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Elderly partner doesn't realise she's going deaf

My senior partner, who is in her early 60s, is going deaf. She seems to be completely unaware of the fact but she is now unable to cope with normal conversations unless she can lip-read. Practice meetings, where everyone tends to talk at once, are a nightmare. Her radio is switched on at full volume during lunch breaks and her consultations can often be heard in the waiting room or in the consulting room next door. She plans to retire next year but we are worried there will be a complaint about breach of confidentiality before then. What should we do?

GP's advice

The big concern is that your partner's consultations are being overheard

Have you tried telling your partner, in carefully articulated words of one syllable, that she is going deaf? If not you ought to. She is an intelligent professional and should be regarded as capable of dealing appropriately with information that concerns her own health and social functioning.

Being a good doctor as well as a caring colleague you will no doubt ask her whether her hearing loss is unilateral and whether she has any other symptoms. You will also offer to look in her ears to see whether there is an instantly curable build-up of wax.

If none of these applies, suggest she seeks testing from one of the high-street pharmacists or opticians offering walk-in hearing tests, or sees her own GP to arrange referral to an audiologist.

There is a risk that, like many people whose hearing is deteriorating, she will deny she has a problem. If so you need to focus on damage limitation, and the big concern is that her consultations are being overheard. If she is unenthusiastic about moving to a consulting room further from the main body of the surgery, try to leave the one next to hers unoccupied while she is consulting.

Many GPs cringe at the idea of piped music in the surgery, but it can be invaluable for stopping consulting-room conversations being overheard in the waiting area. It need not be expensive. A series of speakers mounted high on the wall, linked to a CD machine controlled from reception, and a few recordings of light classical and instrumental music will probably serve the purpose.

At least your senior partner is unlikely to object as she won't be able to hear it.

GP's advice

The issue here is fitness to practise

Doctors are faced with this dilemma frequently. Reluctant patients arrive under duress, their spouse clearly fed up with increasing volumes at home. I never cease to be amazed at how much deafness some patients will put up with or deny before they will consider de-waxing or an ENT referral with probable hearing aid.

It is most unlikely your senior partner is not aware of this problem. She may be unwilling to face the ageing process or (more likely) hates the idea of wearing a hearing aid.

There is little logic in the latter since aids are now much smaller and less obtrusive. However, since when were doctors logical about their own medical problems?

You are right to be concerned about your partner and the worry is not just about confidentiality. She runs the risk of missing vital parts of a history and there is a real danger that when she examines by stethoscope she will miss important clinical signs.

The issue here is 'fitness to practise' and the onus nowadays is firmly on doctors' colleagues to resolve a problem or report it.

Does she have a spouse? It may be helpful to get some background if a confidential discussion is possible. The next move is to have an informal one-to-one discussion with her. Chose a partner who gets on well with her and who can adopt a sympathetic approach.

She needs to be told gently but firmly that she must sort her hearing problem out and that there are medicolegal reasons for this. Failure to do so would leave the partners no choice but to approach the LMC.

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