This document provides guidance for interacting with patients with various special needs or circumstances. It recommends maintaining eye contact and minimizing distractions for hearing impaired patients. For visually impaired patients, it suggests using touch, cues, and describing locations. When interviewing speech impaired or low comprehension patients, it advises using simple questions, written formats, and pictures. Interpreters should be used for non-English speakers and the patient, not interpreter, should be directly questioned. It also gives tips for interacting with patients who are crying, anxious, angry, hostile, sexually aggressive, intoxicated, seriously ill, or older adults.

2. 1. Hearing-Impaired Patient
 Remain within the sight of the patient.
 Ensure that the hearing aid is in working
order and turned on.
 Background noise should
be at minimum.

3.  Even with intermediary, face the patient
and direct all communication to the
patient.
 Use facial expression and body movements
 Give additional time
 Use written form for
gathering data

4. 2. Visually Impaired Patient
 Always look directly at the patient.
 Cues, voice intonation, volume and
inflection are important.
 Use TOUCH.
 Advise the patient when entering or
leaving the room.

5.  Orient the patient to the immediate
environment
 Use clock hours to indicate position of
items
 Offer assistance

6. 3. Speech Impaired- Aphasic
 Ask simple questions
 Allow additional time for patient
responses.
 Use written interview format,
letter board, yes/no cards

7. 4. Non- English Speaking Patient
 Requires assistance interpreter.
 Give direct interview questions to the
patient not to the interpreter.
 Pay attention to nonverbal cues.
 Signs are important.

8. 5. Patient with low level understanding
 Requires time and patience
 Interview also the family and care giver
 Request permission from patient to speak
to someone else.
 Allow patient to ask
assistance
 Observe the interaction

9. 6.Crying Patient
 Gently ask what’s the cause of emotional
response
 Show empathy and allow to cry
 Convey message of
thoughtfulness
 Finish the interview

10. 7. Anxious and angry patient
 Allow to express emotions
 Give permission to bring out their feelings
 Convey the patient’s sentiment to their
attention
 Recognize and acknowledge
the emotion

11. 8. Hostile Patient
 Review documentation.
 Be cautious.
 Do not reciprocate with the anger and
hostility.
 Limit setting and refocusing.
 Position yourself near an accessible exit.

12.  Do not turn your back on the patient
 Never allow the patient to walk behind
you or come between you and the exit
 Watch for signs of increasing tension in the
patient
 Leave the door of the room
open to some degree

13. 9. Sexually- Aggressive Patient
 Alert a colleague or security
 Trust your instinct
 Define appropriate boundaries
 Share personal reactions
 Refocusing the patient
 Set limits

14. 10. Under the influence of drugs/alcohol
 Alert security personnel and station
nearby
 Place yourself at a distance
 Remain calm
 Provide care

15. 11. Seriously ill Patient
 Collect the pertinent data first
 Interview the family member or significant
other
 Allow the patient to be present and
participate the interview
 Show respect

16. 12. Older Adult Patient
 Require additional time for patient
response
 Schedule more than one interview
 Interview an older patient’s family
member or care giver
 Assess the quality of
interaction