May is Better Hearing and Speech month and this year’s theme is “Communication: The Key to Connection.” In a 2015 hearing industry survey, only 10.6% of consumers reported hearing difficulty. Surprisingly though, a 2017 CDC survey revealed that 24% of patients ages 20-69 who reported “excellent” hearing, actually had measureable hearing damage. Addressing this gap between perceived hearing ability and actual hearing loss is a key element to unlocking effective communication between healthcare providers and their patients.
Teens and younger adults are showing higher rates of noise-induced hearing loss, yet the highest percentage of hearing loss is still age-related, especially those over 60. A literature review published in the April Journal of the American Geriatric Society shows few studies acknowledge hearing loss as a factor influencing communications between providers and patients. One of the authors, Dr. Blustein, wanted to know “how we can attend to and improve hearing and understanding so that patients get the best quality care possible.” Several sources make recommendations on how to take hearing loss into account when interacting with patients:
Identify those with, or at risk for hearing loss and refer to a Hearing Healthcare Professional (HHP) if patients answer the following questions affirmatively.
- Do you find it difficult to follow a conversation if there is background noise?
- Can you usually hear and understand what someone says in a normal tone of voice when you can’t see that person’s face?
- Do you feel frustrated with your hearing when talking to family or friends?
- Are you often exposed to loud sounds, either at work or away from work?
Reframe the message:
The way healthcare messages are framed influences the likelihood of people either accepting or rejecting a recommended health behavior. When hearing impairment is viewed as a “condition” (a loss) and test results confirm their “flawed” status, patients tend to avoid discovery, especially if treatments are perceived as negative or they feel powerless to minimize or prevent that loss. Here are ways to reframe the perspective for positive adherence:
- Change the discussion from tests, loss, disability and hearing aids to: prevention, evaluation/assessment, maintaining and/or improving the ability to listen and communicate effectively, and use the term “hearing technology.”
- Focus on “maximal hearing and listening.” Identify the situation the patient has difficulty hearing clearly in, and assure the patient can communicate maximally in work, social and recreational situations.
- Empower patients to use hearing technology that allows them to maintain or increase their self-image.
- Explanations must mirror the perception of the patient. A patient hears “everything” within his hearing range. Sounds outside of that range just don’t exist. It’s not about stubbornness or denial; discuss what the patient would like to hear more of, not what they are missing.
- Normalize hearing healthcare as maintenance of “maximal hearing and listening” throughout life and is as routine as dental, vision and physical exams.
Accommodations to use with patients with hearing loss:
- Minimize ambient noise
- Speak face to face
- Speak in a normal tone of voice, at a regular pace, but allow time for the patient to process and respond.
Patients who feel able to communicate openly and honestly with their healthcare provider, who can hear and understand all the information they need, who feel supported and involved in making decisions about their care, adhere to medical treatment recommendations better. Primary care providers have a significant impact on whether patients follow up with hearing health and/or adopt recommended treatments/technology as well. Effective communication makes a difference in healthcare outcomes.