Caregiving Tips: When Your Elder Is Hard-Of-Hearing

And won’t wear hearing aids

“For those of us who are gradually losing our hearing, it is often too much effort to keep up with a conversation, so we self-isolate. I find that most people mumble, speak too rapidly and use words without consonants. If people spoke with clarity, they would not feel like they had to shout – which makes what they are shouting distracting and even less clearly heard”.
Ingrid Quick – 74 years young, a friend from the United Way North Jersey Caregivers Coalition.

Statistically 25% of people between the age of 65 and 74 have hearing loss. After age 74 that number goes up to 50%. If your elder is like my mom, who is losing her hearing and refuses to get hearing aids, conversations are frustrating.

I worry that hearing loss is isolating mom. On the phone, her lifeline, I often hear her say, “I’m sorry, can you repeat that?” In restaurants and family gatherings she may not participate in the conversation. I have learned to get her attention and then ask the question again or restate the comment. And my cousins, God bless them, will often sit between my mom and theirs to help keep the conversation going, kind of like an interpreter.

Mom is not alone. I know of other elder’s who refuse to wear hearing aids because they are embarrassed, don’t have the dexterity to put them in, or refuse to admit to the hearing loss. And the cost? Why are hearing aids so expensive and not covered by insurance? What about the ongoing cost of batteries? We must do better for people who are hard-of-hearing.

Lip reading instead of hearing aids is not a solution. People only understand 30% of what is being said with lip/speech reading. Add limited eyesight, a doctor wearing a mask, or English as a second language and the number drops dramatically.

And I wonder how often “non-compliance” (to use a medical term) is because a patient didn’t HEAR the instructions on what to do, or how to take the drug correctly.

Communicating with People with Hearing Loss* (Adapted)
*Reviewed by health care specialists at UCSF Medical Center

In general conversation:

• Say the person’s name before beginning a conversation. This gives the listener a chance to focus attention and reduces the chance of missing words at the beginning of the conversation.
• Speak clearly, slowly, distinctly, but naturally, without shouting or exaggerating mouth movements. Shouting distorts the sound of speech and may make speech reading more difficult.
• Avoid talking too rapidly or using sentences that are too complex. Slow down a little, pause between sentences or phrases, and wait to make sure you have been understood before going on.
• Try to find a different way of saying the same thing, if the hard-of-hearing person has difficulty understanding a word or phrase. This is better than repeating the original words over and over.
• Keep your hands away from your face while talking. If you are eating, chewing, smoking, etc. while talking, your speech will be more difficult to understand.
• Know where to position yourself. If the hard-of-hearing listener hears better in one ear than another, sit so that your voice carries to that ear.
• Pay attention to the listener. A puzzled look may indicate misunderstanding. Tactfully ask the hard-of-hearing person if they understood you or ask leading questions so you know if your message got across.
• Do not talk from another room. Not being able to see each other when talking is a common reason people have difficulty understanding what is said.
• Try to minimize extraneous noise when talking. Turn off background noise like television or radio. Most hard-of-hearing people have greater difficulty understanding speech when there is background noise.
• Recognize that everyone, especially the hard-of-hearing, has a harder time hearing and understanding when ill, tired or stressed.

In groups or large rooms:

• Acquaint the listener with the general topic of conversation. Avoid sudden changes of topic. If the subject is changed, tell the hard-of-hearing person what you are talking about now.
• Be aware of possible distortion of sounds. The hard-of-hearing person may hear your voice but still may have difficulty understanding some words.
• Avoid situations where there will be loud sounds when possible. Some people with hearing loss are very sensitive to loud sounds and a reduced tolerance for them is not uncommon.
• Repeat questions or key facts in a group setting, before continuing with the discussion.
• Take turns speaking and avoid interrupting others.

When information is important:

• Have the hard-of-hearing person repeat specifics of a time, place or phone number back to you. Many numbers and words sound alike.
• Provide pertinent information in writing such as directions, schedules, work assignments, etc.

If the hard-of-hearing has the eyesight to speech read:

• Face the hearing-impaired person directly, on the same level and in good light whenever possible. Position yourself so that the light is shining on the speaker’s face, not in the eyes of the listener.
• Beards and moustaches can interfere with the ability of the hard-of-hearing to speech read.

I want to thank Thomas Smith, Social Services Coordinator of New Jersey Deaf Senior Housing (NJDSH) for sharing these communication tips at a United Way of North Jersey Caregiver Coalition meeting.

Disclaimer: The material in this blog is for educational purposes only. It is not intended to replace, nor does it replace, consulting with a physician, lawyer, accountant, financial planner or other qualified professional.

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