For those with hearing loss, navigating life during the COVID-19 pandemic can be particularly challenging.
We now know that wearing a mask is essential in preventing the spread of the virus, but for the hearing impaired, masks can interfere with the ability to use visual cues and read lips. Thankfully, there are ways to reduce such communication barriers while still protecting yourself and others from COVID-19.
Barriers to Communication
Lip-reading provides essential cues that help those with hearing loss to understand the context of what’s being said. For example, some letters (like “b,” “p,” “m” and “f”) are made more in the front of the mouth. Seeing a speaker form these letters provides those with hearing loss added visual information for better understanding. When the speaker is wearing a mask, the barrier not only removes these visual cues but it also alters the clarity and volume of the speech.
During typical conversation, we stand within 5 feet of each other. When talking with someone who has hearing loss, the best distance is about 3 to 5 feet. This allows for lip-reading to naturally occur while providing adequate volume. As distance between communication partners increases, speech information diminishes and becomes quieter.
Yet, to properly social distance, we should be at least 6 feet from each other. Adding that extra foot or more of distance can lead to increased miscommunication, because speech becomes softer and more difficult to understand. Naturally quieter speech sounds (such as “s,” “sh” and “th”), in particular, get lost when communication partners are more than 5 feet apart.
“During the pandemic, as we have been wearing masks regularly, even I have noticed a significant difference in being able to hear what people are saying,” said Julie Ennis, a speech-language pathologist and manager of Acute Rehabilitation Services at Sarasota Memorial.
“I find myself having to truly focus and listen, especially in a noisy environment,” she explained. “And I find that I’m relying on other visual cues like eye expressions, tone of voice and what is happening around me. When I’m speaking, I make a point to speak slower and a little louder. This gives the listener time to process everything I’m saying and allows them to piece words together.”
Tips for Better Communication
If you’re having problems hearing someone who’s wearing a face mask, ask them to repeat what they said more slowly and to enunciate their words more clearly. Be sure you are facing each other, so their voice is projecting toward you.
“The use of face shields is also an option, instead of masks,” said otolaryngologist Jack Wazen, MD, who is chief of staff elect at Sarasota Memorial and whose specialties include treating patients with hearing loss, balance disorders and tinnitus at the Silverstein Institute.
“A big advantage of face shields is that they are fully transparent and allow for lipreading and facial expressions, which are necessary cues for the hearing impaired and especially for those with hearing aids or cochlear implants,” he added. “Face shields also provide extra protection from COVID-19 infection by covering the eyes, which are another site of potential entry for the virus.”
If you’re trying to communicate with someone who has hearing loss, speak a little louder but do not yell. Get as close as is safely possible. Monitor your pitch, volume and rate of speech, and consider using gestures or pointing.
Specialty face masks and technology can also help. In addition to face shields, there are face masks available that have see-through "windows" to allow for lip-reading. Both over-the-counter and high-tech devices are available to amplify the volume of speech for listeners; there are also smartphone apps that can translate speech into text or can provide speech amplification.
If you have hearing aids or implants, your ENT (Ear, Nose and Throat) physician, audiologist or hearing instrument specialist can direct you to the most effective smartphone apps or high-tech devices to pair with your particular hearing aid.
For More Information
The Hearing Loss Association of America (HLAA) website has numerous resources for those with hearing impairments on their website. In particular, its “Guide for Effective Communication in Health Care” offers practical tips for boosting communication with your healthcare providers. This is especially beneficial during the COVID-19 pandemic, which may create a different experience than you’ve encountered in the past during doctor’s appointment or a hospital stay.
Jennifer Wilson, senior service line marketing specialist for Sarasota Memorial, has more than 25 years' experience in healthcare communications and public relations. She has a bachelor’s degree in communications from East Carolina University, is accredited in public relations and is a certified public relations counselor.