The purpose of this article is to describe the unique needs of patients with hearing loss who are receiving hospice care. Hearing loss is the third most chronic condition in older adults and is often untreated. Such losses can interfere with critical communication exchanges that occur during admissions to hospice as well as during home or inpatient care. Three case scenarios are provided to illustrate these points. A comprehensive plan of options from screening to specific interventions is summarized. Options can be implemented to improve the overall communication for persons with hearing loss and their providers and family members. Improving communication may lead to improved quality of life and quality of care at end of life.