Hearing impairment is the most common sensory deficit in the elderly. This makes it essential that you pay particular attention to how you communicate with them. Here are some tips to bear in mind.
1. Recognise the signs that someone has hearing loss. Individuals are not always open about their hearing difficulty; they may feel embarrassed and pretend that they have heard what you say. Indications include the person:
a. Having difficulty following a conversation when two or more people are talking at the same time.
b. Appearing to strain to understand what is being said.
c. Frequently asking you to repeat what you have said.
d. Making comments about people mumbling or not speaking clearly.
e. Reacting inappropriately to an instruction.
f. Wanting you to turn up the TV or radio very loud.
g. Frequently misunderstanding what you say.
The above responses indicate that the person needs to have a hearing evaluation. But even if they are prescribed a hearing aid this does not mean they then have good hearing. Hearing aids and other types of hearing systems greatly enhance the ability to hear but rarely provide perfect hearing. You will still need to communicate in a way that meets their hearing needs.
2. Speak clearly. You may need to raise your voice slightly but this does not mean repeating something very loudly. Clarity is achieved by forming words clearly, speaking at a moderate speed – not too fast or slow. Speaking very slowly can create difficulty as the natural rhythm of speech is lost. It also makes it more difficult to lip-read. And you may come across as patronising. It is helpful to think about what you are going to say before speaking.
3. Speak when you have the person’s attention. Touch them gently on the shoulder, wave or move into a position so they can see that you want to say something. Face the light so that they can see your face and expressions clearly.
4. Do not cover your mouth with your hand or keep glancing away while speaking. Putting your hand over your mouth can muffle the sound, make it impossible to lip read and also hides your expression. Turning your head away has a similar effect – the sound is projected elsewhere, the person cannot see your lips or expression clearly. Make good eye-contact without staring.
5. If you suspect the person has not understood, repeat what you said. Avoid confronting or embarrassing the person. Say something like; ‘Sorry, I’m not speaking very clearly’, then use different words or phrases that are clearer and easier to understand.
6. Reduce any background noise and distractions. Turn off the radio or TV or ask the person if they would like to move to somewhere quieter. Background noise presents difficulty for many people – with and without a hearing aid.
7. Write things down. Write clearly, using plain words. If in a noisy environment: ‘Can we go to the lounge so we can talk?’ or use key words ‘Chat in lounge?’. It is helpful in residents’ meetings to have someone sit next to anyone who has hearing difficulties – especially if they do not sign or a signer is not available. This person can then write things down so the hearing impaired person can follow what is going on.
8. Be patient. Take the time to communicate clearly and in a way that works best for the person you are supporting. If the person senses you are becoming impatient or don’t care enough to make the effort they will gradually stop communicating with you, and be in danger of becoming isolated or depressed. Or they may react by becoming angry, aggressive or difficult – who can blame them for that!
9. Ask the person what you can do to communicate better with them. This point is sometimes forgotten. Everyone is different and has different preferences. Say something like ‘I’m concerned I’m not communicating well with you. What can I do to improve this?’ Be prepared to accept criticisms and suggestions. Accept the person is giving you their viewpoint. Do not take it personally or be offended. If they are shy about commenting, lead them into it or make a few suggestions such as ‘What has worked for you in the past?’, ‘I’m aware I speak very quickly sometimes, would it be better if a slowed down?’ Doing this will raise your awareness of what adjustments you need to make to improve your communication. It will also earn you their respect.
10. Encourage openness. Make other people involved aware that someone has a particular hearing difficulty and what to do to make communicating easier. It will make life better for everyone involved. For example: people can be reminded about only one person speaking at a time, being careful about background noise, etc.
Stopping, thinking and bearing these straightforward points in mind can make a huge difference to people you are supporting.