Improving the Communication Experience Between Caregivers and Patients With Hearing Loss

Hearing loss is invisible – sometimes even to the person experiencing it. The following communication tips will improve interactions between patients and caregivers, and should be used whenever possible.

Clear communication

  1. Speak slowly and clearly. Don’t overexaggerate your words, but speak distinctly.
  2. Speak up, but don’t shout.
  3. Rephrase, don’t just repeat. Find a different way to say what you need to convey.
  4. Make sure you have the listener’s attention before beginning to speak.
  5. Speak simply and directly. Don’t use a complex sentence if it’s not necessary.

Visible communication

  1. Make sure your lips are visible – don’t hold your hand in front of your face; look directly at the person whom you are addressing; don’t speak while looking down or away at a computer screen.
  2. If possible, wear a clear mask.
  3. Facial hair and chewing food or gum while talking can make it harder to read speech.
  4. Body language can help convey your message – use gestures.
  5. Make sure the lighting is good, shining on the speaker’s face, not in the listener’s eyes.

Optimize the environment

  1. Minimize background noise – lobbies, waiting rooms, distance from a check-in desk or counter are all more difficult listening situations. If possible, move the conversation somewhere quieter, reduce the noise, or rely on a written list of prompts.
  2. If you’re conveying letters, numbers, or times, have the listener repeat back what they heard.

Make it more than auditory

  1. Provide next steps and important instructions in writing
  2. Take pauses periodically to confirm the message has been understood.
  3. Don’t ask yes/no questions – have recipient teach back to confirm the message was received accurately.

Optimize device use

  1. If a patient uses a hearing aid or cochlear implant, make sure they have it on and working with fresh batteries any time communication is happening – in the OR, when clinical teams are rounding, etc.
  2. Some people with hearing loss use a remote microphone or FM system – a small device that can be handheld or clipped to a lapel. It sends the speaker’s voice directly to their hearing device which helps in noise, in groups, over distance and in reverberant rooms. If someone asks you to wear it, please do so! Then just speak normally.
  3. If a patient doesn’t have their hearing device(s), Pocketalker’s are available in some Cleveland Clinic pharmacies. Pocketalker’s are great temporary help for situational hearing.
  4. Use speech-to-text software like Live Transcribe, voice-to-text in notes, Dragon Dictation, etc. to convey your message in written form.

Hearing loss takes energy

  1. People with hearing loss must work harder to follow a conversation than someone with typical hearing. Recognize that may not leave as much energy, patience, or focus for other things.
  2. Listening fatigue can be exacerbated when someone is not feeling well.
  3. Take turns speaking if in a group.
  4. Some people with hearing loss have a hard time knowing where sound is coming from and may have to search for the speaker. Help by going to them if you see them searching.
  5. Some people with hearing loss also have tinnitus (ringing in the ears) which may be competing for their attention and adding stress.

Connect patients with care

  1. 75% of hearing loss is undiagnosed and untreated. If you encounter a patient who would like to be hearing better, suggest they schedule a hearing test with Cleveland Clinic Audiology by contacting 216.444.8500.
  2. Use visual indicators to let inpatient care teams know if the individual has difficulty hearing.

Sign Language (ASL) is not for everyone

  1. Sign interpreters are an appropriate accommodation for adults who communicate using sign language.
  2. The majority of adults with hearing loss lose their hearing over time and very few can understand sign language.
  3. Ask your patient how they can hear and understand best.