Faculty, Staff and Student Publications
Publication Date
7-1-2024
Journal
Cureus
Abstract
Sensory deficits, including hypoacusis, can cause a barrier to communication between healthcare providers and patients, which in turn can lead to misdiagnosis and loss of patient autonomy. Such deficits are frequently overlooked in clinical encounters. We present a 92-year-old Spanish-speaking female who presented twice to the Emergency Department for complications of a diabetic foot infection. Limited evaluation, documentation, and accommodations regarding the patient's hypoacusis led to a misinterpretation of her mental status and a transfer of decision-making to surrogates. A two-toe amputation, mechanical intubation, and intensive care unit stay were followed. It was only after these events that the caregivers realized the patient's hypoacusis and learned about her different wishes focused on pain control and hospice care rather than surgical intervention. Available geriatric tools, a consultation with a geriatrician, a thorough evaluation of sensory deficits, and a multidimensional and comprehensive approach could have prevented the loss of autonomy and unexpected care.
Keywords
geriatrics and internal medicine, altered mental status evaluation, comprehensive geriatric assessment, patient autonomy, hearing impairment
DOI
10.7759/cureus.65464
PMID
39184752
PMCID
PMC11344631
PubMedCentral® Posted Date
7-26-2024
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes