When working with a patient who has impaired hearing what strategy should the medical assistant use?

Table of Contents Show

What services can help?
Tips for caring for someone with vision loss
What services can help?
Tips for caring for someone with oral health problems
Tips to help you hear better
Be assertive
Using visual cues
Using context
Reduce background noise
Asking for clarification
Asking for repeats
Importance of concentration and keeping calm
Tips for communicating with a person with hearing loss
Speak clearly and don’t shout
Face the person
Reduce the distance between you and the person
Reduce background noise
Rephrase the sentence

While some hearing loss is considered normal as you get older, people are more likely to have hearing problems if they are over 55 years of age.

If the person you care for is over 65 years of age, it is recommended that they have their hearing tested every year. You can talk to their doctor about getting a test.

When caring for someone with poor hearing, it’s important to:

make sure you have their attention and stand in front of them when speaking
look at the person as you speak
speak slowly and clearly, but do not over-emphasise or distort your lip movements as this can make it hard for people to read your lips
not shout – although sometimes you may need to speak louder
remember that shouting can make it hard for people to lip-read
use body language and facial expressions when you speak to help give some context to the person you are speaking to
write messages so they can read them
remember that beards, moustaches, chewing and putting hands in front of your face can obscure communication
avoid talking in a noisy environment, or try to reduce background noise when possible
speak directly to the deaf person and not to the interpreter if an Auslan (sign language) interpreter is present
make sure that hearing aids are functioning, being used properly and checked regularly
install visual smoke detectors in the house
investigate other visual alerts such as alarm clocks and front door alerts
install assistive-listening devices such as volume-controlled phones for contacting people in an emergency.

What services can help?

If someone you are caring for is having difficulties with their hearing, the first step is to see a doctor. The GP may refer them to another health professional, such as an audiologist or audiometrist.

They may also be eligible to access subsidised hearing services through the Australian Government Hearing Services Program. Visit the Hearing Services Program website to find out more.

Tips for caring for someone with vision loss

After the age of 40, the risk of eye diseases and vision problems increases drastically. People with vision problems can get depression and have an increased risk of falls and hip fractures.

When caring for someone who has vision problems:

say your name when you arrive
use a clear natural voice when speaking
say what you’re doing if you’re moving about the room or leaving
tell them if there’s food in front of them, including what it is and where it’s placed on the plate, perhaps using the idea of a clock face (for example, beans are at 12 o’clock)
warn the person about the temperature of food or drink when you’re giving it to them
leave everything as you found it in their home. If you need to move something, tell them where you have moved it to
be especially careful when the house is being cleaned. Vacuum cords, wet floors and a mop and bucket are all potential tripping hazards
shut doors completely or leave them fully open. A half-open door is a hazard
let them take your arm and walk slowly, and make sure you remove or describe any obstacles in their way when guiding them around.

What services can help?

Regular eye tests may help detect problems early, which can improve chances of receiving effective treatment and support. Eye testing by an optometrist is covered under Medicare. Read more on services that are subsidised by the Government on the Medicare Benefits Schedule website.

You can also visit the Australian Government's healthdirect website to read more eye health tips for people over 60.

Tips for caring for someone with oral health problems

Maintaining a high standard of oral health can become increasingly difficult as you grow older. When caring for an older person, it’s important to make sure they continue to look after their oral health.

Help them do this by making sure they:

visit the dentist as recommended for their dental condition and age to check for dental disease and more serious diseases of the mouth
tell the dentist about any general health problems and medications they are taking as this may affect their dental health and treatment
brush their teeth twice a day, especially after meals, and use dental floss to remove plaque which causes gum disease
use a fluoride or sensitive toothpaste
eat a healthy, balanced diet and avoid sweet foods and drinks between meals
clean their mouth and/or dentures well each day and have both checked regularly by the dentist.

Working with patients who are cognitively impaired presents an ongoing communication challenge. For instance, they likely will have trouble following any instructions about their care, including how and when to take prescriptions. Make sure someone can closely monitor care management, and try to involve a care partner whenever possible.

Here are 15 tips for effectively working with and communicating with cognitively impaired patients.

Try to address the patient directly, even if his or her cognitive capacity is diminished.
Gain the person's attention. Sit in front of and at the same level as him or her and maintain eye contact.
Speak distinctly and at a natural rate of speed. Resist the temptation to speak loudly.
Help orient the patient. Explain (or re-explain) who you are and what you will be doing.
If possible, meet in surroundings familiar to the patient. Consider having a family member or other familiar person present at first.
Support and reassure the patient. Acknowledge when responses are correct.
If the patient gropes for a word, gently provide assistance.
Make it clear that the encounter is not a "test" but rather a search for information to help the patient.
Use simple, direct wording. Present one question, instruction, or statement at a time.
If the patient hears you but does not understand you, rephrase your statement.
Although open-ended questions are advisable in most interview situations, patients with cognitive impairments often have difficulty coping with them. Consider using a yes-or-no or multiple-choice format.
Remember that many older people have hearing or vision problems, which can add to their confusion.
Consider having someone call the patient to follow up on instructions after outpatient visits.
If the patient can read, provide written instructions and other background information about the problem and options for solutions.
Address potential issues of driving, getting lost, and home safety each time you see the patient. And, encourage regular physical activity, social activity, hobbies, and intellectual stimulation, as well as a healthy diet. Some studies link these approaches to the maintenance of cognitive function.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed: May 17, 2017

Your hearing device will help you hear better in some situations, but for better results using a range of communication skills will help you make the most of your hearing and your hearing device. There are other things you can do to give yourself the best chance of hearing and understanding well. These are commonly known as “communication tactics”. The best thing about these tactics is that they are useful for everyone, whether or not they have a hearing loss or use a hearing device.

Tips to help you hear better

Be assertive

Inform people you have a hearing loss and tell them how they can help you. Most people will be happy to oblige if they understand what they need to do.

Explain you don’t need them to shout at you, but to face you when they are talking and speak normally. You might need to remind people of this at times.

Using visual cues

We all “lip-read” to some degree, as we understand how different sounds look on people’s lips when they are talking. We use this naturally to help us figure out what a word might be if we missed it.

Keep a clear view of a person’s face by looking at them when they talk and making sure the room is well-lit.

Using context

When chatting with somebody try not to worry about hearing every single word but focus instead on the theme of the conversation. You can piece in missed words if you understand the general context of the conversation.

Reduce background noise

Try to reduce the noise around you when people are speaking, for example, turn off the television or radio, or sit away from the kitchen or entrance-way in a café.

Asking for clarification

If you miss what somebody has said and you can’t figure it out, try to avoid saying simply “I can’t hear you” or “what did you say?” as this will eventually lead to frustration for yourself and those talking with you.

Instead, ask them to repeat specifically what you missed. For example, “I’m sorry; I missed where you said you were going on Sunday afternoon?”

Asking for repeats

If you keep missing the same word or group of words, ask the speaker to rephrase what they are saying. You might say “I keep missing that last part about your new car, could you please try saying it a different way for me?”

Importance of concentration and keeping calm

Try to keep calm if you can’t hear well in certain situations. When you miss words you might find yourself getting tense, but this will make it even harder for you to catch up with what has been said. There will be times when you don’t hear so well, when you find it almost impossible to figure out the conversation. This is an expected part of having a hearing loss, even if you are wearing a hearing device.

It can help to think about what you can do to help yourself in these situations. For example, can you ask the speaker to write down what they have said?

Remember that if you are tired, or unwell, you will likely find it more difficult to concentrate on following a conversation and you might not hear as well.

Tips for communicating with a person with hearing loss

A person with a hearing loss will struggle to hear at times, even with a hearing device. This is normal and to be expected – a hearing device can help a person, but it cannot cure the underlying hearing loss. Your understanding and consideration of this will help them a great deal.

Try not to get frustrated if somebody can’t hear you – they are asking you to repeat yourself because they value what you have to say.

Speak clearly and don’t shout

Shouting will make your voice distorted and hard to understand. Instead, speak clearly and if necessary, slightly slower than normal. If you do need to raise your voice, project your voice the way you would if you were speaking to a person on the other side of the room. This usually sounds clearer than shouting.

Face the person

When talking to a person who has a hearing loss, make sure you face them. This is helpful because they can watch your face for extra clues about what you are saying, and the volume of your voice will be louder when you are looking at them.

Try not to cover or hold objects in front of your mouth, as this will make it hard for a person with a hearing loss to see and read your lips.

Reduce the distance between you and the person

The ideal listening distance for a hearing impaired person is less than two meters from the speaker. Avoid talking to a person with a hearing loss from a different room.

Reduce background noise

Reduce background noise if you can – turn off the radio or television, close the door leading onto a busy street, pick a quieter restaurant to dine in.

Rephrase the sentence

Rephrase what you are saying if you need to. If a person with a hearing loss asks you to repeat something you said, repeat it once – if they still cannot understand you, think of a different way to say the same thing. This is something most people will naturally do, even for those with normal hearing.