Can't Hear the Doctor? Telehealth Audio Troubleshooting for Seniors

The video connects. The doctor appears on screen. Your parent smiles. Then: "I can't hear you." The doctor repeats themselves louder. Your parent turns the tablet over looking for a volume button. The doctor's lips move but nothing comes through. Five minutes of the appointment disappear into silence and frustration.

Audio is the number one reason telehealth visits fail for seniors. Not the internet. Not the camera. Not the software. The audio.

It fails for predictable reasons: tablet speakers that aren't loud enough for age-related hearing loss, microphones that don't pick up a soft-spoken senior's voice from across a table, Bluetooth hearing aids that unpair at the worst possible moment, and app-level permissions that block audio without any visible warning.

Every one of these problems has a fix. This guide walks through them in the order you should check — from the simplest solutions to the less obvious ones — so you can resolve the issue before the appointment, not during it.

The 60-Second Audio Check

Before any troubleshooting, do this basic test. Open any video on the tablet (YouTube, a news clip, anything with speech) and answer two questions:

  1. Can your parent hear the video clearly at maximum volume? Turn the physical volume buttons all the way up. If they still can't hear it well enough, the built-in speakers aren't sufficient and you need external audio (jump to the "External Speakers" section below).

  2. Does audio come out of the right place? Sometimes the tablet is routing audio to a Bluetooth device that's turned off, to a pair of headphones that aren't plugged in, or to a different output. If you see sound waves in the video but hear nothing, check the audio output setting.

If the 60-second check passes — they can hear video playback clearly — the speakers are fine, and any audio issues during telehealth are likely app-specific (permissions, microphone, or platform settings). If it fails, you have a hardware or volume problem to solve first.

Problem 1: "I Can't Hear the Doctor" (Speaker Volume)

This is the most common complaint and usually the easiest to fix.

Check the obvious first: - Volume buttons are turned all the way up (the physical buttons on the side of the device) - The device isn't muted (look for a mute switch on iPads, or a muted speaker icon on screen) - No headphones are plugged in or connected via Bluetooth that might be intercepting audio

If maximum volume still isn't loud enough:

The honest truth is that most tablet speakers aren't designed for people with hearing loss. They're designed for headphone users. A tablet at full volume in a quiet room might produce 75-80 decibels — fine for normal hearing, but inadequate for the roughly 30% of adults over 65 who have significant hearing loss.

The solution is external audio. You have three options:

Option A: A portable Bluetooth speaker. Place it close to your parent (on the table, not across the room). A speaker like the JBL Go 4 ($35) or Anker Soundcore Mini ($22) can produce 85+ decibels — noticeably louder than any tablet speaker. Pair it once and it should reconnect automatically for future appointments.

Option B: Wired speakers or headphones. If Bluetooth is too complicated (pairing issues, forgetting to charge), a wired connection is simpler. A basic 3.5mm desktop speaker ($15-$20) plugged into the headphone jack "just works." For tablets without a headphone jack (newer iPads), you'll need a USB-C to 3.5mm adapter ($9).

Option C: Over-ear headphones. Some seniors prefer headphones because they block background noise and pipe the doctor's voice directly into their ears. Choose over-ear (not earbuds — those fall out and are hard to position for older hands). Look for models with a simple on/off switch and large, comfortable ear cups. The Sony MDR-ZX110 ($15) or Audio-Technica ATH-M20x ($49) are both good, inexpensive options with clear speech reproduction.

Problem 2: "The Doctor Can't Hear Me" (Microphone Issues)

The doctor can hear the device audio (your parent's speakers work in reverse), but your parent's voice sounds muffled, distant, or inaudible.

Common causes:

Distance. Tablet microphones are designed for someone holding the device 1-2 feet away. If your parent is sitting 4 feet from a tablet on a desk, the microphone is picking up more room echo than voice. Move the device closer, or get an external microphone.

Obstruction. Cases, covers, or even a hand placed over the microphone hole will muffle the audio. Find the microphone location (usually a tiny hole on the bottom or side of the device) and make sure nothing is blocking it.

App permissions. This is the sneaky one. If the telehealth app doesn't have microphone permission, the video connects but the audio only goes one way. The app may not warn you — it just silently fails.

How to check microphone permissions:

On iPad/iPhone: Settings > Privacy & Security > Microphone > make sure the telehealth app (Zoom, MyChart, etc.) is toggled ON

On Android: Settings > Apps > [the telehealth app] > Permissions > Microphone > set to "Allow"

On a laptop: Windows: Settings > Privacy > Microphone > allow apps to access your microphone Mac: System Settings > Privacy & Security > Microphone > check the app

If the microphone works but the voice quality is poor:

Consider a clip-on lavalier microphone ($10-$20) that plugs into the headphone jack or USB-C port. It attaches to your parent's collar and picks up their voice cleanly regardless of where the tablet is positioned. This is a great solution for parents who sit far from the screen or speak softly.

Problem 3: Hearing Aid Bluetooth Pairing

If your parent wears Bluetooth-capable hearing aids, pairing them with the tablet creates the best telehealth audio experience — the doctor's voice goes directly to the hearing aids, clear and personalized. But the pairing process can be fragile.

Initial pairing (do this once, ahead of time):

  1. On the hearing aids: put them in pairing mode (varies by brand — usually by opening and closing the battery door, or holding a button on the charger case)
  2. On the tablet: go to Settings > Bluetooth > turn Bluetooth on > look for the hearing aid name in the list of available devices
  3. Tap the hearing aid name to pair. You may need to pair left and right ears separately.
  4. Play a test video to confirm audio is routing through the hearing aids

The most common pairing problems:

"My hearing aids don't show up in the Bluetooth list." - Make sure the hearing aids are actually in pairing mode (the indicator light should be flashing) - Only one device can be connected at a time — if the hearing aids are already paired to a phone, disconnect them from the phone first - Restart Bluetooth on the tablet (toggle off, wait 10 seconds, toggle on)

"They paired before but won't connect now." - Bluetooth connections sometimes "forget" each other after updates or restarts. Go to Settings > Bluetooth, tap the hearing aid name, select "Forget This Device," and re-pair from scratch - If this keeps happening, check for firmware updates on both the hearing aids (through the manufacturer's app) and the tablet

"Audio cuts in and out during the visit." - Move the tablet closer to the hearing aids (Bluetooth range is typically 30 feet, but walls and interference reduce it) - Close other Bluetooth-connected devices nearby that might be competing for the connection - If the connection is unreliable, fall back to Option A (external speaker) rather than losing audio mid-appointment

When hearing aids won't work with Bluetooth:

Older hearing aids (pre-2018 or so) often don't have Bluetooth. In that case, don't force it — use a loud external speaker placed close to the patient. Some audiologists can also program "telehealth" settings into modern hearing aids that optimize for electronic audio rather than in-person speech. It's worth asking at the next audiology appointment.

Problem 4: Camera Permission Blocks Audio Too

Here's a gotcha that catches many families: on some telehealth platforms, if the camera permission is denied, the app also blocks the microphone — even though they're technically separate permissions.

If your parent joined a video visit and has no audio in either direction, check both camera AND microphone permissions in the device settings. Grant both, close the app completely, and rejoin the visit.

On some platforms (particularly browser-based telehealth like Doxy.me), the browser itself needs camera and microphone permission in addition to any app-level settings. Look for a camera/microphone icon in the browser's address bar and make sure it says "Allow."

Problem 5: Echo and Feedback

If the doctor hears their own voice echoing back, or if there's a screeching feedback loop, the tablet's microphone is picking up the speaker output and sending it back.

Fixes:

  • Use headphones or earbuds — this is the simplest fix because the microphone can't pick up audio that's going into the patient's ears instead of through speakers
  • Reduce speaker volume slightly — feedback happens when the speaker is too loud relative to the microphone sensitivity
  • Move the external speaker away from the tablet's microphone — if using an external speaker, don't place it right next to the device
  • Check the telehealth app settings for "echo cancellation" or "noise suppression" and enable them

The Pre-Visit Audio Checklist

Run through this checklist 15 minutes before every appointment until audio is consistently reliable:

  1. Turn volume to maximum. Can you hear a test video clearly? If not, connect the external speaker/headphones.
  2. Check Bluetooth. Are hearing aids or speakers connected? (Look in Settings > Bluetooth for the device name with "Connected" status.)
  3. Test the microphone. Open the Voice Memos app (iPhone/iPad) or a voice recorder and record 10 seconds of your parent speaking. Play it back. If it's clear, the microphone is fine.
  4. Check app permissions. Open Settings > Privacy > Microphone and Camera. Is the telehealth app allowed for both?
  5. Close other apps. Open apps can sometimes grab audio resources. Force-close everything except the telehealth app.

Write this checklist on a card and keep it with the device. After a few appointments, it becomes second nature.

When Nothing Works

If you've tried everything and audio still fails during the visit, have a backup plan:

  • Call in by phone. Most telehealth platforms have a dial-in number. Your parent keeps the video open (so the doctor can see them) but uses the phone for audio. It's clunky but functional.
  • Use a second device. Join the same video meeting on both the tablet (for video) and a smartphone (for audio through the phone speaker). Mute the tablet's audio and microphone to prevent echo.
  • Request a phone-only visit. If video audio is consistently unreliable, many providers will do a phone-only consultation. It's not ideal, but it's better than missing care.

Audio problems are solvable — they just require systematic troubleshooting rather than guessing. The Telehealth Parent Guide includes a printable audio troubleshooting flowchart that walks through every scenario in this article, plus the device setup guides and pre-visit checklists that prevent most problems before they start.