Hospitals across the country assume that everyone who walks through the door is a possible Covid-19 case, requiring patients to wear a mask and come alone.
Together with my audiology and public health colleagues from the Hispanic Hearing Healthcare Access Coalition, we strongly recommend that communities take special steps to stay connected to the hearing impaired at this time.
The use of masks and social distancing present a real problem for many people with hearing loss.
Muffle speech facial masks
Human brains are designed to use visual cues, such as watching the lips move, to help understand speech. Wearing a mask removes this vital visual information.
Acoustically, masks dampen speech. Putting a mask over a hearing aid or cochlear implant can be troublesome or uncomfortable, as some can remove hearing aids.
The need to stay at least 6 feet away for social distancing can also make listening and understanding speech more difficult.
As the distance increases, the sound levels decrease. Research shows that walking away makes it harder for people with hearing loss to focus their attention on understanding speech.
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Background noise interferes
Research shows that background noise in a hospital makes it difficult to hear, understand and absorb key information, with memory interrupted even if what was said at the time was heard.
After measuring sound levels at a Portland, Oregon, veterans hospital, the researchers recorded background noise from the medical and surgical wards and then evaluated patients with acute illness.
At best with low noise, hospitalized patients with mild to moderate hearing loss could recall only 58% of the keywords. This was reduced to 30% recovery at the highest hospital noise levels tested. All of these interruptions can have serious consequences.
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Some hearing loss goes undiagnosed
People with undiagnosed or hidden hearing loss can now be revealed, as their coping strategies fail.
In this new reality, those who are deaf and hard of hearing may not have access to public health recommendations, be aware of available services, or make informed decisions about their own care when speech is only hearing.
This is especially true for people in hospitals, nursing homes, or quarantined, who may suddenly become isolated without the help of family or friends.
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There are simple ways to help
The good news is that simple and effective strategies can boost communication during this time of wearing masks and beyond.
They face each other at a safe distance of at least 6 feet. Maintaining eye contact improves social connection and keeps attention focused on communication.
Speak slower and more carefully to make it easier for listeners. Speakers often try to naturally compensate by projecting, but a more effective approach is to speak more clearly, with more enunciation.
Ask others to repeat what you said to confirm that the message is being understood and not just listening. For healthcare providers, this “teaching” strategy is essential to ensure understanding, whether the discussion is in person or remotely.
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Ask people how they want to communicate.
Ask the deaf or hard of hearing person: “How can I best communicate with you?” Try rephrasing the information if the listener is having difficulty understanding your message. Write your message or try voice to text if someone has trouble hearing it.
Select quiet spaces with low background noise for better hearing. If available, wear or make clear masks or face shields, which will help restore visual information in speech.
Search for and offer multiple forms of communication, such as real-time written text or subtitles and assistive technology. For those using American Sign Language, qualified interpreters can be accessed through video streaming.
People with hearing loss (PDF) or combined hearing and vision loss (PDF) can take a printed communication card with them to the hospital.
The Hearing Loss Association of America and the National Association of the Deaf are sharing guidance for patients and providers.
Following these recommendations can help people communicate more effectively with people with hearing problems. While many things are out of control right now, everyone can choose communication strategies that help each other.
Nicole Marrone is an associate professor of speech, language, and hearing science at the University of Arizona.