This exclusive content is part of our Healthy Conversations about Hearing Loss series. Read the content below, or download a PDF to print and share.
MILLIONS of people live with hearing loss. The National Institutes of Health (NIH) estimate nearly 30 million Americans could benefit from using a hearing aid. But, according to the World Health Organization (WHO), more than 80% of them do not use one. (A trend we hope will reverse directions as we increase awareness about the significant health and economic benefits associated with better hearing.) Therefore, it’s likely that you know someone who struggles to hear well (even if they don’t wear a hearing aid, and even if they won’t admit it). If we’re not careful, that can get in the way of our communication and even affect our relationship with them.
Communication is an essential part of any relationship, so take the time to be aware of your listeners, especially those that may struggle to hear clearly. We put together this short guide to help. So, when you’re speaking with someone who has hearing loss, even if they’re wearing a hearing aid or other hearing device, follow these best-practice tips for clearly communicating and making the most of the conversation. In fact, many of these practices will improve your communication with everyone—whether they have hearing loss or not.
Look at them when you talk.
People with hearing loss intuitively read lips, even if they’ve never been formally taught. They need to see your lips, but they also need to see your eyes and your facial expressions to pick up on non-verbal cues that color the conversation. Don’t lean into their ear when you talk, so they can see your entire face. Maintain eye contact throughout your conversation and always avoid speaking to them from another room.
If wearing a mask prevents lipreading, try some workarounds. Face masks can be large barriers to communication for those with hearing loss, but they don’t have to be. At first, try to enunciate and speak louder, and use a mask with a clear window or a face shield. If those methods aren’t effective and the person you are speaking with is comfortable trying a distanced method, try stepping back more than 6 feet and removing masks to converse. When all else fails, you can use a pen and paper or the notes app on your phone. Check out our blogs (“Communicating Face to Face Mask” and “Better Hearing and Speech Month Focuses on the Effects of COVID-19”) for more suggestions on communicating during the pandemic.
Make sure your face is well lit and easy to see.
For many of the same reasons just mentioned, the lighting in the room and around your face can affect the conversation. Avoid standing in front of a window or other light source that causes “back lighting.” Take advantage of lamps or lights in the room that can help your conversation partner see your face more clearly. Also, keep your hands away from your face while talking. If you are eating, chewing, smoking, etc. while talking, your speech will be more difficult to understand. For those of you with beards or moustaches, don’t stroke them when speaking.
Eliminate background noise.
Most people with hearing loss find it difficult to separate your speaking voice from distracting background noises. Turn the TV, radio, or dishwasher off. If a room is too “echo-y,” try a different location. When speaking in a small group, like at a dinner party, remember to speak one at a time. Keep everyone focused on one general conversation, rather than several smaller, overlapping conversations. At a restaurant or other public space, find a quieter space when possible.
Speak in a relatively normal voice.
Often for those with hearing loss the trouble is less about the loudness of your voice and more about other factors, like the lighting or background noise in the room. In some circumstances, you can give your voice a small boost in volume, but don’t overdo it. Shouting actually distorts sound and makes it more difficult to understand. If you are wearing a mask, this is especially important. However, don’t overdo it. Raising your voice or shouting can actually distort sound and make it more difficult to understand.
Articulate as clearly as possible, but without exaggeration.
Just like shouting, exaggerated your mouth movements when talking actually makes it more difficult to read your lips and understand your words. Speak at a steady pace and pause every so often to make sure that you’re understood. Be sure to use direct, simple sentences. Longer complex sentences can be hard to follow. Don’t over enunciate your words or move your mouth in “slow motion;” it may seem helpful, but it’s insulting.
Don’t repeat. Rephrase. And never give up!
When the person with hearing loss doesn’t quite get what you’re saying, they may ask you to try again. If so, don’t just repeat it. Rephrase it. Using different words will help clarify your meaning and more quickly get the conversation back on track. Katherine Bouton, New York Times editor and author of Shouting Won’t Help, says: “Once you’ve tried unsuccessfully two or three times, don’t say, ‘Never mind, it doesn’t matter.’ By the time you get to that third try, everything matters.”
Be aware of the listener’s needs.
If you know that the person hears better in one ear than the other, try to position yourself accordingly. Be sure you’ve asked for and obtained their permission before adjusting your position. When moving from one environment to another (i.e., outside to inside, or from a large group to a one-on-one conversation), give the listener time to readjust their hearing. They may need to manually adjust the programming on their hearing aid, or mentally adjust to the new environment. Also, recognize that anyone (with or without hearing loss) has a harder time hearing when they are ill or tired, so be extra patient in those situations.
Pay attention to the listener.
Watch for signs of confusion, puzzlement, or questioning. Raise eyebrows, cocked heads, blank stares, or pursed lips, might mean they aren’t following what you’ve said. Tactfully ask the person if they understood you, or ask leading questions to make sure they’re following the conversation.
We often engage in conversations while doing something else, like making dinner or washing dishes. But remember that these situations can make hearing you more difficult because of the additional noise and inability to see your face. In these situations, pause as often as possible between activity to face the person and speak clearly. If the person with hearing loss seems concerned or confused, try to wrap up the activity and focus on the conversation instead.
Other Ways to Help
Use the person’s name in conversation.
This can be especially important in small groups or meetings, where other conversations and activity creates noise and distraction. We are all attuned to the sound of our own name. When we hear it, it gets our attention and helps us focus on the conversation that follows.
Acquaint the listener with the general topic of conversation.
Introduce the topic and make sure the listener acknowledges and is ready to continue. Avoid sudden changes of topic. If the subject is changed, tell the person clearly what you’re speaking about now. In a group setting, repeat questions or key facts before continuing with the discussion.
Write it down.
For meetings or events, giving the person an agenda or program in advance or at the start can help them stay on track. Even in less formal conversations, write down any important information the listener needs to remember, such as an address or phone number. A quick text message, for instance, can avoid confusion and frustration. If writing it down isn’t possible, and you need to share information verbally, have the listener repeat specifics back to you. Many address numbers and street names sound alike.
Use humor and patience.
Miscommunication can be frustrating for the listener and the speaker. Try to laugh off any mistakes and keep at it with a smile. Patience and persistence lets the listener know that they are important to you and that you enjoy being with and talking to them above all else.
Tips for communicating with face masks.
In response to COVID-19, many are wearing masks that have made communication for everyone more challenging, but especially for those with hearing loss. Masks muffle sound and take away the ability to lip read. Physical distancing also makes communication more difficult as sound levels go down with distance. When talking with a person with hearing loss, use a mask with a transparent window, if possible. Talk a little slower and a little louder, but don’t shout. It may be helpful to use your hands or body language to enhance communication. Moving to a quiet place with less background noise will make it easier to hear what is being said.
Effective communication is always a challenge, and even more so when a person has hearing loss. You may want to use a note-taking app or a pen and paper as a backup plan to ensure mutual understanding.
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