Social isolation and hearing loss often go hand in hand. Conversation takes effort, so sometimes we avoid it. Communication best practices are often overlooked, even by those closest to us. Accessibility options in public spaces are often limited. The good news is that there are many simple ways to help combat this issue. Read on for my suggestions for how you can help.
My Hearing Loss Journey
My hearing loss story began in my mid-20s, when I was in graduate school. Fairly soon into my first semester, I started missing things in class, particularly comments made under one’s breath or as an aside. Sometimes the entire room would burst out laughing while I would be left trying to figure out what was so funny.
When I discovered I was losing my hearing, it was embarrassing, depressing and scary. I felt left out.
As the years passed and my hearing loss worsened, I found myself more often alone. For friends that I could hear well, I was always available, but for those I could not, I made excuses. I began avoiding the theater and other activities that I had once enjoyed because I was worried I might not be able to hear the actors. It was easier to sit at home and watch TV with the captions on than to risk an outing to the movie theater where the dialogue might be unintelligible to me.
When I did make the effort to socialize, it was challenging, particularly if people continued to talk over me when I asked for a repeat. This behavior made me feel unimportant, ignored and resentful. I often wished I had simply stayed home instead.
It is common for people with hearing loss to feel socially isolated, but once I had children I knew this had to change. My hearing loss is genetic and I feared I might have passed it on to them; I needed to set a better example of how I could still thrive with the condition. Inspired by them, I began wearing my hearing aids regularly, requested accommodations as needed and taught my friends and family how to best communicate with me. I even started this blog where I share the tricks I use to live my best life in spite of hearing loss.
Hearing Loss is More Common Than You Might Expect
According to the World Health Organization (WHO), more than 460 million people worldwide have disabling hearing loss and that number is expected to almost double by 2050. Hearing Loss Association of America estimates nearly 50 million Americans currently suffer from hearing loss, with 65% of them younger than 65. Only 2 million consider themselves culturally Deaf, using sign language as their primary mode of communication.
Hearing loss is an invisible disability so it is easy to overlook, particularly as hearing aids have become more discreet. Considered a common side effect of aging, it is not always taken seriously, though it should be, as it can contribute to many serious medical conditions including higher incidence rates of diabetes, cardiovascular disease, and falling.
When left untreated, hearing loss is also associated with a higher likelihood of dementia. Part of that link is thought to be due to the social isolation that often accompanies hearing loss. The WHO explains it well: “Exclusion from communication can have a significant impact on everyday life, causing feelings of loneliness, isolation, and frustration.”
What Is It Like to Communicate When You Have Hearing Loss?
Hearing loss is hard to understand if you have not experienced it. The best analogy I have found is a game board from the Wheel of Fortune. Some of the letters are filled in, while others are blank. People with hearing loss must take these assorted and incomplete sounds and turn them into words or phrases that make sense in the context of the conversation. This requires a lot of concentration. It is exhausting and can lead people to avoid social interactions altogether because they are too much work.
This is true even when using hearing aids. Hearing aids do not work like glasses, which for most people take an image that is blurry and sharpens it into something crisp and clear. Hearing aids only amplify sounds; they do not make them sharper. Hearing aids also have difficulty differentiating among sounds so the background noises are boosted in addition to the more important speech sounds. In a loud environment, hearing aids can sometimes make it more difficult to hear!
How You Can Help People With Hearing Loss To Feel Less Isolated
The good news is that common sense fixes like using best practice communication techniques make it much easier to include somebody with hearing loss in conversation. For larger events, technologies like communication access real-time translation (CART) and hearing loops are incredibly helpful. CART is like closed captioning on TV, but it is provided real-time on screens set up for this purpose. Hearing loops allow people with hearing loss to directly connect to a venue’s sound system through hearing aids.
Conversation To Dos
1. Provide context.
Context makes it easier to fill in the blank spaces in the words on the Wheel of Fortune game board. If all you hear is “___oot”, knowing if the conversation is about owls (hoot) or a robbery (loot) or musical instruments (flute) is a big help! If the subject changes abruptly, be sure to let them know.
2. Get their attention before speaking.
Hearing take concentration for people with hearing loss so make sure they are ready and attentive before talking otherwise they will be playing catch-up. Make sure you are facing them and that they can see your lips for lip-reading.
3. Optimize the surroundings.
Keep background noise to a minimum and make sure the area is well lit so they can see your facial expressions. When meeting at a restaurant or other public spaces, let them choose their seat first so they can minimize background noise. A corner location often works the best.
4. Ask how you can help.
There is no one-size-fits-all solution for hearing loss. Ask the person what you can do to help them hear their best and then do it routinely. Because hearing loss is invisible, it is sometimes hard to remember to continue speaking louder or clearer, but the more consistently you can provide assistance, the more pleasant the communication will be.
5. Be attuned to body language.
If you notice your communication partner leaning forward to hear you or is looking confusing, speak louder or repeat what you just said in different words. Being attentive to social cues can help prevent the person with hearing loss from always having to ask for assistance, which can feel awkward.
Conversation Don’ts
1. Raise your volume, but do not shout.
Volume is only part of the problem — clarity of speech is really the key. Shouting distorts the way words look on your lips making lip-reading more challenging. Speak at a steady pace since rapid speech is difficult to process and slower than typical speech will also make lip-reading difficult.
2. Don’t cover your mouth when speaking.
Most people with hearing loss are also lip-reading, even if they are not aware they are doing it. Do not cover your mouth when you speak, and avoid talking while chewing, which can distort lip movements.
3. Avoid the dreaded “Never Mind.”
A person with hearing loss may not catch everything you say the first time. Be willing to repeat or rephrase or even spell a difficult word. If someone is having trouble hearing you, do not dismiss them with a “never mind.” This is insulting and will only reinforce their feelings of not belonging.
4. Limit cross talk.
Multiple speakers are difficult to follow and remove the possibility of lip-reading since the person with hearing loss does not know where to look. Taking turns speaking is also more polite.
5. Don’t assume that everyone can hear.
I have attended many a business meeting or small discussion group where the leader does not use the provided microphone. Always using the mic delivers inclusive communication for everyone.
Readers, what suggestions would you add to my list?
This article first appeared on Chaos+Comrades.
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This is from an unsuccessful grant proposal I wrote:
“In 1819 Thomas Jefferson wrote, “My hearing is distinct in particular conversation, but confused when several voices cross each other, which unfits me for the society of the table.” The social isolation described by Jefferson may lead to depression and dementia. As has been noted by the Alzheimer’s Association, “the brain loves company.” “
Great quote. Thanks for sharing.
Face the person you are talking to. I do not consciously read lips, but still have a more difficult time understanding someone who is not facing me. I also feel somewhat dismissed, as though what I have to say is unimportant.
Great point. Thanks for your comment.
My husband has a quirky sense of humor. So he may make a comment that is so disjointed that even when I heard, it would need some extra thinking – it’s much more difficult to understand when you miss half of it! I don’t want him to stop or even make it more obvious – it would lose its humor! Haven’t thought of a method yet to deal with it. So we just laugh at whatever silliness I get out of it. Sometimes you do have to have a sense of humor about your lack of hearing! Makes for some interesting conversations.
Having a sense of humor is key! I am glad you and your husband can find ways to chuckle no matter what. Thanks for sharing your thoughts.
Good article, we all have to do our bitc
Thanks for your comment Sarah.
I plan an evening out and by the time it’s gets here I am so nervous I won’t be able to participate. Sometimes it’s easier to give up but I keep plugging along.
We must keep plugging along. It gets easier with self-advocacy and practice. Thanks for joining the conversation.
One further thought on seating in restaurants. Yes, corner tables are often the best choice, but not always. Another, and in my opinion, overriding consideration is whether you are or not close to large parties. At a table of more than 4 people there are likely to be multiple conversations going on simultaneously. And people there tend to speak loudly because that is often the only way they can be heard by others at the table.
Great point. Thanks for sharing what works for you.
Sitting at round tables helps everyone see each other’s faces, which results in more effective communication/understanding what people are saying.
Great tip. Thanks for sharing it.