When you (or someone you care about) is about to enter a hospital, you might not be thinking about hearing loss. After all, you have another health issue on your mind.  

Hospitals are noisy, full of whirring machines. Imagine that you’re embarrassed, uncomfortable or in pain, anxious or acutely frightened, or simply low in energy. Staff come and go, at all hours, speaking to you. Even before COVID-19 arrived, they might have been wearing a mask. Now they definitely are. Because more than 16 percent of U.S. health care workers are immigrants, you will likely be hearing accents, too.

If you pretend or guess that you understand (you won’t be alone), you risk saying “Yes” when the answer is really “No,” though any seemingly small detail might be important when your health is at stake. You think, “I understand, basically, except for that one word that kept coming up ... who knows what that was.”      

Why would anyone put themselves in this position? It’s crazy, yet most older people with hearing loss arrive at the hospital without hearing aids. In fact, most adults with hearing loss don’t know—or don’t admit to themselves—that their hearing loss is a problem.

In a noisy hospital (and they are indeed quite noisy), a hearing loss that you're used to “may become a much bigger deal,” noted Catherine Palmer, director of audiology for the UPMC Integrated Health System in Pittsburgh, during a hospital safety webinar hosted by the Hearing Loss Association of America.  

People with hearing loss more likely to need hospital care

This scenario comes up all the time: About 40 million American adults have some trouble hearing, and they are more likely to need hospital care. Americans with untreated hearing loss have a 17 percent greater risk of emergency room visits, are more likely to need a hospital stay, spend more days in the hospital, and have a 44 percent higher chance for readmission within 30 days, according to a 2019 study by a team at Johns Hopkins. A separate review of a variety of studies also concluded that people with untreated hearing loss had a higher risk of hospitalization, readmission and mortality.

How hospitals can help

Hospitals have a number of strategies to help, including:

• providing you with an amplifier, also sometimes called a pocket talker
• flagging hearing loss in your electronic record
• posting a sign on your bed or door to notify all workers
• using clear masks or other specialized equipment
• using transcription technology to caption speech

'It's critical that you speak up'

"If you feel any sense of stigma or anything about hearing loss …don't feel that way in a hospital, because we focus on everybody. We take care of everybody. We're not looking to judge you based on your hearing ability, and we're not looking to stereotype either."

As patients, things will go better if we do our share. The first step: Tell everyone you come in contact with that you have hearing loss. As caregivers, we may have to do this job.

“It's critical that you speak up. We cannot just look at you and see, oh, this person has hearing loss,” noted Shawn Norris, Coordinator of Interpreting Services and ADA/Section 1557 Coordinator, at Flagler Hospital in St. Augustine, Florida. In rare cases people have been sent to “behavioral health,” the unit for those with mental health issues, just because “they misunderstood a question or misheard it or misspoke,” he added.

What about my hearing aids?

Should you bring your hearing aids when you go on a planned hospital stay? Many people leave them at home for fear of losing them, which does happen.

If you make that choice, be sure to tell hospital staff you have hearing loss. If clear masks help, bring fresh, wrapped, clear masks with you and offer them to staff. Ask for a hearing amplifier. Plan ahead and practice with a captioning app program, like Otter, which uses artificial intelligence to transcribe a conversation, right before your eyes on your smart phone. The hospital can’t provide this for you, for legal reasons, but you can use it yourself.

If you do bring your hearing aids, and they require charging, don’t forget your charger. A hospital might find a charger if you forget or provide you with batteries if you run out. Ask!

When decisions must be made

This can happen at any step along the way, especially if you’ve arrived as an emergency. Even for people with perfect hearing, it’s difficult to absorb unfamiliar medical terms and see the big picture. Medical decisions can be complex. Often there’s a decision tree—first this, then if we get answer “x”, we’ll do “y.” You might be presented with options, each with its own set of risks and possible benefits. 

It’s best to have a friend or family member with good hearing and concentration present. This is also a time to use a transcriber on your phone. If it’s too distracting to listen and watch the phone, record the conversation and read the transcript later.

Even if you’re wearing the best hearing aids, or are using an amplifier, your hearing probably isn’t perfect. It’s essential that you let your doctors know if they need to slow down, speak louder and repeat themselves. 

More: Communication tips for talking to someone with hearing loss

If your loved one won't admit she has hearing loss

You can’t count on staff to catch that your relative or loved one has hearing loss—only about half of medical staff workers will pick this up, Palmer noted. Make sure that the person accompanying the patient will tell staff at intake that your loved one can’t hear well. This becomes vitally important in other medical settings, too, such as hospice care or in a nursing home.

Encourage her to speak up: Hospital staff will understand and respond kindly. As Norris puts it, “We want to encourage you. If you feel any sense of stigma or anything about hearing loss …don't feel that way in a hospital, because we focus on everybody. We take care of everybody. We're not looking to judge you based on your hearing ability, and we're not looking to stereotype either. We want to take care of you, get you better, have you go home.”