I thought I had figured out how to live with hearing loss. I wear my hearing devices regularly and employ a handful of assistive listening devices as needed in various situations. I advocate for myself with friends, family and strangers, teaching them to use communication best practices. I utilize lipreading cues and am not shy to try to change the environment to meet my hearing needs whenever possible. I am confident and competent. But then came COVID-19, and a new hurdle entered the field — masks — the latest in a long line of obstacles for people with hearing loss.
Masks Make it Hard to Understand Speech
During the pandemic, we are told to wear face masks when we are in public and unable to social distance. It is for our protection as well as the safety of others. It is important to do it, but it makes communication very difficult for people with hearing loss for a number of reasons.
The mask physically blocks the sound.
According to a fascinating study highlighted in Hearing Review, medical masks act as a low-pass acoustic filter for speech, weakening the high frequencies spoken by the wearer by up to 12 dB depending on the type of mask. The study concludes, “The speech quality degradation, in combination with room noise/reverberation and the absence of visual cues, renders speech close to unintelligible for many patients with hearing loss.”
Lipreading cues are absent.
Like many people with hearing loss, I am usually speechreading while I listen. The lipreading cues help me better understand speech, while the facial expressions help me to find the emotion behind the words. With a mask, neither of these clues are available making it more taxing to organize the sounds into a meaningful word or phrase. This can lead to hearing loss exhaustion from the increased listening effort.
The 6-feet apart rule compounds the issue.
Along with wearing masks, people have been asked to physically distance from one another by staying home as much as possible and by maintaining a six foot distance from others when in public spaces. This rules helps reduce the likelihood of transmitting the virus from one person to another, but it also makes it more difficult to hear since most hearing devices work best when they are within six feet of the source of the sound.
Tips For Communicating With People Wearing Masks
While we hope the pandemic will end soon, chances are that physical distancing, mask wearing and other precautions will continue for several more months. We must learn to adapt our hearing loss coping strategies to this brave new world.
Here are my suggestions. Please add yours to the comments.
Request others use clear masks if available
While this may be a good long-term solution, it is unlikely to be realistic in the near term. Clear masks allow people with hearing loss to pick up some lipreading cues from speech, but clear masks are hard to find and are expensive. The only FDA registered clear mask is The Communicator, which has been out of stock for months. Handmade masks with a clear cutout can be helpful in some situations, but they are not appropriate for use in a medical setting. Clear masks also tend to fog up with use, although a little baby shampoo rubbed on the clear area of the mask can help.
Supplement with speech-to-text apps
I already use speech-to-text apps to help me understand speech in difficult listening environments, but this may become even more critical with masks. My favorite speech-to-text apps are Live Transcribe (Android only) and Otter.ai. Hold your phone as close to the person as possible while maintaining physical distance. The closer the microphone is to the person speaking, the better chance it will have to pick up the sound. Practice at home so you are not fumbling with the app in real time.
Go Lo-tech with paper and pen
Paper and pen or a Boogie Board device can be helpful in real time, or you can use them to prepare signs in advance with your name and what you need to say. For example, if you are picking something up at the pharmacy, include your name, what you are picking up, and that you have trouble hearing so they know to communicate with you carefully.
Use your phone as a notepad
Use the notes app or similar app on your phone to type out what you want to say and show it to the other person. They can do the same so you can communicate without passing any devices or paper & pen back and forth between the two of you. Make sure to increase the font size so that it can be read more easily from a distance. Practice this at home so it goes smoothly in real time.
Wearing Masks Makes It Easier to Lose Hearing Devices
Audiologists are reporting large increases in the number of lost hearing devices due to the challenges of wearing masks. Depending on the type of mask, the straps can become tangled with behind the ear devices, sending them flying when the mask is removed. Nobody wants to lose an expensive hearing device at any time, but during the pandemic, this is more critical due to limited access to audiological care.
The first step is to be aware of this issue and operate with caution. One strategy could be to only remove your mask when you are safely back at home and in an area where a flung device could be easily found. Another is to find ways to keep the straps away from your devices by redirecting them higher up your head. Or wear a cloth headband to cover the devices and keep them snug to your head and away from the mask straps. This might cause feedback depending on your hearing aid. Try a variety of options to see what works best for you.
Center for Hearing and Communication (CHC) hosted an informative webinar which demonstrated many of these tricks (and others) to reduce the risk of losing your hearing devices while wearing and removing masks. You can watch a replay here.
Readers, how are you coping with the new reality of face masks?