title: Hearing loss in palliative care.
abstract: BACKGROUND
  Age-related hearing loss is remarkably common, affecting more than 60% of adults over the age of 75. Moreover, hearing loss has detrimental effects on quality of life and communication, outcomes that are central to palliative care. Despite its high prevalence, there is remarkably little written on the impact of hearing loss in the palliative care literature.
  
  
  OBJECTIVE
  The objective was to emphasize its importance and the need for further study. We use a case as a springboard for discussing what is known and unknown about the epidemiology, presentation, screening methodologies, and treatment strategies for age-related hearing loss in palliative care.
  
  
  CONCLUSIONS
  The case describes a 65-year-old man with acute myelogenous leukemia (AML) that has progressed despite treatment. No concerns are raised about communication challenges during conversations between the palliative care team and the patient in his quiet room. However, in the midst of a family meeting, shortly after discussing prognosis, the patient reports that he cannot hear what anyone is saying.
  
  
  CONCLUSIONS
  We describe simple methods of screening patients for hearing loss, and suggest that practical approaches should be used universally in patient encounters. These include facing the patient, pitching one's voice low, using a pocket talker, and creating a hearing-friendly environment when planning a family or group meeting.
authors: 1Division of Geriatrics, University of California San Francisco, San Francisco, California.|2Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, California.
authors: Alexander K
authors: AK
authors: Smith
authors: 1Division of Geriatrics, University of California San Francisco, San Francisco, California.|2Geriatrics, Palliative, and Extended Care, Veterans Affairs Medical Center, San Francisco, California.
authors: Nelia
authors: N
authors: Jain
authors: 3Department of Physiological Nursing, University of California San Francisco, San Francisco, California.
authors: Margaret L
authors: ML
authors: Wallhagen
mesh_terms: D000367:Age Factors; D000368:Aged; D034381:Hearing Loss / Q000175:diagnosis*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000451:nursing*; D008297:Male; D010166:Palliative Care