JAMA: Overcoming boundaries to care
Ellen Lafargue, AuD, CCC-A
We want everyone to be aware of an important article just published in the Journal of the American Medical Association, Otolaryngology: Overcoming Additional Barriers to Care for Deaf, Hard of Hearing Patients During COVID-19.
This terrific piece alerts the medical community to the many communication barriers that deaf and hard of hearing people face when receiving medical care in a time when COVID-19 requires the wearing of face masks and the use of social distancing. The article goes on to recommend actions that health care workers can take to increase communication access and ensure an optimal level of care for people with hearing loss. Specific recommendations include the wearing of clear face masks to allow for lipreading; use of sign language interpreters; and the use of real-time captioning apps.
Click below to read the JAMA article by Michael McKee, MD, MPH; Christa Moran, NIC, MEd; and Philip Zazove, MD.
I’d like to point out three tips, not mentioned in the article, that could also be of benefit to physicians when speaking with deaf and hard of hearing patients:
Pencil and Paper – Sometimes the simple solution is the best solution. Old-fashioned pencil and paper may help to get a point across to a person who is having difficulty understanding a particular word or phrase. Having something at the ready at all times to enhance communication is always helpful.
Direct Communication – During this time of masks and social distancing (and really, during any time) the person with hearing loss can often benefit from direct communication. Use effective communication strategies such as speaking directly to the person rather than conversing with your head turned away. Even though the person may not be able to see you if you have a mask on, the direct line between the medical professional and the patient will enhance sound to some extent. Do not talk to someone while your back is turned, for example as you get supplies out of a cabinet. If you are behind the person doing an examination, walk around to the front before asking a question. All of these are basic communication strategies that will allow the patient to hear more of what you say.
Extra Amplification – Remember that masks muffle sound, a fact that has now been well documented. Encourage the patient to make their hearing aids louder if that is possible. A microphone attached to a speaker might be very appropriate in some settings. For patients who have a hearing loss but do not use hearing aids, it’s always a good idea for a physician to have a Pocketalker on hand to facilitate better hearing.
Please let us know what you think of the article and its indication actions. And let us know if the authors (or I) have overlooked a communication tip or tool that you find helpful.
If you haven’t already, please check out our Face Masks and Hearing Loss webinar hosted by the Hearing Loss Association of America and featuring myself and CHC colleague Carolyn Stern.
Be well, everyone!