Mr. C. was described in the chart as being “unresponsive” by multiple providers. Sure enough, when I spoke to him, he did not reply. When I leaned in and shouted in his ear, laughter down the hall could be heard from the nurse’s station. But I didn’t care: the “unresponsive” Mr. C was answering my questions.
That was a scene from my training a few years ago. Unfortunately, hearing aids are still notoriously difficult to use, uncomfortable and expensive. Amplification devices for the hard-of-hearing start at $20 from electronics suppliers. However, for routine verbal communication, you are likely already carrying a cheap amplification device in your pocket — a smart phone.
A brief Google search for apps for the hard of hearing gave me a list of potentially useful devices. I decided to check out SoundAmp: 99 cents on the iTunes store, because like most medical professionals, I carry an iPhone. Earbuds didn’t work well, and can be difficult for the elderly, so I bought a $3 headset online and presto, instant communication with my hard of hearing patients.
You can choose a near/far distance mode for conversations. It has a feature called Boost, which will increase high frequency amplification–key when talking to the elderly, who tend to lose the high frequency range.
The cheapie headsets don’t last long, unfortunately. I have found that the airline disposables work fine — my favorite so far is jetBlue.
For patients on contact precautions, a cheap set of headphones can be left in the patient’s room, just as we have dedicated stethoscopes and blood pressure cuffs. You can place the smartphone in the middle of a table in order to pick up conversation from a group. More sophisticated users can get a Bluetooth headset.
Overall, instead of paying $20 and up for an amplifier and one more device you have to carry, you can make your smartphone into a communication device for under $5. Your patients will be grateful.
Earl Smith is a palliative care physician.
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