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Karen Franklin has not ventured out much from her home in Yonkers, N.Y., recently—and it’s not just because of fears of COVID-19. The 65-year-old has had hearing loss for over 30 years, and even with a hearing aid in one ear and a cochlear implant in the other, she now finds it too difficult to navigate a world where everyone suddenly communicates from behind a mask, often at a great distance.
“I was at an outdoor baby shower a few weeks ago, with everyone wearing masks and staying 6 feet apart, and I felt completely clueless,” she says. “I could not hear people clearly, and I also couldn’t lip read, which often helps me if I miss a word or two. Up until now, I’ve never felt isolated because of my hearing loss. . . . But now it’s a whole different world.”
Wearing a mask can be challenging for everyone. But for the 48 million Americans who, like Franklin, experience some form of hearing loss, it can be particularly fraught.
“A mask itself is a physical barrier that blocks sound, and when it touches your lips, it can cause speech to be mumbled,” says Douglas Hildrew, an ear, nose, and throat specialist at the Yale School of Medicine in New Haven, Conn.
People with hearing loss also rely on visual cues more than someone without hearing loss, adds James Denneny III, executive vice president and CEO of the American Academy of Otolaryngology—Head and Neck Surgery. “A mask takes away a person’s ability to read lips and see facial expressions, which help people better understand what they’re hearing,” he says.
Plus, social distancing guidelines, which require you to stand at least 6 feet away from others, are key to staying safe but also decrease the level of sound that will ultimately reach you. “We are finding that individuals with mild hearing loss who may have felt that they didn’t have enough of a problem hearing are coming into the clinic to get hearing aids because the addition of masks has made their communication challenges much greater,” says Catherine Palmer, PhD, president of the American Academy of Audiology and director of audiology and hearing aids at the University of Pittsburgh Medical Center. (If you’re considering buying hearing aids for the first time, here are CR’s top picks.)
Even with hearing aids, however, wearing a mask—though it’s a necessary and important step for safeguarding public health—may still create communication difficulties for many people. These tips can help.
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Better Communication During COVID-19
Ask people to speak slowly and clearly. While it’s normally not helpful to shout, they may want to raise their voice slightly to counter the effects of the mask, says Sarah Sydlowski, audiology director of the Hearing Aid Program at the Cleveland Clinic.
But the focus should really be on the careful enunciation of each word: “They want to emphasize the beginnings and ends of words, where the consonants fall, because those are the sounds that people with hearing loss tend to miss the most, and what masks dampen the most,” she says.
Face one another. Although social distancing requirements may mean standing at least 6 feet apart, it’s important that you engage in eye contact. “Even though all you may be able to see of a person is their eyes, subtle gestures such as squinting or raising eyebrows can give you important visual cues,” Hildrew says. You’ll also be able to better see their body language.
Use the right mask. A mask with a transparent window in front—which you can buy online or make at home—can make lip reading and facial cues more visible, Hildrew says. (Some masks also have anti-fog features, as well.) But just be aware that you may not be able to hear quite as well as if someone is wearing a surgical or cloth mask, Palmer says.
Her research has found that masks with an insert reduce sound more than surgical masks because of the plastic. “These masks are especially important for individuals with more severe hearing loss. Those with mild hearing loss may be better off listening to someone using a surgical mask,” she says.
Tweak your hearing aid. Some of the newer aids connect to an app on your phone that will allow you to adjust the volume for hearing mid- to high-level pitches, the sounds most difficult to hear through a mask, Palmer says. (Your audiologist can create a “mask” program that specifically tunes the hearing aid for these situations.)
If your hearing aid also has a remote microphone, you can use it to navigate social situations. If you’re sitting around a yard with a group of people, for example, you can set the remote microphone right next to them to hear them better. “Some work from over 80 feet away, and it sounds like the person is right next to you talking in your ear,” Sydlowski says. (Just wipe it off with a disinfecting wipe if it’s being passed around a group of people).
Try a transcription app. Speech-to-text apps such as Dragon or Google Live Transcribe improve communication by converting what is being said into text on your phone, Sydlowski says. “As a person is talking, you can read along to make sure you don’t miss anything,” she says. The ability to use external wireless microphones, such as those found on Bluetooth headsets, is also provided in the app settings once the device is paired up; this would allow the speaker to sit at a distance from you while you read the display on your phone
Consider doing events virtually. You may be better off conducting gatherings online, rather than in person, Palmer says, because you can control the volume on your computer, and you’ll be able to read lips. (That is also the safest bet for keeping the virus at bay.) Appointments with doctors might also be easier when they are virtual, so ask when a telehealth visit is an option.
How to Wear a Mask With Hearing Aids
If you wear a behind-the-ear hearing aid, it’s easy for the aid to get caught in the mask loop that goes behind your ear when you remove the mask. “We’ve had many patients lose hearing aids in the past few months because of mask removal,” Palmer says.
The easiest way to fix this is to move your mask strap away from directly behind your ear, she suggests, whether it’s wearing a headband or hat with buttons, pulling your mask around a ponytail or bun, purchasing a mask with ties, or buying an elastic strap for the mask.
You can also clip the hearing aid directly to your clothing with a device such as the OtoClip or Ear Gear, or even double stick tape, so even if it does come out of your ear, it won’t get lost. “We often use these with active children or older adults who may pull out their hearing aids,” Palmer says.
She also recommends talking to your audiologist about hearing aid insurance, and/or check with your homeowners policy or renter’s insurance policy to see if you can add lost hearing aid coverage.
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