Recently, second-year medical student Zina Jawadi shared how the pandemic has impacted her—and others like her—who have significant hearing loss. Zina offers the following tips to help health care providers improve communication with patients with hearing loss:
Prior to the visit
- Standardize accommodation requests and arrange for accommodations before the patient arrives at the clinic (e.g., include a question about accommodations in a pre-visit questionnaire).
- Make waiting rooms more hearing accessible — implement a schedule numbering system that flashes on the TV or enable automatic texts to notify patients.
- Have live chat to obtain support instead of telephones.
During the visit
- At the start of every visit (regardless of whether a disability is on record), ask if the patient needs any accommodations.
- Face the patient. Speak slowly. Speaking louder does not help those with hearing loss, as it does not improve clarity of sound. Provide visual aids. Make topic transitions visual and clear.
- Avoid noises like typing on the computer, flipping papers, and walking around the room.
- Enable lip reading by avoiding covering your face with your hands, taking off the mask when feasible or using a clear face mask, and facing the patient. Federal and state mask mandates have exemptions for those speaking to someone with hearing loss, including in the health care setting (e.g., Centers for Disease Control and Prevention, Federal Register).
- Context is crucial for being able to follow conversations. Point to words, especially if using medical jargon.
- Repeat when asked, ideally paraphrasing what you said. Some words, sounds, and frequencies are easier to hear than others.
- Ask patients to reiterate what they understand — they may not realize they did not hear something important.
- Accommodate people based on what they say they need. If a patient’s hearing loss is in the medical record, practice these communication tips even if accommodations are not requested.
- Ask patients how hearing loss has impacted their health. At the same time, do not assume that a patient’s chief complaint is related to a disability.
- Connect the patient with local resources and support groups.
- Encourage people to seek treatment for their hearing loss. Evaluate the patient for potential comorbidities like depression and social isolation.
- Life transitions can be challenging; provide resources if feasible (e.g., an excellent audiologist in the area).
Special considerations for telehealth visits
- Ensure that the platform offers captions. Activate captions.
- Avoid having light behind you, since it makes it harder to read lips and facial expressions.
- Ensure that your room is quiet and has excellent Wi-Fi. Wear a headset with a microphone.
- Write down the key points. Utilize the chat function, especially for words that may not be familiar to the patient.
Read about Zina’s experience and what she has observed in patients who share her disability.
Do you have additional tips to suggest? Have you seen colleagues, learners, or patients struggle with hearing loss—especially in the pandemic?
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Penny Schnarrs
Virtual Communities Program Manager
Association of American Medical Colleges
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