By Jennifer Sowards, AuD
The use of masks, plexiglass barriers, and physical distancing have become the norm in order to mitigate the spread of COVID-19. As important as these measures are, they have a significant negative impact on the ability to communicate for those with hearing loss. This is especially challenging if medical care is needed, in particular for COVID-19, when a patient may need to be isolated. As a person with hearing loss, I am learning to navigate the ‘new normal’ in this pandemic and want to share some tips for better communication.
Masks are problematic for individuals with hearing loss because the material makes speech sound muffled. This makes it very difficult for someone with hearing loss to clearly understand a masked speaker, even if they are wearing well-adjusted hearing aids.
The masks also limit the amount of visual cues available in the form of lip reading. Certain high-frequency consonant sounds such as ‘s’ and ‘f’ may be difficult for individuals to distinguish even with normal hearing, but these sounds could be sorted out by watching the talker’s lips because they use very different mouth positions. A person with hearing loss could understand the difference between the words ‘sit’ and ‘fit’ by watching the lips of the talker. However, most masks make it impossible to lip read and make it more difficult for those with hearing loss to understand.
“Masks are problematic for individuals with hearing loss because the material makes speech sound muffled.”
Another strategy for preventing viral transmission has been the installation of physical barriers in certain grocery stores and retail sites, usually in the form of a clear plexiglass sheet between the workers and customers. These barriers also block sound and make it more difficult to understand speech. This problem may be compounded if the worker and the customer are also wearing masks.
Maintaining a safe social distance of six feet between those trying to communicate can also be problematic for people with hearing loss. A typical communication strategy for those with hearing loss is to place themselves physically closer to the person speaking in order to be able to hear their speech more clearly and better see the talker’s face for lip reading and visual cues. An individual with hearing loss will likely have a more difficult time clearly understanding the speaker at a safe social distance.
If you have hearing loss, we recommend that you come up with a communication plan in case you need to seek medical care during the pandemic and do not have access to your hearing aids, your main communication partner, or other assistive devices due to infection-control measures.
The Massachusetts Commission for the Deaf and Hard of Hearing has a communication card that can be printed and brought with to medical appointments related to COVID-19. It is available online at www.mass.gov/service-details/covid-19-card.
Also, if a person with hearing devices experiences difficulty understanding, we recommend they look into whether adjustments can be made to their hearing aids, such as adding a second program that would boost the sounds that are being muffled by the masks and protective barriers.
Fortunately, we are now able to offer telehealth sessions with remote programming of most hearing devices (for patients who can download a remote-care app to their smartphones). We also want to remind hearing-aid users to be careful when removing their masks so as not to inadvertently knock the hearing devices from their ears.
If you are communicating with someone who has hearing loss, there are things you can do to improve understanding. We also recommend that, when wearing a mask and speaking to someone with hearing loss, you should use clear, articulate speech at a slightly higher volume than you would normally use to help them hear more clearly. Using written communication in the form of paper and pen may seem primitive, but worth it if important information needs to be conveyed, such as directions and medication instructions.
At Florence Hearing Health Care, we have masks that have a clear area over the speaker’s lips in order to allow the person with hearing loss to lip read when we reopen for in-office appointments. There are patterns available online to make a homemade version of this type of mask as well.
Jennifer Sowards is an audiologist and founder of Florence Hearing Health Care.