients may use wheelchairs, crutches, or canes, and some may even have disabilities you can't see. Because this group's physical capabilities, such as hand strength and motor skills, vary, accommodate these clients by personalizing their pet's treatment plan. If Ms. Anderson isn't able to fulfill the treatment protocol, also address the person who will assist with Abby's care when you give instructions.

Many wheelchair-users feel uncomfortable always interacting with people who are standing—so take a seat. This places you at their level, so Ms. Wilson isn't forced to look up while you explain Whiskers' parasite prevention and vaccination schedules.

A friend whose disability causes extreme fatigue told us her veterinarian alters his protocol to assist her. When her condition makes it difficult to use the wheelchair lift and wheel into the hospital, he comes out to her van to examine her dogs. Simple, thoughtful gestures like these will help your clients offer the care their pets need to live longer, healthier lives.

Toni Eames, MS, and Ed Eames, PhD, adjunct professors of Sociology at California State University, Fresno, live with their golden retriever guide dogs, Keebler and Latrell, and four cats, Bonanza, Kismet, Bambi, and Nifty, in Fresno, Calif. They co-authored A Guide to Guide Dog Schools (Baruch College Guide Dog Book Fund, 1986) and Partners in Independence: A Success Story of Dogs and the Disabled (Barkleigh Productions, 2004). Please send questions or comments to firstline@advanstar.com