When communicating with a resident with hearing loss how can you get the persons attention?

1. The consultation room

   • Give the patient privacy: they should be able to ask you to raise your voice without fear that others will hear about their medical history.

   • Minimise distractions. This is even more important if your patient is a child.

   • Reduce background noise.

   • Ensure the room is well lit, so that the patient can see your face or any written information they may be given.

   • Ask the patient to wear their hearing aids (if they have them and find them helpful) and sit closer to them than you would to another patient.

   • If possible, have a helper of the same gender as the patient in the room.

   • When adult patients are accompanied, always ask them before you start if they would prefer to be alone with health personnel in the consultation room. Do not wait until the questions become uncomfortable for the patient.

2. Remember that your face is an essential communication tool

   • Face the patient, not their interpreter or carer.

   • Remove any masks or face shields.

   • Do not have anything between your lips (cigarette, pen, etc.) or in your mouth (chewing gum, sweets, etc.) as this can distort lip movement when you are speaking. Avoid placing your hand or an object in front of your mouth when talking.

   • Have the light on your face rather than on the person you are talking to. This makes it easier for them to read facial expressions and to lip-read.

   • Support your speech with facial expression where you can, e.g. look happy if you are giving good news and sad if you are giving bad news.

   • When signing, hold your hands up at chest level to enable both your face and hands to be clearly seen.

   • Understand and use the local culture of gestures, expressions and accepted physical contact (or absence of it).

3. Ensure that you speak effectively

   • Speak normally, not too fast or too slowly. Certain sounds can be distorted or lost if speech is rushed or slowed down too much.

   • Use short, simple sentences.

   • Do not exaggerate your speech or lip movements.

   • Ask questions if you are not sure you understand what the patient is saying.

   • Patients tend to agree with their health are workers, sometimes without understanding what has been said to them. After every important point or message, ask the patient if he/she has understood you and, if necessary, ask him/her to repeat the message or instructions back to you (especially important if the patient is unaccompanied).

4. Use other means of communication, e.g. writing and signing

   • If the patient can sign, use an interpreter. If at all possible, learn the local sign language yourself. This can be fun and can be done with other colleagues.

   • Be prepared to write down any questions or answers, and give the person with a hearing impairment the opportunity to do the same if necessary.

   • Write down important information, e.g. instructions for taking medicines, to give to the patient. Have this information available in alternative formats (e.g. large print) for people with impaired vision or give the information to the person assisting them.

   • Use pictures and drawings to help the patient to understand you.

PARTICIPATION

Deputy Director, Advocacy and Alliances for Inclusive Development, CBM.

‘Nothing about us without us’ has been a slogan of the disability rights movement for decades. Participation is fundamentally about people with disabilities participating in decisions that relate to them so that actions affecting people with disabilities are not planned or performed without their input. This guiding principle highlights the need for people with disabilities to be brought into the process in such a way that they can directly influence decisions. This results in greater inclusion of people with disabilities and also brings with it lasting change.

Extensive involvement of people with disabilities will build skills and capacity. At the same time, people with and without disabilities working alongside each other can often foster changes in attitudes and understanding about the abilities, contributions, and aspirations of people with disabilities.

People with disabilities are often empowered and enabled by the confidence and skills that result from the fostering of genuine partnerships. These partnerships can include partnering with families, wider support networks, service providers, and community leaders, where appropriate. Working in partnership with disabled people's organisations (DPOs) is a very effective strategy (page 12).

Contributed by Joy Victory, managing editor, Healthy Hearing
Last updated November 16, 20202020-11-16T00:00:00-06:00

Even without the added issue of hearing loss, conversations require a lot of focus, energy and patience. For people with hearing loss or other hearing impairments, a noisy environment or friends who speak too quickly can make communication extra challenging.

someone with hearing loss.

Below are some things that you can do to help facilitate communication when someone has hearing loss, whether that person is you—or a loved one, friend, or coworker.

Please note this article is for people who have mild to moderate hearing loss. People who have untreated profound hearing loss, or are Deaf, have different communication methods that will be more effective than the ones discussed below. More on degrees of hearing loss.

How to talk to someone with hearing loss

Some environments are much easier for communication for people who are hearing impaired. Here are some things you can do to ensure the environment is perfect for communication:

• Make sure the room has enough lighting. People with hearing loss often rely upon lip reading, facial expressions, speech reading, body language and gestures to supplement their remaining hearing and improve communication. 
• Pick a place that has minimum background noise. Though our ears and brain are able to filter out background noise in most situations, people with hearing loss often have a difficult time hearing over excessive noise. Keep in mind that small rooms with no carpeting or curtains tend to have poor acoustics and can distort voices.
• Make it easy to see everyone's faces. If you will be in a group setting, choose a location—or if you're at a restaurant, a round table —where the person with hearing loss will have visual access to everyone's faces to facilitate better communication. 

Here are a few examples of using the above tips to pick an appropriate environment for communication:

• If you're planning a dinner out, pick a restaurant that you know has ample lighting, does not play loud music and has decent acoustics. Choose a restaurant that you have been to before, where you know the noise levels do not get too loud. Another good tactic is to select an off-time: Rather than having dinner at 7 p.m. on Friday or Saturday night—the busiest dinner hours—opt instead for a late lunch or early dinner, between the hours of 3 p.m. and 5 p.m. when restaurants are likely to be the least busy.
• During a group gathering at your home, if you'd like to have a conversation with a friend or family member with hearing loss, invite him or her to speak in a different, quieter room. Turn off the TV and any other sources of noise.

Hard of hearing communication tips

Here are some do's and don'ts you can keep in mind to help facilitate better conversations and include someone with hearing loss:

• Make sure you don't cover your mouth. Don't talk through a yawn or while chewing gum. (For deaf and hard of hearing people who use American Sign Language and lip reading, this is especially important.) 
• Don't speak from another room or when your back is turned to the person. Don't shout in any situation.  
• Sit or stand close to the person with hearing loss, but not so close that he or she can't easily switch focus between maintaining eye contact and speech reading.
• If the person with hearing loss hears better in one ear, take note of that and try to speak more toward their right or left side.
• Before starting a conversation, say the person's name so you can get his or her attention. Wave or gently tap them if they don't hear you.
• When giving specific information, like an address or time for a meeting, write the important information down or ask the person to repeat the specifics to you so you can make sure they got them right. 
• Pay attention to the listener's cues. People with hearing loss sometimes feel embarrassed or get tired of asking others to repeat themselves or clarify. If the person looks a bit puzzled, find a tactful way to ask if he or she understood you.
• In group settings, make sure to avoid speaking over each other.
• Don't talk about a person with hearing loss as if she or he isn't there. Instead, talk directly to that person and do your best to use the above and below tactics.

How hearing loss affects communication

Sometimes, there will be a breakdown in communication. Here are some things that you can do to get back on track for successful conversation with your friend, family member or colleague:

• Speak at a normal level. Sometimes it's tempting to speak too loudly to someone with hearing loss, but this can distort the words.
• Provide the topic of conversation or key word to someone having difficulty understanding, especially if there has been a topic change.
• Spell a tricky word. For people with hearing loss, many consonants sound the same, which can trigger misunderstanding. Write it out on paper if necessary.
• Use gestures if they might help.
• Speak more slowly, but still clearly.
• Rephrase what you have said.
• Shorten your sentences and use less complex phrasings.
• Change environments if the location is giving you problems.
• Ask the listener what he or she needs you to do to facilitate better communication in the event of a break down.

The impact of hearing loss

Many of these problems can be improved if the person wears properly adjusted hearing aids. If you or a loved one needs a hearing test, you can find can find trusted hearing specialists and audiologists near you with our directory.