Patients who are deaf or hard of hearing use different communication methods. The right approach depends on the individual and the conversation. A sign-language interpreter, written exchange, captioning or an assistive listening option should not be selected simply from a diagnostic label.
DOJ's hospital communication brief explains that support should reflect the person's abilities and the complexity of the exchange. It describes sign-language and oral interpreters, written communication and real-time transcription as different options.
Establish the preferred method
Ask the patient how they prefer to communicate and what assistance works for them. Determine whether they have personal equipment they wish to use and whether an additional service is needed for this encounter. Use the organization's process for arranging and documenting support.
Do not assume that a patient who answered a greeting can follow a complex explanation. Similarly, do not assume that writing is an adequate substitute without checking whether the patient can use it for the particular discussion.
The goal is a two-way exchange: the patient needs a way to ask questions and explain concerns as well as receive information.
Make the conversation easier to follow
NIDCD recommends facing the person, speaking clearly without shouting and reducing background noise when communicating with someone who has hearing loss. These practical steps may help a spoken conversation; they do not replace needed communication aids or services.
In a suggested nursing workflow, first obtain the person's attention, identify yourself and ask how to make the exchange accessible. Check the environment before beginning a detailed explanation. Keep the patient included when other team members enter the conversation.
For a fictional example, a patient may hear an individual speaker in a quiet room but struggle during a group discussion in which several people speak at once. Address the actual difficulty instead of documenting only that the patient “has hearing loss.”
Check remote support in use
For a video-interpreted encounter, check that participants can see the necessary communication and that the connection remains usable. DOJ notes that remote video interpreting is not effective in every circumstance, including when the person cannot see or be positioned to view the screen. Escalate an ineffective arrangement through the organization's access process.
A record that a video device was supplied does not describe whether the exchange worked. Document the method used and any unresolved barrier according to local standards.
Carry the arrangement into follow-up
Before closing the encounter, agree on an accessible way to communicate subsequent information. Check the actual reminder, telephone process or written resource rather than assuming that the clinic's default method will work.
Share relevant communication arrangements with the next team through the authorized handoff. See communication access for the broader service approach and patient education materials for reviewing the resources supplied.
Sources
- Communicating with People Who Are Deaf or Hard of Hearing in Hospital Settings (accessed 2026-09-17) — U.S. Department of Justice, historical guidance used here for communication-method examples.
- ADA Requirements: Effective Communication (accessed 2026-09-17) — U.S. Department of Justice.
- Age-Related Hearing Loss: communication advice (accessed 2026-09-17) — NIDCD.