II. Management: Communication
- American Disabilities Act mandates "Auxiliary Aids and Services" for deaf or Hearing impaired patients at healthcare facilities
- Attempt to adapt to the patient's preferred communication method (and note in medical record for longterm patients)
 
 - 
                          General
- Maintain eye contact with patient (regardless of Interpreter presence)
 - Speak in a normal volume and tone
 
 - Lip readers
- Maintain eye contact
 - Have a supply of clear masks for staff to allow patients to lip read through the mask
 
 - Speech to Text Applications
- Live Transcribe
 - Otter.ai
 - Ava
 
 - Sign Language Live or via Remote Interpreter
- Use a professional medical american sign Language Interpreter
 - As with any Translation Services, avoid using family members or friends (unless patient declines professional Interpreter)
 
 - Phone Relay or Video Relay Service (via typed text, TTY)
- Calls may be received through a relay service, or initiated by dialing 711
 
 - Makeshift Hearing amplifier
- Use the stethoscope as an amplifier
 - Place the ear tips in the patients ears
 - Speak into the diaphragm of the stethoscope
 - References
- From email communication with D. Nagase, MD
 
 
 - References
- (2021) Presc Lett 28(6): 34-5
 
 
III. Complications
- Decreased social engagement
 - Adverse effects on partner relationship
 - Decreased quality of life
 - Major Depression
 - Decreased functional status (e.g. Activities of Daily Living)
 - Delirium
 - Exacerbates Dementia
 - Increased Fall Risk
 - Increased Mortality