Providing Nutrition Care for Deaf Elderly People

At Mercy LIFE Valley View, a group home for elderly deaf people, Beatrice Agar is responsible for all things food and nutrition: ordering food, performing nutrition assessments, managing the kitchen and ensuring it is compliant with regulations, and more. "Valley View is unique because the majority of the 36 participants are deaf, as well as a majority of the staff who care for them," explains Agar, who is learning American Sign Language, or ASL, primarily by immersion in this community. "Dietetics is a helping profession," Agar says. "It is very rewarding to be able to learn ASL and to communicate with my colleagues and the participants in their heart language!"

Tell us about your work. Who is your audience? What need does this work help serve?

I am a Dietitian/Manager with Mercy LIFE (Living Independently For Elders). LIFE programs are what PACE programs are called in PA. I am the Dietitian/Manager at Valley View, a group home where 36 deaf elderly people reside. The Interdisciplinary Team (IDT) comes to Valley View to provide care for these elderly folks whom we refer to as participants. I am the person responsible for everything that has to do with food and nutrition, including performing nutrition assessments, managing the kitchen, ordering the food, ensuring that the food service and kitchen is in compliance with regulations, troubleshooting issues that come up regarding food or nutrition, doing payroll for the kitchen staff member who reports to me, etc. And (since we are a small facility), I also help out in the kitchen, re-stock the food, etc. as needed. Valley View is unique because the majority of the 36 participants are deaf as well as the majority of the Staff who care for them. The work that I (and the other members of the Mercy LIFE IDT) perform enables these participants to live as independently as possible in their home. Since the participants mostly communicate using American Sign Language (ASL), it is wonderful that they can be cared for by staff who are either deaf themselves, or can communicate with ASL. If it wasn't for Valley View, many of these participants would likely be living in long-term care facilities where few, if any, people know ASL. I imagine they would feel quite isolated there.

What inspired you to undertake this work or project? Include when and how you became involved.

It is truly amazing how I became involved in working with the deaf. First, some background information: In addition to being a dietitian, I teach part-time at Delaware County Community College as an adjunct instructor (at that time, I also worked as a full-time clinical dietitian at a long-term care facility). In 2014, I accepted a temporary position at the college as the executive administrator to the interim dean of Allied Health, Emergency Services and Nursing. As part of this position, I was also the coordinator of the Nurse Aide Program. One day, I received a phone call that Mercy LIFE recently had begun a LIFE program at Valley View, and Mercy LIFE required all of the first line caregivers at Valley to become Nurse Aides by completing an accredited course and passing the test so they could be placed on Pennsylvania's Nurse Aide Registry. To make a long story short, I had to collaborate with many people (including the PA Dept. of Education, Mercy LIFE and various people at the college ), but the result of the collaboration was that a unique and beautiful thing happened: As far as I know, this is the first time a group of deaf first line caregivers successfully completed a Nurse Aide Program at a college, passed both the skills component and the written component of the exam, and are now on the PA Registry as Nurse Aides! As the coordinator, I worked very closely with the students (especially the first cohort to go through the program). I did not know ASL and communicated mostly through an interpreter or by writing notes. I truly enjoyed working with these students, and we developed a great working relationship. As the first cohort was finishing their clinical rotations, my temporary position at the college was completed. I was accepted back at the long-term care facility where I previously worked. Then a surprising thing happened: A position opened for a Dietitian/Manager at Valley View. I excitedly interviewed for the position and was offered the job. Needless to say I was thrilled beyond belief at the prospect of working with these colleagues whom I got to know so well at the college!

What do you personally find most rewarding about your efforts?

It is very rewarding to be able to learn ASL and to communicate with my colleagues and the participants in their heart language! I am still in the process of learning ASL and am learning primarily by immersion. I have been at Valley View for about 16 months now, and every day either a colleague or participant teaches me a new sign! Everyone is so accepting, patient and helpful! For the first time in my life, I am a minority (a hearing person in a deaf world)! I love the irony… and I didn't even realize it until I was working there about six months! At home, I study ASL flashcards and also use the internet to learn new signs. It is rewarding to be able to conduct a nutrition assessment in sign language, or to have a simple conversation with one of my colleagues. It is rewarding to speak ASL to the participants who are both blind and deaf (I have learned to sign into their hands so they can feel the signs)!

What are the most important values you demonstrate in your work?

Compassion is one of the values that I demonstrate. When a participant is unhappy with the food or has a suggestion for the menu, I like to listen to them and troubleshoot with them. Dietetics is a helping profession, and I really feel that at Valley View!

What about food, diet, nutrition or health drew you to this field?

I was interested in food and nutrition from a young age. My mother enjoyed cooking and serving a wide variety of foods from different areas of the world. We had our own garden and fresh vegetables were often a part of our meal. I was heavy as a child and my mother made sure that I ate healthy, and she enrolled me in dance class. It worked! Not only did I slim down as I grew up, I became a dietitian to help others!