Improving Communication Equity in Hospitalized Patients with Hearing Loss Using Low Cost Amplification Devices

Introduction: Hearing loss is frequently unaddressed due to hearing aid unaffordability. As a result, hospitalized patients present with untreated hearing loss, creating inpatient communication barriers. Personal sound amplification devices (PSADs) offer a low-cost, deployable intervention in the hospital setting, yet quantitative and experiential studies describing their use remain limited.

Methods: We conducted a mixed-method observational study (8/2025- present) of hospitalized adults at a tertiary care center with subjective hearing loss. Eligible patients were identified at the start of hospital admission after a bedside hearing screening in adherence to ASHA protocol. Enrolled subjects completed a Montreal Cognitive Assessment (MOCA) and received a PSAD. Qualitative thematic analysis of post-use surveys and multidisciplinary and multimodal clinical documentation evaluated patient experience, communication equity, and safety.

Results: Fifteen patients were included (mean age 72.8±15.7 years; 46.7% female). Eighty-six percent of patients underwent MOCA at enrollment (mean = 17.5, SD= 4.3), indicating frequent cognitive vulnerability. Nursing staff reported that patients utilizing PSAD’s exhibited improved bedside communication and completion of routine assessments. Physical and occupational therapy teams observed improved reception of instructions, engagement, and efficiency during mobility and functional tasks.

Post-use surveys were completed by 8/15 of subjects, reporting a mean use of 5.1 hours/day for an average of 5.3 days. Subjects reported improvement in understanding providers (4.75/5), hospital satisfaction (4.88/5), engagement in care decisions (4.50/5), and reduced communication-related stress (3.88/5). All recommended PSAD use, and 3 reported purchasing a device for personal use.

Conclusions: PSAD use led to improved inpatient education and engagement, enhancing patient participation in care. In patients with delirium, aphonia, or vision loss, benefits were limited. One patient assumed normal hearing status with amplification, indicative of an implementation gap.