With a rapidly ageing population, family physicians will encounter more patients with disabilities, including those with hearing impairment. Effective communication with these patients, especially those with chronic conditions is becoming increasingly important. A case study is included to illustrate the difficulties faced by the hearing impaired patient in the community and consequent poor control of his chronic medical conditions. The discussion includes: the main causes of hearing impairment locally, recognizing a patient with presbycusis, hearing aids and assistive devices, communication methods, enhancing effectiveness of communication, and finally community resources available.