Best Practices in Managing Patients with Hearing Loss

Looking at the paragraph given for the challenging patient situations and behaviors referenced for this week's assigned reading. Discuss best practices in managing this scenario in the context of the focused history and physical examination encounter. Support your response with a minimum of two APRN-approved scholarly resources.
situation from the reading please use this example and resources provided
Patient with Hearing Loss
According to the World Health Organization (WHO), >5% of the world’s population (466 million) has disabling hearing loss defined as hearing loss >40 dB in the better hearing ear in adults.56 In the United States, approximately 10% of the population is deaf or hard of hearing. This population “is a heterogeneous group that includes persons who have varying degrees of hearing loss, use multiple languages, and belong to different cultures. Solutions to providing health care to one group from one population do not necessarily apply to other groups. Factors that must be considered with this population include the degree of hearing loss, age of onset of loss, preferred language, and psychological issues.”57 Communication and trust are particular challenges, and the risk of miscommunication is high.58 Even hearing-impaired patients who use English may not follow standard English usage.
Find out the patient’s preferred method of communication. Learn whether the patient belonged to the deaf culture or the hearing culture when the hearing loss occurred relative to the development of speech and language as well as the kinds of schools the patient attended. Review responses to written questionnaires. Patients may use American Sign Language (ASL), a unique language with its own syntax. These patients typically have a low English reading level and prefer having certified ASL interpreters present during their visits.57 Other patients may use varying combinations of signs and speech. If working with an interpreter, adopt the principles identified earlier. Alternatively, time-consuming handwritten questions and answers may be the only solution.
Partial hearing deficits vary. If the patient has a hearing aid, find out if the patient is using it. Make sure it is working. For patients with unilateral hearing loss, sit on the hearing side. A person who is hard of hearing may not be aware of the problem, a situation you will have to address tactfully. Eliminate background noise from the television or hallway. Face patients who can read lips directly, in good light. Patients should put on their glasses to see cues that help them understand you. Speak at a normal volume and rate. Avoid letting your voice trail off at the ends of sentences, covering your mouth, or looking down at papers while speaking. Emphasize key points first. Even the best lip readers comprehend only a part of what you say, so asking them to “teach back” is essential. When closing, write out your instructions for them to take home.