By Nancy J. Rennert, MD and Carolyn Stern, MBA
Life this past year has certainly been different – and healthcare is different, too.
With the Covid- 19 pandemic, our lives changed. Access to health care was restricted and people with hearing loss faced additional communication barriers due to the use of face masks and policies limiting in-person interpreters. With vaccines and declining infection rates, recommendations recently changed to allow certain groups of people to go without masks in some situations. However, in healthcare, masks continue and may be with us for some time. Here are some ways to optimize health care visits with a hearing loss. Please be sure to click on the links for further details and to view the videos.
Effective communication strategies
How to access the healthcare TEAM and find your medical ALLY
It’s especially helpful if you can identify a medical ALLY – someone in the office or hospital who understands your needs and can make things go as smoothly as possible. This person may be the practice manager, an assistant or a medical navigator, for example. It is a good idea to ask who can best assist you with communication issues and contact that person prior to your visit. You may also want to connect with a medical TEAM member to arrange necessary accommodations and to answer any questions. These contacts can be done electronically, using a patient portal or email, if available, or by telephone or virtual (video) visit.
How to choose and use in-person vs. virtual visits (or both!)
With hearing loss, it’s important to find out what to expect for the different types of visits. For example, will the clinician be wearing a mask or a clear mask? Will it be video or by telephone? Are translation services (including interpreters and captioning) available? Can you use your own technology? (See below for more information on these options.)
Sometimes you can choose the type of visit and sometimes in-person visits may be needed (for example when an examination, test or procedure is planned). Virtual visits are new to many patients and providers, and we ae all trying to make them work better. You can request that someone contact you prior to the virtual visit to assist with technical details and discuss any assistive devices or other accommodations you may want to use. There is also the option of a virtual visit with video and assistive devices in addition to being in-person for tests or procedures. Let’s think about a medical visit not as a single event in time but include what happens before and after. Before the visit, contact a TEAM member to arrange necessary accommodations and to answer any questions. A virtual visit with a healthcare TEAM member after your visit can help to cross check details, confirm your understanding and give you another opportunity to connect.
Exploring technology options
Here’s where we get creative! A variety of practical tools including patient portal messaging, speech to text apps, videoconferencing (including family and interpreters), assistive listening devices, clear masks and others can help. See below for a list of these tools and links for more information. We encourage you to give them a try.
What to do when it does not go as expected and how to pivot
Ultimately communication is a two way street. Remember to set the tone, be kind, find common goals and try to be as flexible as possible. Work through the barriers and the unexpected with your medical ALLY and TEAM and include interpreters and family members (virtually if not in person). Consider a real-time pivot and even a complete reset if needed. There is always another opportunity to connect after the visit and technology can help.
Resources
Click here for our Tip Sheet for Individuals with Hearing Loss about how to prepare for and manage health care visits and communication.
Click here for our Tip Sheet for Your Medical Team that we encourage you to share with your health care providers. We suggest you add individual details about your hearing loss, how you prefer to communicate and the tools you would like to use at the visit.
Click here to view CHC's Clear Face Mask Tip Sheet (updated August, 2022).
Where to buy clear masks
BendShape Mask - Visit www.bendshapemask.com
FaceView Mask - Visit www.faceviewmask.com
Rafi Nova Smile Mask - Visit www.rafinova.com
Safe'N'Clear - Visit www.safenclear.com
The Clear Mask - Visit www.theclearmask.com
Other clear mask options are available online.
Speech-to-text apps
Video Remote Language Interpretation
Telephone relay services (TRS) for captioning
The following captioning phones and apps can be integrated with videoconferencing platforms used for virtual health visits.
InnoCaption’s DeskView » (Links with all videoconferencing platforms)
Videoconferencing platform with embedded captions
Communication Apps
Big Note app
Video relay services for sign language
The following can be used with videoconferencing/televisits
Assistive listening devices
For guidance on which assistive listening devices are best suited for your hearing loss and/or your hearing aids or cochlear implants, please discuss with your audiologist. Click here to learn more about assistive technology.
Personal sound amplifiers (PSAPs)
Personal sound amplifiers can offer assistance to people with hearing loss who do not use a hearing aid. Acoustical benefit will vary by individual and degree and type of hearing loss. Two PSAP manufacturers to consider are:
Live Listen App and AirPod Pros
Sound Amplifier App by Google
HLAA health care and communication guide
This excellent resource from the Hearing Loss Association of America was developed by Toni Iacolucci and Jody Prysock.
September '20 Webinar Recording
CHC’s webinar Health Care, Hearing Loss and Communication Challenges: Taking Charge in 2020 and Beyond is available to view as a video below. Note we have two versions – one with real-time captioning (CART) and one with sign language interpreting. Scroll past the videos to access many more resources on this topic.
Health Care, Hearing Loss and Communication Challenges – Captioned Version
Health Care, Hearing Loss and Communication Challenges – ASL Version
Bios
Nancy J. Rennert, MD
Dr Nancy J. Rennert is System Chief of Diabetes Care, Nuvance Health, Chief of Endocrinology and Diabetes, Norwalk Hospital and Associate Clinical Professor of Medicine at Yale School of Medicine and The University of Vermont Larner College of Medicine. Her leadership of the multi-hospital Glycemic Care Team, which aligns clinical care with quality improvement, has been recognized nationally. Dr Rennert has extensive experience in medical school admissions, fellowship, residency and medical student training and mentorship for quality improvement and clinical research. She has a longstanding, deep commitment to care for the underserved and marginalized at a Federally Qualified Community Health Center in Connecticut. While pregnant with her third child, Dr Rennert experienced sudden and profound bilateral deafness and uses two cochlear implants. She has been a member of the Association of Medical Professionals with Hearing Loss (AMPHL) since its founding, published on stethoscope use and mentors aspiring and early career hearing impaired medical professionals. She is passionate about health care access, quality and equity and is looking forward to sharing insights from her professional and personal experiences.
Carolyn Stern, MBA
Carolyn Ginsburg Stern is the assistant director of outreach and strategic initiatives at the Center for Hearing and Communication (CHC). As a bilateral cochlear implant user, she helps others hear and connect better with tips, technical information and support and is passionate about the role of healthy hearing in helping people lead productive and connected lives. Carolyn earned her BA from Northwestern University and MBA from Columbia University’s School of Business.