The referral message came one day, as a hurried hand-off discussion in our office with my therapy coordinator: "She's pretty demented". When I later asked the person in question to consider an evaluation with speech-language pathology (me), she asked more than once - "what does this have to do with my walking?" I told the woman, who reclined in her wheelchair but occasionally vented energy by chewing at her nails, that there was no connection between her recent fall and problems communicating. She then asked me to repeat what I had just said. There; I had my diagnostic hunch confirmed. You can't use information if it does not get in first.
As many as half the population of seniors in America may be afflicted by hearing loss, though prevalence figures vary widely among age ranges and cultures. When an older adult who has hearing loss attempts to engage her/his community - to meet needs; to share information; to follow the rules of etiquette for the community; and - to maintain social closeness - there are often breakdowns in the efficiency of sharing information. When communication routinely breaks down, the person with hearing loss often may cut off, decline or withdraw from interaction entirely. The person's impaired sensory status can pose a significant safety risk. Speech-language pathology is one profession called upon to increase the hearing-impaired person's function.
Communication breakdown can be a factor of the type of hearing loss a person has: is more loudness needed to make the speech clear, or is more clarity? It can be due to the noise in the background: TV, other speakers, clattering dishes, or hard and smooth surfaces that reflect sound well. It can be affected by the cognitive status of the person, so that a person with impaired cognition who also does not hear well may not use strategies to listen intently. SO, what can be done to help the person with hearing loss communicate better??
Speechreading cues are often key tools in the tool box of a communication partner. Those cues include: giving the hearing-impaired listener a constant view of your face; keeping your face lighted; controlling your speaking pitch, its loudness and the speed of your conversation; stressing key words with either pitch, loudness or timing changes; and overarticulating (using exact pronunciation) each conversational turn you take. Each hearing-impaired person who benefits from speechreading has learned to apply the cues in both familiar and unfamiliar environments.
Background noise is often the lingering pest that nags at a hearing-impaired person's daily activities. Arrange for it to be turned down or off, or get away from it. The current generation of hearing aids, expensive though they may be, are much more successful at filtering out that noise. Hearing aid users should get help in adjusting to the aid though guided listening exercises.
Cognitive strategies for improved communication may be initiated by the hearing-impaired person, or by her/his communication partner and the community. Examples of strategies not previously discussed include keeping sentence structures and vocabulary concrete and simple; pairing conversational turns with gestures that clarify the message; conveying the emotions of the message with facial expressions; guessing of the intent of the message when not all words are understood; and writing key words for your message, if the listener does not initially understand what you said. Hearing-impaired persons who may benefit from strategies should have practice in their use.
The brief listing of helping strategies for hearing loss above is not comprehensive. For example, not all the current assistive technologies for hearing are hearing aids. Contact your friendly neighborhood speech-language pathologist, for more information on helping hearing-impaired persons better communicate.
