Addressing Communication Gaps in Stroke Care for the Deaf Community: Angelina Wronski, RN

For many Deaf and hard-of-hearing (DHH) individuals, a stroke hospitalization can expose deep cracks in a health care system built around spoken language and written English. From recognizing symptoms to navigating discharge instructions, communication barriers can undermine timely care and safe recovery at home. Those gaps were the focus of a caregiver-centered initiative highlighted in an interview conducted at the International Stroke Conference 2026, where new strategies for more inclusive stroke care were discussed.

The work was presented by Angelina Rose Wronski, RN, BS, a stroke coordinator at Rochester Regional Health, whose clinical experience in western New York has been shaped by caring for one of the largest Deaf communities in the US. Rochester is home to roughly 40,000 DHH residents, and prior research has shown striking deficits in stroke-related health literacy in this population. Previous research has found that more than 60% of deaf respondents could not name a single stroke symptom, and only about 61% said they would call 911 if they suspected a stroke or heart attack.

Wronski said those findings prompted her and her team to look closely at discharge processes and caregiver engagement, where many of these disparities become entrenched. She identified a lack of culturally relevant education as a core problem, noting that English is often a second language for American Sign Language (ASL) users and that written discharge instructions frequently fail to translate key concepts accurately. In the hospital setting, communication challenges are compounded by limited access to qualified ASL interpreters and heavy reliance on video relay services, which can be unreliable and difficult to use in fast-paced, high-acuity environments such as the emergency department.

Caregiver involvement, while essential, can also complicate discharge planning. According to Wronski, hearing caregivers may unintentionally dominate conversations, whereas deaf caregivers may hesitate to ask questions if they are unsure what to ask or lack interpreter support. Lip reading is often assumed to be an adequate substitute for interpretation, despite evidence that only 30% to 40% of spoken English is visible on the lips. As a result, patients may appear to understand discharge instructions but leave the hospital without a clear grasp of medications, warning signs, or follow-up expectations.

The initiative Wronski described centers on bridging these linguistic and cultural gaps. Educational materials are designed to be easy to read, highly visual, and culturally relevant, with attention to the structural differences between English and ASL. The approach also extends beyond the hospital, emphasizing community-based support and making patients aware of their right to interpreter services during primary care and pharmacy visits.

Presented as part of a broader discussion on equity at the International Stroke Conference, the project reflects a shift in stroke care toward home-based success and value-driven outcomes. By prioritizing communication, trust, and caregiver engagement, Wronski’s work underscores how culturally and linguistically appropriate care can play a critical role in reducing disparities and improving stroke outcomes for the DHH community.

Reference

Wronski AR. Breaking barriers: stroke recognition and prevention in the Deaf community. Presented at: International Stroke Conference 2026. February 3-6, 2025; New Orleans, LA. Poster DP207.