My mother is a very independent and somewhat private person, and at 94 still lives in her own home, helps care for my father, and drives (cautiously). So I was surprised during my last visit when she asked me to go with her to her doctor. The doctor’s office had just started offering face-to-face appointments again and she hadn’t been feeling well.
We wore our masks and sat in the socially distanced chairs in the spare waiting room. When they called my mother to the examination room, she asked me to join her. It wasn’t exactly protocol, but I was finally allowed to accompany her.
When the doctor walked in with a face mask and a clear face shield, I knew why I was there. I was my mother’s interpreter: from English to English.
My mother wears two hearing aids and has managed for eight years to get by with just a few adjustments. But since COVID-19 mask mandates and social distancing, she has lost much of her ability to navigate the hearing world, decreasing her independence and her confidence.
The National Center for Health Statistics reports that approximately 48 million American adults have some degree of hearing loss. Hearing loss increases with age: nearly 25 percent of those aged 65 to 74 have hearing loss and 50 percent of age 75 and older have disabling hearing loss.
As social distancing and face masks became prescribed to manage coronavirus, millions of people face new hurdles in communicating—with doctors, dentists, bankers, clerks, and even neighbors. Communication is a complex transaction that depends on visual cues, said Dr. Debra Tucci, director of the National Institute on Deafness and other Communication Disorders.
“Factors that influence how well our spoken language is received include eye contact and body language, the tone of our voices and our facial expressions, and environmental lighting and background noise,” she said. “Cloth face coverings obscure facial features, disrupting speech, and the emotion conveyed by the speaker. They also filter speech, making sounds less clear. When it is harder to understand speech — whether because of face coverings, distance, or other factors — we have fewer cognitive resources to process information.”
In fact, research shows that face masks reduce the volume of someone’s speech anywhere from 2 to 25 decibels. Add six feet of social distancing and the sound really deteriorates, said Barbara Kelley, executive director of Hearing Loss Association of America.
As a result, communication suffers, and feelings of stress increase. For people with hearing loss, the sense of isolation is already present. By adding directives to “shelter in place,” shutting doors to community centers, churches, rehabilitation centers, and senior care homes, and cutting back on neighbor and family visits, isolation increases, along with a sense of abandonment.
Yishane Lee, an editor of Hearing Health magazine, surveyed their hearing-challenged readers and found an overwhelming 87 percent said they were experiencing difficulty communicating in the age of coronavirus. Many added that being able to hear from a distance of at least six feet while the speaker is covering the bottom half of his face has been daunting, to say the least. “Even hearing people seem to be having issues,” said one survey taker.
There is also the difficulty of fitting mask elastics with hearing devices — 42 percent in the survey cited difficulty wearing their hearing aids or cochlear implant processors with a mask, with the fear of losing the expensive devices. There is also the issue with canceled appointments with hearing aid specialists for cleaning and adjusting the hearing aids, which is done periodically to improve hearing.
Overall, the stress of health concerns, isolation, and communication loss can cause additional problems. Carolyn Stern, assistant director of outreach and strategic initiatives for the Center for Hearing and Communication (CHC), is particularly concerned with the psychological effect of these complicated interactions.
“It is triggering stress, anxiety, aggravation, frustration, and fear because now they’re entering situations they used to manage well, and now their communication strategies are not working,” she explains. “They’re no longer in control and are cut off.”
“The issue is perhaps most acute where clear communication is most vital — in the medical setting. For those who can’t hear, the fear of being lost in translation with your physician is only compounded by the stress of illness and treatment at a time like this.”
Some proposed options include masks with clear face coverings to enable lip reading and, for those who are tech-savvy, the use of talk-to-text apps on phones and tablets, or attaching a directional microphone to a smartphone.
With no end to wearing masks and practicing social distancing in sight, when even family visits are cut, the challenges for those with hearing challenges, especially seniors, remain. The National Institute for Deafness and Other Communication Disorders offers eight “tips” for helping those with hearing loss get through this pandemic. The first two are patience and awareness, and the final one is “bring someone with you.” This person will be your interpreter, who can “translate” the message from the speaker to the person with a hearing loss, from English to English.