Communicating With an Older Loved One Who Is Hard of Hearing

Hearing loss not only leads to social isolation and loneliness, but it can also raise a person’s risk of falls, depression and even dementia. Many families know the sadness of seeing a loved one who was once vibrant, engaged and maybe even the life of the party withdraw because it’s just too hard for them to hear.

If you have a loved one with hearing loss, encourage them to have an evaluation by their doctor or an audiologist, and to be fitted for hearing aids if recommended. If they already have hearing aids, encourage them to use the devices and to have them adjusted as necessary.

Beyond that, there is a lot we can do to help our loved one communicate. Sometimes older adults with hearing loss try to hide it. Or they just give up—it can be exhausting and demoralizing to constantly ask people to repeat themselves or speak up. They might just nod as if they understand, even if they don’t. So the first step is to assure your loved one that effective communication with them is important to you. Ask your loved one to give you feedback about what’s effective.

Here are 10 things to try as you work together:

1. Reduce background noise. Choose a quiet location for conversations if possible. Turn off the TV or music. Get away from other conversations. Even rustling paper or a dishwasher running can make it hard to make out speech.
2. Get your loved one’s attention before beginning a conversation. Catch their eye or gently touch their hand or shoulder.
3. Lip movements, facial expressions and gestures provide much information. Face your loved one, and avoid turning away or covering your mouth during the conversation.
4. If your loved one has adequate vision, speak at a distance of 3 to 6 feet. Make sure there’s a light source on your face.
5. Don’t speak directly into your loved one’s ear—this hides visual cues and may distort sound.
6. Speak more loudly than usual. But don’t shout; shouting also distorts sound. Ask your loved one to let you know if you need to speak up, or if your volume is too high.
7. Don’t exaggerate your speech, but speak at a moderate speed. You might need to slow down, but not too much. Leave pauses between sentences.
8. If you’re chatting over a meal, don’t talk with your mouth full. And don’t chew gum.
9. Encourage your loved one to signal you any time they miss something. Repeat what you said, or paraphrase slightly. Try shorter, simpler sentences.
10. Write notes or use gestures. You can even text if you’re both in a noisy space.

And finally, encourage your loved one to mention their hearing loss to other people. You might facilitate a “what works” conversation with other friends and relatives.

COVID-19 prevention measures present extra challenges.

Loneliness among older adults has increased during the pandemic. For seniors with hearing loss, the problem is even greater. For example, we’re advised to stay 6 feet away from other people, but that may be too far away for your loved one to hear. We’re advised to meet outdoors—but that can mean a lot of background noise, whether it’s street sounds or wind that distorts hearing aid sound.

Then there are the impediments face masks present! Masks muffle sounds, make it hard to pick up cues from lip reading, and hide visual cues. Even if your hearing is intact, you’ve probably experienced communication challenges while wearing a mask. So imagine how much harder it is for your loved one. Here are some things you can do to help:

Have extra patience. Confirm that your loved one understands you, and repeat things if necessary.

Speak a little louder. Both the mask and the extra distance might call for a little higher volume. Ask your loved one what’s working.

Use extra gestures—everything from thumbs up or down for “yes” and “no” to pointing to your ear and raising your eyebrows to ask if your loved one is picking up what you’re saying.

Offer to accompany your loved one to places where they’ll need to communicate. Even if your loved one is fully vaccinated, there may be situations where they need to maintain a distance from others. You can stand near and repeat things to them as needed.

Help with hearing aids. Audiologists say many seniors are leaving their hearing aids in a drawer these days. It’s tricky to put on a mask over hearing aids—to say nothing of adding glasses to the mix. Catherine Palmer, Ph.D., president of the American Academy of Audiology, reminds us that seniors should continue to have their hearing aids adjusted and checked. “If an individual continues to use their hearing aid when it is not working, it functions like an earplug—actually blocking sound,” she cautions.

What about clear face masks and face shields?

In response to the needs of people with hearing loss and other communication challenges, cloth masks with clear panels are now available. The Centers for Disease Control and Prevention (CDC) says that these masks should be properly fitted so …

• You can breathe easily in the mask.
• Excess moisture doesn’t collect on the inside of the mask.
• You don’t fall asleep in the mask, as the plastic could make it hard to breathe.

The CDC cautions that face shields alone are not a substitute for masks, as they have large gaps that could allow respiratory droplets to enter or escape. However, the CDC says, “People who interact with those who are deaf or hearing impaired may find that a face shield is better than a mask when communicating. If you must wear a face shield instead of a mask, choose a face shield that wraps around the sides of your face and extends below your chin, or a hooded face shield.”

“When it is harder to understand speech—whether because of cloth face coverings, distance or other factors—research suggests that we have fewer cognitive resources to process information deeply. As a result, communication suffers, and feelings of stress and isolation may increase,” says Debara L. Tucci, director of the National Institute on Deafness and Other Communication Disorders. “These difficult times offer all of us the opportunity to be mindful about communication. It will require extra effort. I encourage everyone to meet these challenges with patience, kindness and a commitment to problem solving.”

1. Reduce background noise. Choose a quiet location for conversations if possible. Turn off the TV or music. Get away from other conversations. Even rustling paper or a dishwasher running can make it hard to make out speech.

2. Get your loved one’s attention before beginning a conversation. Catch their eye or gently touch their hand or shoulder.

3. Lip movements, facial expressions and gestures provide much information. Face your loved one, and avoid turning away or covering your mouth during the conversation.
4. If your loved one has adequate vision, speak at a distance of 3 to 6 feet. Make sure there’s a light source on your face.
5. Don’t speak directly into your loved one’s ear—this hides visual cues and may distort sound.
6. Speak more loudly than usual. But don’t shout; shouting also distorts sound. Ask your loved one to let you know if you need to speak up, or if your volume is too high.
7. Don’t exaggerate your speech, but speak at a moderate speed. You might need to slow down, but not too much. Leave pauses between sentences.
8. If you’re chatting over a meal, don’t talk with your mouth full. And don’t chew gum.
9. Encourage your loved one to signal you any time they miss something. Repeat what you said, or paraphrase slightly. Try shorter, simpler sentences.
10. Write notes or use gestures. You can even text if you’re both in a noisy space.