Doctors should consider whether older patients can hear them


(Reuters Health) – Elderly people with hearing loss may have difficulty understanding speech in noisy healthcare settings – and the situation isn’t helped when doctors speak fast and use medical jargon, experts say.

But research on communication between doctors and patients has largely excluded older people with hearing problems. Not taking hearing loss into account means those earlier studies overlooked a common, important and fixable problem in communication, researchers write in the Journal of the American Geriatrics Society.

“This is one of the many things in geriatric medicine that I call low hanging fruit,” said senior author Dr. Joshua Chodosh of NYU Langone Medical Center in New York City. “There are very simple things we can do to make a difference.”

In their report, he and his colleagues point to data suggesting that a quarter of adults ages 60 to 69, and 80 percent of those age 80 and older, have some hearing loss in both ears.

To analyze the extent to which research on doctor-patient communication has taken hearing loss into account, Chodosh and colleagues identified 67 studies published between 2000 and 2016. All measured verbal communication between doctors and patients age 60 and older in healthcare settings – but only 16 of the studies made any mention of hearing loss.

In six studies, hearing loss was merely mentioned. Only three studies examined or discussed a link between hearing loss and communication, and only one actually tried to address hearing loss to improve communication.

In the study in which researchers tried to address hearing loss, 22 percent of participants rated communication with their doctors as poor or unsatisfactory at the start. That proportion fell to 6 percent after the introduction of voice amplifiers and cards for informing doctors of patients’ hearing problems.

“For a long time, I’ve been aware that we don’t pay attention to this enough in clinical medicine,” Chodosh told Reuters Health. “It’s a prevalent problem, whether it’s in the hospital and the clinic.”

The new analysis highlights a clear gap in research on patient-provider communication and offers an area for improvement, write Dr. Frank Lin of the Johns Hopkins School of Medicine in Baltimore and Dr. Heather Whitson of the Duke University School of Medicine in Durham, North Carolina, in an editorial.

Even when formal hearing and vision evaluations are not available, patients can usually let doctors know if they’re having problems hearing or seeing, Lin and Whitson say.

They advise doctors that simple solutions, like minimizing background noise, speaking face to face and creating education materials, can sometimes help.

“We can start improving the evidence base – and clinical practice – by simply remembering to ask,” they write.

Chodosh and his team have more studies planned.

“I would like to see a much greater appreciation of this problem or even just be able to partner with patients to come up with strategies to improve communications,” Chodosh said.

SOURCE: bit.ly/2pEDgeq and bit.ly/2pEwQfc Journal of the American Geriatrics Society, online April 24, 2017.


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