Hearing Loss: Communicating With the Patient Who Is Deaf or Hard of Hearing

Hearing loss impairs health care communication and adversely affects patient satisfaction, treatment adherence, and use of health services. Hearing loss is the third most common chronic health condition among older patients after hypertension and arthritis, but only 15% to 18% of older adults are screened for hearing loss during health maintenance examinations. Patients with hearing loss may be reluctant to disclose it because of fear of ageism, perceptions of disability, and vanity. Lipreading and note writing often are ineffective ways to communicate with deaf and hard of hearing (DHH) patients who use American Sign Language; use of medical sign language interpreters is preferred. A variety of strategies can improve the quality of health care communication for DHH patients, such as the physician facing the patient, listening attentively, and using visual tools. Physicians should learn what hearing loss means to the DHH patient. Deaf American Sign Language users may not perceive hearing loss as a disability but as a cultural identity. Patients' preferred communication strategies will vary. Relay services, electronic communication, and other telecommunications methods can be helpful, but family physicians and medical staff should learn from each DHH patient about which communication strategies will work best.