Hearing loss can happen so gradually that it can go unnoticed for many years. Having difficulty hearing in large groups or noisy areas, having to ask people to repeat themselves and listening to the television or radio at levels that are uncomfortable for others may signal that the individual has a hearing loss.
Hearing loss is an extremely common health issue. According to the World Health Organization (WHO), the number of persons with hearing is rising due to both an increase in the world’s population and longer life expectancies.1 Currently, the WHO estimates that there are 278 million people with moderate to profound hearing loss in both ears.1 The good news is that properly fitted hearing aids can improve communication in at least 90% of these individuals.2 Unfortunately, current data suggest that only one in five people who could benefit from hearing aids actually uses them.3
There are many causes of hearing loss, but the results are the same. The most obvious problem is communication difficulties, but relationships and independence are also affected. Persons with hearing loss have difficulty communicating in noisy situations, in large groups and at a distance, and may have trouble hearing voices over the television, radio and telephone. These difficulties are likely to remain (although to a lesser extent) even when the individual is using a properly fitted hearing aid because hearing aids work best in quiet environments with a limited number of communication partners.
What can be done if you suspect a family member has a hearing loss?
If you suspect that a family member has a hearing loss, encourage the person to have their hearing tested by an audiologist. Audiologists in Canada are registered healthcare professionals with, at minimum, masters-level degree training. They are licensed to practice within the province in which they work.
If family members are candidates for hearing aids, encourage them to follow through with this recommendation. The earlier the individual is fitted with hearing aids, the better the outcome. Those who are candidates for using a hearing aid in each ear will likely see greater benefits than when using only one hearing aid. Ask the audiologist what sources of funding might be available to help with the purchase of these instruments.
Also ask the audiologist about other technologies that will help family members in situations in which hearing aids do not perform optimally. For example, infrared assistive listening systems and frequency-modulated (FM) listening systems are available in some public places. These can also be purchased for use in the home with the television, at meetings and in other group situations such as dining out at a restaurant with friends. Special telephones designed specifically for persons with hearing loss can provide extra amplification of the voice of the caller on the other end of the line.
The audiologist can also advise you about courses that are designed to educate persons with hearing loss and family members about the impacts of hearing loss, coping with hearing loss and getting the most out of hearing aids and other assistive technologies. Group-based programs provide an opportunity for persons with hearing loss and their family members to meet. Many people discover that they are not alone in dealing with the problems associated with hearing loss and learn to support each other in changing the ways in which they communicate.
What other things can be done to improve communication?
Whether or not the person is using a hearing aid, there are many things that can be done to improve communication. Communication is affected by three key factors: the environment, the talker and the listener.
Noisy environments make communication difficult for persons with hearing loss. Noise is defined as any sound that is unwanted in an environment. Sources of noise include (but are not limited to) multiple conversations and sounds coming from televisions, stereo systems, public address systems, heating and cooling vents, fans, running water and traffic. It is important to remove or move away from sources of noise when communicating with someone who has a hearing loss.
Rooms that have an echo also make communication difficult. Gymnasiums and other rooms with hard surfaces such as tiled or hardwood floors, high ceilings and a lack of soft furnishings or drapes can be difficult communication environments for persons with hearing loss.
When you would like to speak with a person who has a hearing loss be sure to get their attention before you being to speak. You can do this by saying their name, gesturing or touching the person lightly on the arm. Always face the person while speaking and be sure that you are in a well-lit area. Never cover your mouth, either with your hand or another object, and never speak with something in your mouth such as food or gum. Speak in a normal tone of voice, not raising the loudness level of your voice unless you are asked to do so. Speak clearly and at a moderate pace—not too slowly and not too fast. Use natural facial expressions and gestures and do not move around when you are speaking.
If you are having difficulty being understood by the person with hearing loss, try simplifying your message or saying it in a different way, providing clues about the topic or writing key information on a piece of paper. Do not hesitate to ask people with hearing loss for suggestions on how to best communicate with them.
Another factor that can have a negative impact on communication is the distance between talker and listener. It is important that you are no more than six feet apart. When you are having a conversation, being close will allow you to be both heard and seen.
As a person with hearing loss, you also have responsibility when communicating with other persons. Be sure to wear your hearing aid or other assistive listening device when engaging in conversation with others. Do not hesitate to let speakers know that you have a hearing loss and suggest ways in which they can help to improve your understanding of the message. Avoid pretending that you have understood what has been said if you have not and do not be afraid to ask people to repeat their message, to simplify it or to say it in a different way. You might also ask them to write key information on a piece of paper.
Talk to one person at a time as one-to-one conversations are easier than group discussions. Position yourself so that you can see the speaker’s face clearly and remove or move away from sources of noise. Be sure to pay attention to the speaker—watch his or her lips, facial expressions, body language and gestures.
Be realistic about what you can expect to understand in a given situation – do not expect to hear 100% of group conversations in noisy environments. Finally, be a positive role model for the kind of communication you would like to receive from others and don’t be shy with your praise when people are doing a good job.
- World Heath Organization. Deafness and hearing impairment. Available from: www.who.int/mediacentre/factsheets/fs300/en/index.html. Accessed August 17, 2009.
- Smith AW. Editorial: A new journal. Community Ear Hear Health 2004;1:1–2.
- National Institute on Deafness and Other Communication Disorders. Statistics about hearing disorders, ear infections and deafness, 2008. Available from: www.nidcd.nih.gov/health/statistics/quick.htm. Accessed August 17, 2009.
For further information
- Canadian Academy of Audiology: www.canadianaudiology.ca
- Canadian Association of Speech-Language Pathologists and Audiologists: www.caslpa.ca
- Canadian Hard of Hearing Association: www.chha.ca
- Canadian Hearing Society: www.chs.ca
- College of Audiologists and Speech-Language Pathologists of Ontario: www.caslpo.com
- Hearing Loss Association of America: www.hearingloss.org
- National Centre for Audiology: www.uwo.ca/nca
- National Institute on Deafness and Other Communication Disorders: www.nidcd.nih.gov
- World Health Organization Project and Programme on Prevention of Blindness and Deafness: www.who.int/pbd/deafness/en
Tips for improving communication with a person who has a hearing loss
- Communicate in quiet areas with little ambient noise.
- Choose small rooms with carpets, drapes and soft furnishings.
- Turn off the television/radio/music.
- Get the attention of the person with hearing loss before you begin to speak.
- Sit or stand in good lighting.
- Face the person with whom you are speaking.
- Keep your face visible and do not eat or chew gum.
- Sit or stand within six feet between of the listener.
- Speak clearly and at a moderate pace. Do no speak too quickly or too slowly. Do not over-articulate your works.
- Speak in a normal tone of voice. Shouting distorts the sound of the voice.
- Use natural facial expressions and gestures and avoid moving around while you are talking.
- If you are not being understood, try simplifying the message, saying it in a different way or writing key information on a piece of paper.
- One-to-one conversation is easiest. When in a group, take turns and be sure that the person with hearing loss knows who is talking.
- When in doubt, ask the person with hearing loss for suggestions about what you can do to make conversation easier.
- Wear your hearing aid and/or other listening device when you are engaging in conversation.
- Position yourself so that you can see and hear the person with whom you are communicating.
- Watch the talker carefully. Attend to the lips, facial expressions, body language and gestures.
- When you do not understand what has been said, ask the talker to simplify the message, say it in a different way or write key information on a piece of paper.
- Do not hesitate to tell talkers that you have a hearing loss and suggest things that they can do to help improve communication.
- Do not pretend that you have understood what has been said. Provide feedback to the speaker when you understand or fail to understand.
- Limit the number of people you speak with at one time. One-to-one conversations are easier than group conversations.
- Be realistic about how well you will be able to communicate in any given situation.