Many older adults have difficulty understanding speech in acute healthcare settings owing to hearing loss, but the effect on patient care is often overlooked, argue Jan Blustein and colleagues
Many healthcare settings are difficult listening situations, with beeping alarms, competing conversations, and poor sound insulation
Communication is key for healthcare quality and safety, so people with hearing loss are at risk of receiving poor care
Clinicians should be aware that older patients might have trouble understanding speech and should use established strategies to improve communication
Hospitals might be able to provide hearing assistive devices and could routinely screen older patients for hearing loss
The World Health Organization estimates that disabling hearing loss affects nearly a third (32.8%) of people aged 65 years and over around the world.1 The prevalence of hearing loss is growing; it is now the fourth leading cause of years lived with disability globally.2
But the implications tend to be overlooked. Clinical care is often delivered in settings where people with hearing loss struggle to understand speech. Communication is key for healthcare quality and safety, so people with hearing loss are at risk of receiving poor care. Simple steps can improve communication in clinical encounters. Changes in practice environments, processes, and policies could substantially improve the quality of medical care. But first, we need greater awareness.
Typically hearing loss isn’t a problem of hearing sounds, but rather of understanding speech. People with mild to moderate presbycusis (age related hearing loss) can often detect sound well and have good speech understanding in ideal circumstances; for example, in rooms with little competing ambient noise, in conversation with one speaker who is facing them. Understanding can decrease when the setting is less than ideal—when the speaker turns away, when there are multiple simultaneous speakers, or when ambient sound …

中文翻译：

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解决听力损失以改善老年人的护理

Jan Blustein和同事认为，许多老年人由于听力受损而在急性医疗保健环境中难以理解语音，但对患者护理的影响却常常被忽略，
许多医疗保健环境都是听力困难的情况，会发出蜂鸣警报，竞争性对话以及隔音效果差
沟通是医疗质量和安全的关键，因此听力障碍的人有受到不良护理的风险。
临床医生应意识到，老年患者可能难以理解语音，应使用既定策略来改善沟通能力
医院可能能够提供助听器并可以定期筛查年龄较大的患者是否有听力损失
世界卫生组织估计，残疾听力损失会影响全球65岁及以上的人中近三分之一（32.8％）。1听力损失的患病率正在上升；现在，它已成为全球残障人士生活的第四个主要原因。2
但是其含义往往被忽略。通常在听力障碍人士难以理解语音的环境中提供临床护理。沟通对于医疗保健质量和安全至关重要，因此听力受损的人有受到不良护理的风险。简单的步骤可以改善临床交流中的交流。执业环境，流程和政策的变化可以大大提高医疗质量。但是首先，我们需要提高认识。
通常，听力损失不是听声音的问题，而是理解语音的问题。轻度至中度老花眼（与年龄有关的听力损失）的人在理想情况下通常可以很好地检测声音并具有良好的言语理解；例如，在几乎没有竞争性环境噪音的房间中，与面对他们的一位发言人交谈。当设置不理想时（扬声器旋转，同时有多个扬声器或环境声音时），理解可能会减少。