Caring for patients with hearing loss during the Covid-19 Pandemic

For health care professionals:

These are stressful times for health professionals around the world, whether working in Covid-19 ICUs or simply seeing regular patients, everyone could potentially be an asymptomatic Covid-19 carrier. So how can we as healthcare professionals make the patient-provider interactions a bit easier during these difficult times, when patients may be wary of even coming in to see the doctor? Hearing loss can be a barrier for patient and healthcare professional communication. Even without masks blocking our lips, patients often report on difficulty understanding doctor's questions, explanations - even on drug prescriptions! (Iezzoni, Oday, Killeen, & Harker, 2004) These days, with all medical professionals wearing face masks, people with hearing loss are losing critical lip-reading cues to help them understand speech.

So what can we do? First of all, be aware of potential hearing loss - if your patient is over the age of 65, keep in mind that 1 out of 3 adults at this age and older have some hearing loss and the numbers rise with age, with over 50% of adults with some hearing loss over the age of 73 (Eyken, Camp, & Laer, 2007). Look for signs of hearing loss - patients may ask for multiple repetitions, or answer a question with an unrelated answer because they may have misheard the question. Sometimes, a sign of hearing loss can be as simple as the person leaning-in, squinting their eyes, or a slight turn of the head to hear better.

Speak slowly and clearly. Often, just by slowing down our speech, our message can be understood much better. This means, that even when we're stressed out due to the overload of patient care, taking an extra minute to give a clear explanation and confirm our patient understood the message. Especially in this time of Covid-19, be prepared to provide a written alternative, whether a piece of paper & pen with written instructions to give to patients to take home, or just swivel the screen to show them and write in a blank word document (for us fast typers). Another easy way to provide a written alternative is to use a transcribing app, such as Live Transcribe (for Android) or Hearing Helper (for Apple products). Keep in mind these apps aren't always 100% accurate, so it's best to also keep an eye on the transcriptions to avoid issues or miscommunications. Live Transcribe has multiple language options, including Hebrew!

If you want to go the extra mile: There are a few companies that produce face masks with a view: Safe'N'Clear - a surgical mask with a clear window The Clear Mask, a completely clear mask or make your own, just like this college student! (Please note these solutions are for surgical masks, and do not comply with N95 regulations) These are tough and stressful times for all of us on the planet, so try and keep that in mind when communicating and be patient and respectful of one another. Wishing health and happiness to us all!

References: Iezzoni, L. I., O'Day, B. L., Killeen, M., & Harker, H. (2004). Communicating about health care: observations from persons who are deaf or hard of hearing. Annals of Internal Medicine,140(5), 356-362. Van Eyken, E., Van Camp, G., & Van Laer, L. (2007). The complexity of age-related hearing impairment: contributing environmental and genetic factors. Audiology and Neurotology,12(6), 345-358.