September 16, 2020
Hospital care for older patients can be difficult for a variety of reasons, but one thing that’s been pointed out in medical literature recently is the difficulty posed by hearing loss. Medical care relies, even more than we might guess, on dialogue between the patient, nurses and doctors. When the patient suffers from untreated hearing loss, effective medical treatment can be difficult or impossible.
In fact, a study conducted at the New York University in New York City discovered that patients with hearing loss are 32% more likely to be readmitted within one month of being discharged from the hospital. Taking into account that people with hearing loss are more likely to be admitted in the first place, this accounts for a lot of hospitalization that might be preventable with treatment for hearing loss.
Hearing loss, especially when undiagnosed and untreated, leads to a cascade of negative health outcomes. Social isolation is a common one. Hearing loss can cause miscommunication with nursing home staff that can lead to erroneous assumptions of dementia, as well. As hearing loss progresses and the auditory cortex in the brain begins to atrophy, a patient with hearing loss who is generally socially isolated might be unable to understand speech even when they hear it clearly.
The most likely reason for the inconsistent treatment of patients with hearing loss is miscommunication. Patients undergoing emergency room treatment are often disoriented by their acute medical condition or anaesthetics. The hospital environment is also likely to be noisier than the patient encounters with regularity, and miscommunications due to hearing loss are exacerbated by background noise. One way miscommunication could be avoided is placing patients who have hearing loss or are suspected of having undiagnosed hearing loss in quieter environments for consultation.
Sometimes hospital staff, when having difficulty making themselves understood to patients with hearing loss, resort to shouting. Unfortunately, this usually does not increase the likelihood that they will be understood; shouting will more often distort speech than make it clearer. It might also violate HIPAA privacy regulations.
The best way to communicate, un-aided, to a person with hearing loss is to speak a little more slowly—not drawing out your words but adding more space between them—and a little more loudly. Make sure they can see your face. If they ask you to repeat something, rather than saying the same thing again, try saying it in different words.
Patients with age-related hearing loss, who were comfortable in hearing culture for most of their lives, rarely know sign language, so sign language interpreters who are on staff to communicate with the deaf will not get far with a patient who has age-related hearing loss.
Hospitals should keep FM devices at the ready. Unfortunately, this is not currently a common practice. If a patient is having trouble communicating, an FM device, which will simply make the sound of medical staff’s voices louder, could be enough to improve their outcome. Many patients will not be familiar with this technology, so hospital staff will need to explain it to them.
Most patients who arrive in the emergency room with pre-existing, undiagnosed hearing loss are from lower income brackets. It could be very significant for them to discover that their hearing loss can be treated with an FM device, though hearing aids may unfortunately be out of reach for them, financially.
To help with the problem of diagnosing hearing loss, patients’ medical records can be tagged with a highly visible indicator that the patient has demonstrated hearing difficulty when interfacing with medical professionals in the past. This avoids the problem of having to rediscover on each visit that a patient has hearing loss.
Of course, hearing aids are one of the best ways for people with hearing loss to spend as little time in the hospital as possible, and to get the most out of their treatment when they are there. Education about the importance of hearing aids to general health and well-being should be more prevalent, but in the meantime, medical staff should make the most of every encounter and encourage patients to get their hearing tested regularly.