The Power of the Ask
Getting Hearing Access in Our Healthcare System

By Cheri Perazzoli, HLAA-WA President

color photo of a hand stacking blocks with medical symbols. on the right is the universal blue ear symbol for hearing access.

People with hearing loss have to plan how we’ll hear everywhere we go. This can be especially intimidating and challenging when we’re seeking healthcare. While hearing accommodations should be waiting for us every time, in reality, we have to ask. Well in advance. Every time.

And when I found myself needing a day of medical tests, I learned firsthand how powerful the ask–combined with a simple technology and some education–can be.

Before My Appointments: Ask In Advance

Recently, my primary care doctor ordered three tests: a bone density scan, a heart CT, and an abdominal ultrasound. When the scheduler called, I asked if I could have the appointments all on the same day. Then I told her I have a severe hearing loss and I would need communication assistance for my appointments. I explained that since I wore hearing aids, I might need to remove them for some tests, and depending on the particular test, the type of accommodations might vary. I explained that I customarily request a hearing aid compatible assistive listening device (a Pocketalker with a neckloop and a long extension cord for the microphone.) But given the nature of the test, I wasn’t sure that device would be helpful beyond my check-in. 

Many of these tests require you to hold your breath for specific intervals, so I might need written instructions beforehand or I might need something else. The scheduler transferred me to interpreter services and I repeated the request.  Interpreter services contacted the staff for all three tests and confirmed they had a communication process in place.

Arriving at Overlake Hospital: The Pocketalker Awaits

When I arrived, I was glad to see the receptionist was not wearing a mask. I provided my name, and before the receptionist asked another question, I said, “I’m hard of hearing and requested communication assistance. Do you have a note in the chart or has a device been delivered for this purpose?” She checked the chart, saw the answer was affirmative, picked up a Williams Sound box on the back counter, came back to me, and spoke a little louder and slower and said, “My manager is on the way and I may need your help with this.” 

She opened the box and was already pretty comfortable with the Pocketalker. She slid the neckloop across to me. As she unwound the 12-foot (!) extension cord for the microphone, the manager arrived and the other receptionist watched us. The manager wanted to use some basic ASL, but I explained I don’t communicate in ASL. I needed aural communication assistance.

color photo of a hearing assistive device called a Pocketalker. it has a microphone, cords, and a main unit.
The Pocketalker at Overlake Hospital.
The full label reads, “Use with telecoil hearing aids.”

The receptionist knew she was supposed to use the mic! I encouraged her by saying, “Yes, that’s right, you’ve got it. When you speak into the microphone, what you say will travel through the neckloop directly to my hearing aids, and I’ll be able to better understand what you say.” The other two staff members were pleased to watch and learn about this process. I realized she needed a lavalier or lapel microphone. She could not type and hold the microphone.

After the check-in, the receptionist escorted me to the waiting area and said the technician would be with me shortly. I asked if they would call my name, and the receptionist said yes, and that she’d come get me if I didn’t hear them.

During My Tests: Pocketalker + Education Save the Day

My technician seemed surprised that we would need to communicate via the Pocketalker and asked if I could hear her. I explained I could and told her how the Pocketalker worked. Like many people with hearing loss, I never know if I’ll be able to understand technicians or providers because many wear masks and speak with dialects and accents, and some people don’t understand that with hearing loss, speaking louder is not necessarily better. I explained to her that seeing facial cues with context improved my comprehension. As I prepared for the bone scan, I got all tangled up in the cords. As this was a small space and straightforward directions for the scan–no breath-holding required–we placed the Pocketalker on a chair next to the exam table and her computer.

Next was the CT scan. Once again, I explained my hearing loss, the communication device and how it worked, and why I was using it. I asked if I could keep my hearing aids on and could and could I wear the neckloop (I could). Speaking into the microphone, she explained the procedure. She placed the Pocketalker on the exam table above my head and put me through the tube. The CT machine gives an automated “hold and release breath” command. The Pocketalker amplified the commands; however, there was a great deal of interference, probably electromagnetic (EMI). I could understand the commands but would not have wanted to listen more than a few minutes.

Last was the ultrasound. This technician wore a mask and she spoke with an accent. Plus, this scan required me to lay in different positions and face different directions, plus hold and release my breath. Thus there were many directions I needed to understand. Unfortunately, the microphone didn’t work well, because without a clip, the microphone was a hindrance for this particular procedure.

After the Tests: Gratitude and Suggestions for Improvement

After my tests were done, I returned the Pocketalker to the receptionist, thanked her for her help, and asked if she might make a note to the interpreter services. She was happy to do so. I suggested they contact Williams Sound and order lavalier or clip-on microphones.

As I walked through the lobby and admittance, I couldn’t help but notice all the information geared towards translator and interpreter services, such as ASL, but not much for communication access for people like me with hearing loss. I stopped at the concierge desk to see if I might meet with or speak with someone in interpreter services. I explained I’d just had some testing done and wanted to provide feedback. Of course, I used this opportunity to explain that I was hard of hearing and mention the communication assists I could use.

At Overlake Hospital, translation and interpretation are available in exam rooms and at the volunteer info desk.
Hearing access should be added, as well.

Interpreter services sent someone from patient services. When I explained that I’d had scanning services, I think he wanted to dismiss me, saying he worked with inpatient services, but I persisted, as I noted that my experience took place in this facility and I needed communication support all during my visit. He was very receptive. I complimented what they HAD done for interpretation (languages, including ASL), but at the same time, I let him know didn’t see much information to support my communication needs. I explained those solutions might vary depending on a given situation, such as info / concierge situation. Of course, I let him know about our work in Seattle’s Swedish healthcare system, how hearing loops at counters and tablets with captions can help, the need for the mics with clips, and so on, and gave him my card. Fingers crossed for improvements in the future!

What You Can Do to Get Healthcare Hearing Access

You’ve read my story above. Here are some highlighted suggestions for your next medical appointment.

  • Ask for access far in advance, when you make the appointment, if you can. Specify the kind of access you need: tablets with caption apps such as Ava or Otter preloaded, a Pocketalker or another personal amplifier, telehealth captions, a hearing loop, or an ASL interpreter.
  • If you’re getting an MRI, you will likely be asked to remove your hearing aids. You never know when else you might be asked to remove them–something to keep in mind.
  • If you’re in the Swedish system, ask about hearing loop availability. Several locations have hearing loops at check-in, including Swedish Edmonds, Swedish ER Downtown Seattle, and Swedish Issaquah.
  • Island Hospital also has hearing loops.
  • Learn more about HLAA’s healthcare access work, and read their webpage, Guide for Effective Communication in Healthcare, which includes advice for specific healthcare settings and help for providers.
  • Bring our hospital kit, especially if you’re having surgery. To find out more, read our blog post , then download and print communication tip cards, signs to go by your bed, and more.
A hospital kit lets healthcare staff know that you have a hearing loss and how they can best care for you. We encourage you to print these items and bring them with you.

Share Your Questions, Tips, and Success Stories

Have you successfully received hearing access in our healthcare system? Or do you have questions that we can answer? Please share with us below in the comment section, or send us a message:

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