The prevalence of hearing impairment in older adults – as many as two-thirds of those over the age of 70 – is slowly being addressed in the culture at large. The importance of hearing loss treatments such as hearing aids and cochlear implants is being recognized for reducing the risks of negative health outcomes and even reversing the effects of cognitive decline and dementia. But one area where the significance of hearing loss is being overlooked is in acute healthcare situations.
Doctors and nurses communicate with patients to determine what is ailing them and to discuss treatment options. In a confusing situation and while suffering high pain levels, hearing loss is an additional and destructive barrier to the patient’s receipt of effective treatment. Simple changes can bring about the necessary conditions for better communication with patients with hearing loss, but awareness of the problem needs to be addressed first.
A study conducted at New York University in New York City found that patients with hearing loss were 32% more likely to return to the hospital within one month than patients with normal hearing.
In emergency situations, a patient who normally wears hearing aids may not have them in when they arrive at a hospital. If they do have hearing aids with them, make sure the hearing aids are sanitised and presented to the patient before a conversation is started.
Frequently, older patients who have developed age-related hearing loss may not treat their hearing loss at all, and may be in denial about it. Recognizing the difference between hearing loss and cognitive impairment is crucial to providing proper care. Many of these patients will bluff their way through a conversation; medical personnel who suspect a patient is bluffing ought to ask that the patient repeat to them the information that’s being provided.
When communicating with patients whose hearing loss is established, a few normal methods of communicating with the hearing impaired should be employed:
- Speak clearly
- Get the patient’s attention before speaking to them
- Always face them when you speak, and don’t cover your face
- If they ask you to repeat something, rephrase it rather than simply saying the same thing again
- Make sure the room is well-lit
- Repeat especially important concepts throughout the conversation; hearing loss is also tied to memory impairment
- Reduce background noise as much as possible
Special Difficulties in Healthcare Environments
A large part of the problem here is that hospitals are not designed for the hearing impaired. Many situations that a patient will encounter will make it more difficult for them to focus on a conversation. Emergency rooms are full of competing sounds like beeping machines and multiple conversations. Since the barriers between patients might be as minimal as a curtain, it’s little wonder that patients with hearing loss don’t hear everything they need.
Patients with hearing loss that developed later in life are unlikely to use sign language. These patients should have signage and chart records indicating their need for accommodation. Nurses and technicians should be informed of the possibility that they may encounter patients who are in denial about hearing loss.
Hospitals should keep assistive technologies on hand for situations where patients are suspected of having untreated hearing loss, though few currently do. FM systems can often be enough to reduce the signal-to-noise ratio enough for patients to make better sense of what’s being said to them. Real-time captioning is an option for those with more profound hearing loss.
Many of these patients will not have heard of assistive technology, so hospital staff should explain the technology enough that the patient understands that this technology will improve their experience.
If hospital staff encounter a patient with untreated hearing loss, the patient should always be encouraged to get a hearing test and pursue treatment. Treating hearing loss improves health outcomes in myriad ways, inside and outside the hospital, and slows the onset of cognitive decline and dementia.
For patients with hearing loss, communication is still a two-way street. The problems caused by hearing loss won’t go away once they leave the hospital. Staff need to go the extra mile to make themselves understood to the patient, and communicating the importance of getting their hearing treated once they’ve left the hospital should be a priority.
Treating Hearing Loss
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