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?
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Terrible issue, great column.
Thank you for reading and sharing your thoughts.
Why is it “terrible” ?
All of Shari’s columns are fantastic and chock full of great information!
I think she means the mask wearing is a terrible issue.
Along with the masks are the large plastic screens in front of the cashiers. Although I understand the need, it makes it more difficult to understand. Anyhow since I have problems with both I have started to go to self-check. Another reason I like self-check, they are disinfected after each person has finished with them. Great article!
Great idea! Thanks for sharing what works for you.
Shari, most everything you’ve listed has been a challenge for me. The missing piece however is that people with hearing loss won’t likely benefit from being the one to wear a clear mask. People they are interacting with must be wearing that clear mask to benefit those who need to see faces. I can only imagine that I’d have to purchase dozens of these masks, carry them around and hand them out to people I need to speak with especially in an emergency! As an aside, I think clear masks should be the standard since everyone benefits from seeing people’s whole faces and expressions and can make more useful social connections. The opaque mask is more of a visual barrier.
Yes, good point. Hopefully over time clear masks will become the norm in medical settings at a minimum. Thank you for sharing your thoughts.
I reposted! Such a great article !
Thank you for sharing!
I’ve had a couple of instances (in a noisy grocery store) where I couldn’t hear what someone was asking me. I just said, “sorry I can’t hear you” so they pulled their masks down and repeated. The masks have definitely made it challenging for the ones with hearing loss.
So true. Thank you for sharing your experiences.
Rather than pull the mask down, you might try asking the person to speak more slowly, because you do not hear very well. I have found that people are most accommodating. I also wear a button, that says, HARD OF HEARING. When people see that button, their entire demeanor changes….
Good suggestion. Thanks for sharing it.
Excellent column!
Great idea on wearing that button that says “Hard of Hearing.” Where did you buy them – online or in a retail store? I would like to buy a couple of those buttons or something similar.
Shari
In med diagnostic or treatment situations, mask or not, if the speaker is not directly looking, at the listener, ex looking at an xray on their computer, or running a machine. I think the med world would do well to have a small tablet running a speech to text app as standard office equipt for the patient to see. They can be bought these days for less than $100. I know, yea right. BUT if we all advocate…
As an extreme example, for a lung capacity test I was put in a ” glass sealed phone booth: and the tech was 6 feet away looking at a control panel hollering at me. I don’t think I followed her instructions correctly.
I showed her my ipad mini with Otter and said if the manufacture or your clinic had hung 1 of these on the outside , we would both been happier and the results would have been more accurate.
Les Greenberg
Wonderful idea. Yes, we must continue to advocate for these things. They would help everyone! Thank you for sharing your thoughts.
Excellent point and suggestion. I’m SURE, with a little thought, tech can be used in work places. The ADA needs to advocate for this as well.
Hopefully this will lead to better access for all over time. Thank you for sharing your thoughts.
I hate masks for the obvious reason that they block the face so I can’t speech read. But, they also crowd the ear wear I house bilateral cochlear implant processors and eyeglasses or sunglasses
Masks are challenging for so many reasons. Thank you for sharing your experiences.
Great column about a very challenging issue for those with hearing loss who like myself rely heavily (almost 95%) on lip reading to survive. I dread the cashiers with masks who usually always have a question or two . Don’t like to be rude and ignore them . Luckily the protective barriers are clear , but in most cases the cashier is still wearing a mask . I find I’m looking constantly at masked peoples eyes for clues , which is hopeless . lol . Find just explaining the situation nicely helps best and most people are kind enough to move their mask down away from their mouth . My family does alot of social distancing visiting from their cars and driveway these days and I find I tend to avoid even bothering to try and understand the conversations .
Thank you for sharing your suggestions.
I’m struggling with how I will manage in person meetings when they resume. I’m already having difficulty with WebEx and Zoom conference calls. There is no closed captioning, the audio lags behind the video, video quality is often times poor making it difficult to view visual cues and read lips. I’m having mild anxiety attacks at the thought of how the masks are going to handicap me!
This is a serious issue. In the workplace, hopefully the ADA will have some impact so you can ask for the accommodations that you need. Thank you for sharing your thoughts.
I make sure to hold on to my hearing aids when putting on and removing the mask to make sure the hearing aids stay in place and don’t get tangled in the straps. When you put the mask on, put the straps in front of the hearing aids so they don’t get caught on each other.
Great suggestion. Thank you for sharing what works for you.
And those acrylic sheets all the stores are going to. I just love having my wife with me when managing these sheets. She jumps right in when she senses a disconnect.
It is great to have a hearing buddy with you! Thank you for your comment.
Shari, This is an important column. And you are correct to point out that the distancing alone has an important effect without the mask problem added on. A 60DB sound, normal conversation, at 2 feet, becomes about 50 DB at 6 feet. With my thresholds of 70+DB, 60DB conversation is already very challenging. When it goes down to 50DB, it will become close to impossible. When you factor in the muffling effect of the mask, and the inability to see lips and faces, it is impossible. And in the current hospital situation, the fact that patients cannot bring anyone along to help communicate is a disaster. The NYC HLAA chapter has already started to advocate for hospitals to acquire clear masks as they become available, to educate their staffs about the issue, and to permit caption devices.
Excellent points. Thank you for your advocacy on this issue.
Thanks Shari for such a great article. I specially experienced the issue of losing hearing aids when weraing mask. I have not lost it but they always stuck around the mask earbands.
Thank you for your comment.
Great article. I am struggling too. The wearing of the mask is difficult as I wear glasses and behind the ear hearing aid. A friend gifted me a couple of ear savers, the mask hooks to that the wraps around the back of my head. Works great, it also helps the a put my hair in a ponytail. I put the ear saver above that. Still struggle with hearing through the mask. My husband is with me most of the time so that helps, he translates, but when I am alone I have to ask people to repeat themselves most of the time. The majority of people are accommodating but a few a just down right rude.
Thank you for sharing the tricks that work for you.
To keep your masks for scuba diving clear , you spit in them , then dip quickly in water before you put them on. This should work for the clear masks too. There is also a product you can buy but spit works just as well. I never realized how much I lip-read until I can’t.
Thanks for sharing your tip.
https://youtu.be/dGf0VkjTnqk
Shari…here’s one suggestion for getting the hearing aids to stay on, while wearing a mask
….there are also other suggestions….
such as…..using a piece of material with a button on it..you can hook the string of the face mask onto the button, so that the mask stays in place. `
If, Gd forbid, you are put on a ventilator (having Covid19), and you have an iPhone…you can download the cardmedicapp….created by a physician…it enables DHH people to understand what physician is saying and it enables the patient to communicate ……amazing application
I sent more info to your email address about other clear masks…did you receive that? There are a couple of great ones being made by a firm in Alaska the that is connected with an audiology company. There are several in Israel.
Thanks for sharing your tips.
I posted pics of various plastic masks on your Facebook page. One is being made in Alaska…sold through Northland Audiology…fits around entire head…looks like a space helmet…people are very excited about it…but, again..not approved by FDA (as the Communicator is)…You can see the pics on your FB page.
Thanks for sharing the information.
I went for an appropriately distant & masked walk with a friend, knowing I wouldn’t hear, so we tried this. We Each of us brought our own phones with bluetooth headsets with mikes, and talked via cell call. There’s a slight lag/echo but otherwise it worked really well for me for our conversation! We could walk even further apart, good for narrow trails, and that would eliminate the lag effect (which is due to hearing some of our direct speech before it comes through the phone). Of course that is a limited work-around.
Nice idea. Thank you for sharing what has worked for you.
Thank you Shari, for all your posts, but this particular one resonated!! I agree on every point you make and know that masks will be a new, long-lasting frustration!! I hope the manufacturing of clear masks will catch up and catch on so everyone would wear them!!
Me too! Thanks for sharing your thoughts.
I shaved both sides of my head because I cannot stand the tickle of hair on my face, so I was trying to tuck it behind my ear but it was too much with glasses & BTE aid! I left most of my hair to cover the left side of my head. I discovered my long hairs would wrap around my BAHA implant & cause infections. Adding a mask only adds to the amount of stuff behind my right ear! Ouch! But, I have decided to use a thin balaclava as a mask. So far, I have been able to hear with it. But I always go out with my husband, son or daughter (teens, used to a SSD/HOH mom). I have not been out much since we have the stay home, stay safe ordinance in Michigan until May 28. I do not wear a mask when I walk in the neighborhood. I wear my balaclava in the grocery store & really don’t interact with people there except my family member, the cashier and bagger. I can’t wait till we can reopen restaurants, retail stores & not need to undergo major health checks to go see my audiologist!
I am looking forward to things moving back towards normal as well. I fear it may be awhile. Thank you for your comment.
The mask era came on at the same moment I chose to buy, as a hearing aid backup (for when repair was inconvenient), a set of the new Bose Hearphones. (“hear”, not “head”). These are a newly-engineered high quality PSAP. Not cheap, but much less $ than the cheapest hearing aids. They work fabulously well; they do NOT sit behind the ear, but IN the ear, thus the back of my ear is available for a mask ear loop. Since buying these, I will never again wear a mask concurrently with BTE hearing aids. If you are interested in an alternative system, do check out the Bose Hearphones!
I have heard good things about them as well. Thank you for sharing this idea.
I learned of the Bose Hearphones via the excellent new book, “Volume Control”, by David Owen. It recounts the background story of their development, among many aspects of coping with hearing loss, in general.
I also wear the Bose Hearphones. Yes. Terrrific and no worries about the inserts popping out of my ears!
👍
The email address for that strange looking mask..in Alaska, through Northland Audiology, is..rapidresponsepp@gmail.com
That clear mask was discussed in the Juneau Alaska newspaper..about Northland audiology. I called them and they told me how to find out about ordering the large, clear face masks that go around the entire head, thereby protecting your face more, from particulates.. of course…not approved by FDA, but, I’m trying to find something comfortable and practical at this point….in any event…the way to order the masks is through the email address provided above….rapidresponseppe@gmail.com (corrected…I wrote the wrong email address…sorry.
The report from the Juneau paper appeared on Facebook, yesterday.
Thanks for sharing the information.
Hi Shari, I pull up Ava captions on my cellphone … several pics on my Facebook page show my use of them. I gave blood & asked questions of police officer and store owners this way!
Also, a sweet young woman posted the pattern to make masks with clear “lip reading“ inserts. I suggest volunteer hearing health organizations have them made for us who need to give them to our health care providers. I also wonder if some non-profit grant $ to say, the deaf & hard of hearing organizations in states might be used to make these “lip reading” masks…
Thanks for sharing what works for you and the information about the masks.
Could you explain what you mean by lip reading inserts? How does this work?
I am a teacher in Ontario and there is talk of us going back to school in June. If that is the case, we will be wearing PPE – and in the fall, I am sure – I am very worried about how I can communicate with colleagues and potentially with students wearing masks. I don’t think that I will be able to do it successfully! Very stressful times for all of us with hearing loss.
It is a tough situation. I suggest you begin brainstorming with the school admin for any possible accommodations that could be made available for you to hear better. The more time you have to prepare the higher likelihood of success. Good luck to you!
Biggest problem is when wearing a glasses and cochlear device. Cant wear the behind the ear mask as too many and keep sliding off. I tried the ties one on top of head and one back of neck,but the one on top head slide and my magnetic device comes off. Really frustrating.
But luckily I live where the population of deaf people and deaf school the workers at stores etc will pull their mask down at safe distance to be able to read their lips.
It is very challenging! I am glad you have a supportive community near you. Thank you for sharing your thoughts.
Funny you mentioned the recent high incidents in lost hearing aids due to wearing masks.
I was halfway home from work when I realized that one of my hearing aids was missing. I quickly did a u-turn and began my search by retracing my steps, etc…
Luckily, I have an app on my phone that allows me to track my hearing aids by location. Never thought I’d need it, but glad I have it!
Anyway, walking back and forth across the areas I worked was sort of like using a metal detector. The signal got strongest in the break room next to the garbage can. I furiously started digging through discarded food, paper all the nastiness you’d expect in a garbage can. Luckily, I found the little bugger on the very bottom of the can, dry and working… and next to the mask I discarded at lunch.
So disgusting, but so worth it!
Needless to say I’m hyper aware every time I take off my mask.
Thank goodness you found it! Thank you for sharing this cautionary tale.
I have items to content with: hearing aids, mask, and glasses!
That is a lot to manage at once! Thanks for your comment.
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