Hearing Access in Healthcare: What’s Coming and What You Can Do Now

When HLAA-WA president Cheri Perazzoli was injured a car accident a few years ago, she needed hospital care. But once at the hospital, she wasn’t able to understand hospital staff or communicate, even with her hearing aids.

“I was bewildered and under stress, and I couldn’t hear what the hospital staff were saying to me,” Cheri explained. “I had suffered a concussion, which was disorienting by itself, but it was accompanied by a bout of roaring tinnitus making it even harder to understand.” She had a remote microphone on her hearing aid, but she couldn’t use it because the battery was low. Hospital staff didn’t know how to communicate with people with hearing loss, and they had no technologies available to help her.

“The whole experience was hard enough, because who wants to be injured or sick?  But it was made worse by a lack of communication access,” Cheri said

Hearing access in public spaces is improving across America, but in most places, healthcare settings lag behind. Advocates are stepping in to close the gaps.

In Washington State, HLAA-WA developed hospital kits several years ago to empower people with hearing loss to advocate for themselves in healthcare settings. The kit includes a button that says “Please face me, I lip read,” plus a card that says, “I am hard of hearing. Please face me. Speak clearly.” Advocates Karen Utter and Judi Carr worked with the Swedish medical system to make similar kits available for everyone.

“It’s not widely known, but hospitals are required to provide communication access,” Cheri said. Some hospitals do, she explained. She and Karen Utter found hearing loops at several Swedish locations throughout the Puget Sound area, including the hospital ERs in Seattle and Issaquah, in 2016. “It’s crucial to keep staff informed about these loops, keep the loops turned on, and make sure the sign is visible so people know to use the loop,” she said. “Staff come and go, but the loops need to stay,” she added, noting the need for staff training about the hearing loops and also about how to communicate with people with hearing loss—both of which are often lacking.

The pandemic revealed — and worsened — the barriers people with hearing loss face as they navigate our healthcare systems. Help is coming, such as this looped vaccination site in Seattle, which also drew attention to the need for improved healthcare access for hard-of-hearing people throughout Washington State.

Ann Thomas, hearing loop advocate and HLAA-Diablo Valley president, is working with the University of California San Francisco Health (UCSF) and is a member of the UCSF Patient Advisory Council and John Muir Health to improve communication access for people with hearing loss.

“People with hearing loss live uncertain lives. We don’t know when we will be able to hear and understand and when we won’t.  We need to prepare for the worst-case scenario and ask for communication access because if we don’t, it will be too late to receive the assistance we need. In healthcare settings, we need to prepare for our worst hearing situations and ask for communication access, rather than only think about how well we hear in the best situations,” Ann explains.

Until enough systems and technologies are in place, how can people with hearing loss get the accessible care that they need now?

  • Check out this outstanding Effective Communication in Health Care guide from HLAA, which includes a video geared to patients with hearing loss, communication tips, guides for specific situations (inpatient settings, outpatient settings, tests, and so on) and much more.
  • For telehealth visits, request captions—CART, if possible.
  • Bring clear masks (also available here) and ask hospital staff to use them.
  • Download and print a communication tip card to give to hospital staff, and a sign that tells people that you’re hard-of-hearing.
  • If you’ll be in the Swedish healthcare system, you can print these communication aids.
  • Inform your providers that you have a hearing loss. Ask them to face you, speak clearly, and even drop their mask briefly if you’re really struggling to hear.
  • Let the hospital or clinic know that communication access options such as hearing loops are available. Counter (point-of-service) loops are inexpensive but life-changing.
  • Practice good self-care and prepare carefully before you go. See this hospital survival guide from Consumer Reports.
  • Bring an advocate with typical hearing with you, if possible, to help you communicate.
  • Read this  excellent advice from Dr. Chad Ruffin, which is geared specifically for care during the COVID-19 era.
  • Use a caption app on your phone or iPad, such as Otter or AVA. Tina Childress has more app suggestions on this list.