"Historically, the dominant hearing culture has relegated deaf people to social categories such as "handicapped" and "outsider." The history of oppression and exclusion of the deaf community -- although with important variations depending on the countries -- and the ignorance and rejection of the natural and preferred means of communication of many of them is a well-known and many times denounced phenomenon," (Munoz-Baell & Ruiz, 1999, p. 1). Finally, there is a real deficiency of information in Deaf culture regarding hospice and its related services. Finding appropriate facilities can be a time-consuming and frustrating process.

The program: breaking down barriers

The purpose of this program is to meet the challenges stated above by providing hospice services that cater to the unique needs of deaf individuals. This will be accomplished through the use of educational classes and workshops provided in churches and community centers. Deaf persons skilled in ASL will be trained as volunteers and must be available on call when a deaf patient is admitted to the facility. Only those individuals with a high level of signing skills will be accepted. The volunteers will also be asked to accompany the patient to doctor visits as well as make needed home or hospital visits. However, volunteers will not replace certified interpreters who accompany the patient on office and doctor visits. Grief counselors will also be interviewed and possess ASL skills, and may include pastors, ministers, priests, and other religious clergy who serve the Deaf community.

Another vital part of this program will be to generate program awareness throughout the local deaf community by providing advertising and educational materials and possibly a Website.

Community outreach classes will also be a vital component of the program. These classes will help promote program awareness among medical facilities and staff and will also provide a resource for those patients needing deaf services.

In addition, deaf bible study groups and support groups will be offered to assist with the grieving and healing processes. It will be encouraged that family members of deaf patients be included in these classes to help provide the support their deaf family member and/or friends need.

Program staffing

Educated individuals, grief counselors, and religious clergy will make up the program staff. Volunteers will be taught by the core staff members with hopes that these individuals will comprise an extension of the staff. Additional volunteers may include current and retired medical staff as well as volunteers from schools, non-profit organizations, churches, etc. The intention is to find enough volunteers to help keep costs to a minimum.

Program funding

The program will be funded through a variety of efforts. Local churches and churches aware of Deaf needs will be solicited for donations and to perform community fundraisers. Donations from foundations, Deaf organizations, and private organizations will also be sought. Program staff will communicate with the overall Deaf community to generate other fundraisers such as bowling tournaments, sports events, craft and bake sales. Additionally, significant time will be dedicated to grant research. Some of these research resources will include:

Grants for Mental Health, Addictions, and Crisis Services: A published resource that provides information on more than 6,300 grants from 880 foundations for a variety of facilities, including support groups and bereavement counseling.

Grants for People with Disabilities: A publication that offers more than 8,200 grants made by approximately 940 foundations including a range of needs from blindness and deafness to family counseling and general care.

The Complete Directory for People with Disabilities: A Comprehensive Source Book for Individuals and Professionals. This directory includes information about national and state agencies and associations, foundations, camps and exchange programs, living centers and facilities, conference and trade shows and more.

Directory of Grants for Organizations Serving People with Disabilities: A Reference Directory Identifying Grants Available to Nonprofit Organizations: Short entries are provided that describe foundations that provide funding for accessibility, blind, deaf, developmentally disabled, and elderly programs and services (to name a few).

Program marketing: getting the word out

The key to success for any program is effective marketing. To generate interest and promote this program, advertisements will be placed in Deaf bulletins and monthly newsletters, Websites, newspapers, and agencies for the Deaf. Since word of mouth is very popular among the deaf community, additional advertising will also be pursued at local funeral homes, churches, universities and community colleges, community centers and clubs, police and fire departments, city hall, and the chamber of commerce. Along with advertisements, educational literature such as informative brochures and fact sheets will also be displayed where appropriate.

Educational...

These educational workshops will be taught by ASL interpreters and/or Deaf people who are affluent in the language. Other workshops will be designed to educate about bereavement, provided by religious clergy, grief counselors, and professional teachers.
To further market the program, staff members and volunteers would be encouraged to participate in events such as Deaf Awareness Week. Also known as the International Week of the Deaf, Deaf Awareness Week is the last full week in September is Deaf Awareness Week. The About.com Website describes this increasingly popular event, "The purpose of Deaf Awareness Week is to draw attention to deaf people, their accomplishments and their issues. During this week, many deaf organizations hold activities to celebrate and conduct public information campaigns to educate people about deafness. Companies and agencies often mark the event, and schools, colleges, and universities hold awareness events."

If funding allows, a program Website will also be created. The Website will include the above items and more, such as information on the program mission and contacts, training, publications, newsletters, and upcoming events. The intention of the Website is to provide a central resource that will allow program staff to connect and communicate with the deaf, as well as provide volunteers and medical staff with essential program information. One example of a similar existing Website is the Rochester Medical Center Website, part of the National Center for Deaf Health Research, located at: http://www.urmc.rochester.edu/ncdhr.

Assessing program effectiveness

Evaluating a program's effectiveness is just as critical as all the other program elements. Without proper feedback and input, it is nearly impossible to understand what necessary improvements must take place. Therefore, it is our goal to provide a program that incorporates the feedback of the deaf community by providing surveys and evaluation questionnaires to deaf individuals as well as churches and local organizations. Focus groups will also be organized to determine program effectiveness across different aspects of care.

Positive momentum

This program recognizes that there are numerous challenges facing the deaf community today. Add to that major communication and language barriers and lack of consistent, statistical knowledge of the deaf population, and it can be a tricky landscape to navigate, especially when implementing new programs related to hospice services. But the good news is that positive momentum is building, and with programs like the one being proposed, opportunities to connect with and support deaf individuals are on the rise. State and federal programs, although rudimentary at this point, are being embraced across the United States.

One such program, known as The Deaf Community Health Worker Initiative, is based in Minnesota and exemplifies how an organization can break down the communication barriers between deaf individuals and health professionals. In a recent study, program feedback was provided from family members, patients, providers, and interpreters, indicating that they are on the right track by increasing patient understanding, trust and empowerment, improving adherence to recommended care, and helping providers better understand the barriers facing Deaf patients ("Deaf Community Health Workers Provide Education and Support to Deaf Patients," 2005).

In addition, Gallaudet University, the only institution of higher learning for the deaf in America, continues to be a positive example of deaf education and empowerment. Also, the Jacob Perlow Hospice, serving the Bronx, Queens, Brooklyn, and Manhattan in New York, is paving the way for other organizations by establishing the first major U.S. hospice program for the deaf and hard of hearing community. With a $75,000 grant provided by the Open Society and its Project on Death in America, the Jacob Perlow Hospice-Deaf Service Project supplies specialized care to terminal patients as well as assists deaf patients with deaf family members, deaf patients with hearing families, and hearing patients with deaf family members. Licensed and certified in 1988, the Jacob Perlow Hospice has since served more than 3,900 patients and family units.

There's no doubt that a communication gap exists between the hearing and the deaf community. But with through the proper structure, education, staff, volunteers, and marketing provided by this program, we can get one step closer to supporting a misunderstood population during their most sensitive and crucial time of need.

REFERENCES

Berke, J. (2009). Deaf Awareness Week. Retrieved April 10, 2010, from the About.com Website: http://deafness.about.com/cs/events/a/deafawareness.htm

Deaf Community Health Workers Provide Education and Support to Deaf Patients, Facilitating

Access to Linguistically and Culturally Appropriate Care, Improving Patient Health

Knowledge and Adherence to Recommended Care.…