II. Management: Communication
- American Disabilities Act mandates "Auxiliary Aids and Services" for deaf or Hearing impaired patients at healthcare facilities- Attempt to adapt to the patient's preferred communication method (and note in medical record for longterm patients)
 
- 
                          General- Maintain eye contact with patient (regardless of Interpreter presence)
- Speak in a normal volume and tone
 
- Lip readers- Maintain eye contact
- Have a supply of clear masks for staff to allow patients to lip read through the mask
 
- Speech to Text Applications- Live Transcribe
- Otter.ai
- Ava
 
- Sign Language Live or via Remote Interpreter- Use a professional medical american sign Language Interpreter
- As with any Translation Services, avoid using family members or friends (unless patient declines professional Interpreter)
 
- Phone Relay or Video Relay Service (via typed text, TTY)- Calls may be received through a relay service, or initiated by dialing 711
 
- Makeshift Hearing amplifier- Use the stethoscope as an amplifier
- Place the ear tips in the patients ears
- Speak into the diaphragm of the stethoscope
- References- From email communication with D. Nagase, MD
 
 
- References- (2021) Presc Lett 28(6): 34-5
 
III. Complications
- Decreased social engagement
- Adverse effects on partner relationship
- Decreased quality of life
- Major Depression
- Decreased functional status (e.g. Activities of Daily Living)
- Delirium
- Exacerbates Dementia
- Increased Fall Risk
- Increased Mortality
