Impairment | Recommendations | Helpful material, resources, or personnel |
Hearing | Ask the patient: "Can you hear me okay the way I'm speaking now?" Speak slowly and clearly, but don't over-exaggerate words. Face the patient to allow lip-reading. As you increase the volume of your voice, try to keep pitch low (higher frequencies are more impaired in presbycusis). Minimize ambient noise. | Portable amplifiers* Written instructions or educational material |
Vision | Avoid communication that relies on gestures: "Place your urine sample over there" or "Can you do this with your hands?" Be aware that the patient may miss subtle body language or facial expressions (a smile or an empathic nod). Use words to share those emotions. If you offer a hand, tell the patient so they can return the gesture. Likewise, tell the patient when you enter and leave the room. If there are multiple people in the room, speak the patient's name to signify that you are addressing them. | Large-print forms and patient education material Reading glasses/magnifiers available Audio-recorded information or personnel to read consent forms or other materials |
Cognitive | Stick to the point. When questions are repeated, answer them again, just as you did the first time. Involve caregiver or companion when available and appropriate, but avoid excluding the patient. Write down key instructions and findings for the patient to take home and refer to later. | Take-home education materials Nurses or other extended care providers to reinforce teaching and assess patient's understanding on issues discussed |