II. Management: Communication

  1. American Disabilities Act mandates "Auxiliary Aids and Services" for deaf or Hearing impaired patients at healthcare facilities
    1. Attempt to adapt to the patient's preferred communication method (and note in medical record for longterm patients)
  2. General
    1. Maintain eye contact with patient (regardless of Interpreter presence)
    2. Speak in a normal volume and tone
  3. Lip readers
    1. Maintain eye contact
    2. Have a supply of clear masks for staff to allow patients to lip read through the mask
  4. Speech to Text Applications
    1. Live Transcribe
    2. Otter.ai
    3. Ava
  5. Sign Language Live or via Remote Interpreter
    1. Use a professional medical american sign Language Interpreter
    2. As with any Translation Services, avoid using family members or friends (unless patient declines professional Interpreter)
  6. Phone Relay or Video Relay Service (via typed text, TTY)
    1. Calls may be received through a relay service, or initiated by dialing 711
  7. Makeshift Hearing amplifier
    1. Use the stethoscope as an amplifier
    2. Place the ear tips in the patients ears
    3. Speak into the diaphragm of the stethoscope
    4. References
      1. From email communication with D. Nagase, MD
  8. References
    1. (2021) Presc Lett 28(6): 34-5

III. Complications

  1. Decreased social engagement
  2. Adverse effects on partner relationship
  3. Decreased quality of life
  4. Major Depression
  5. Decreased functional status (e.g. Activities of Daily Living)
  6. Delirium
  7. Exacerbates Dementia
  8. Increased Fall Risk
  9. Increased Mortality

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