The conversation
Masks and distance make it difficult for the hearing impaired, but here’s how to help
An already difficult situation is exacerbated for those with hearing loss. filadendron / Getty Images The Centers for Disease Control & Prevention has recommended that all Americans wear face masks when in public. Hospitals across the country assume that anyone walking through the door is a possible case of COVID-19, and therefore patients should wear a mask and come alone. These changes pose potential communication problems for approximately 60 million Americans suffering from hearing loss, ranging from mild problems to severe loss or deafness in one or both ears. The vast majority of people with hearing loss have never had a hearing test and do not use hearing aids, especially not in populations affected by health inequalities. For example, only an estimated 5% of Hispanic / Latino hearing-impaired adults use hearing aids. Together with my audiology and public health colleagues from the Hispanic Hearing Healthcare Access Coalition, we strongly recommend that communities take special measures to stay in touch with the hard of hearing at this time. Mask wear and social distance is a real problem for many people with hearing loss. Hard of Hearing Human brains are designed to use visual cues, such as seeing each other’s lips move, to understand speech. Wearing a mask eliminates this important visual information. Acoustic muffles face masks speech. Wearing a mask over a hearing aid or cochlear implant can be problematic or uncomfortable, causing some people to remove their hearing aids. The need to stay at least six feet apart for social distance can also complicate the audience and the understanding of speech. As distance increases, the sound levels decrease. Research shows that it is further challenging for people with hearing loss to focus their attention on understanding speech. People cannot rely on pre-pandemic habits to compensate, such as leaning in to get closer, seeing someone talk, or bringing a loved one to the hospital to help. Image Source / Getty Images Research shows that background noise in a hospital makes it difficult to hear, understand and absorb important information while interrupting memory, even hearing what is being said at the moment. After measuring the noise levels at a veteran hospital in Portland, Oregon, researchers recorded background noises from medical and surgical wards and then tested acutely ill patients. At best, with low noise, patients with mild to moderate hearing loss were able to recall only 58% of the keywords in the hospital. It dropped to 30% recall at the highest levels of testing in the hospital. All of these interruptions can have serious consequences. People with hidden or undiagnosed hearing loss can now be exposed as their coping strategies falter. In this new reality, those who are hard of hearing and deaf cannot access public health recommendations, learn about available services or make informed decisions about their own care if speech is only auditory. This is especially true for people in hospitals, nursing homes or quarantine, who can suddenly be isolated without the help of family or friends. Improving communication The good news is that simple, effective strategies can promote communication during this time of masks and beyond. Laura Coco, Au.D., a Ph.D. candidate at the University of Arizona, demonstrates the use of teleaudiology to remotely connect with someone with a cochlear implant. Laura Coco, Au.D., CC BY Stand each other at a safe distance of at least six feet. Maintaining eye contact increases social connection and keeps attention focused on communication. Speak slower and more carefully to make it easier for listeners. Speakers naturally try to compensate by projecting, but a more effective approach is to speak more clearly, with greater pronunciation. Ask others to repeat what you said to confirm that the message is understood and not just heard. For healthcare providers, this ‘learning back’ strategy is essential to ensure understanding, whether the discussion is personal or remote. Real-time captions can improve access to telehealth communications, virtual meetings and online education. Ask the deaf or hard of hearing person, “How can I best communicate with you?” Try phasing the information again if the listener is struggling to understand your message. Write down your message or try speech-to-text if someone struggles to hear you. Bryan Wong, Au.D., an audiologist and Ph.D. student at the University of Arizona, makes face screens for local Tucson hospitals. Bryan Wong, Au.D., CC BY Choose quiet spaces with little background noise for better listening. Use or make clear masks or face screens if available, which will help by restoring visual information in speech. Search for and offer various forms of communication, such as written text or real-time captions and auxiliary technology. For those who use American Sign Language, access to qualified interpreters is available via video delivery. People with hearing loss or joint hearing and vision loss may want to bring a printed communication card to the hospital. The Hearing Loss Association of America and the National Association of the Deaf share guidance for patients and providers. Following these recommendations can enable people to communicate more effectively with the hard of hearing. Although many things are currently out of control, everyone can choose communication strategies that will help each other. [You need to understand the coronavirus pandemic, and we can help. Read The Conversation’s newsletter.]This article was published from The Conversation, a non-profit news site dedicated to sharing ideas from academic experts. It was written by: Nicole Marrone, University of Arizona. Read more: Deaf Christians often struggle to hear God’s word, but some find meaning in the riches of who they are. Elderly Americans risk exposure to coronavirus to get their medication Increases Elder Abuse Without Increased Awareness Nicole Marrone receives funding from a patient-centered research institute for patients. ® (PCORI®) Eugene Washington PCORI Engagement Award (EA-15629-UOA), the National Institute for Deafness and Other Communication Disorders (NIDCD) of the National Institutes of Health (R33DC015062), and the Arizona Community Foundation.