What is the best way to communicate with a hearing-impaired patient?

Contributed by Joy Victory, managing editor, Healthy Hearing
Last updated November 16, 20202020-11-16T00:00:00-06:00

Even without the added issue of hearing loss, conversations require a lot of focus, energy and patience. For people with hearing loss or other hearing impairments, a noisy environment or friends who speak too quickly can make communication extra challenging.

someone with hearing loss.

Below are some things that you can do to help facilitate communication when someone has hearing loss, whether that person is you—or a loved one, friend, or coworker.

Please note this article is for people who have mild to moderate hearing loss. People who have untreated profound hearing loss, or are Deaf, have different communication methods that will be more effective than the ones discussed below. More on degrees of hearing loss.

How to talk to someone with hearing loss

Some environments are much easier for communication for people who are hearing impaired. Here are some things you can do to ensure the environment is perfect for communication:

• Make sure the room has enough lighting. People with hearing loss often rely upon lip reading, facial expressions, speech reading, body language and gestures to supplement their remaining hearing and improve communication. 
• Pick a place that has minimum background noise. Though our ears and brain are able to filter out background noise in most situations, people with hearing loss often have a difficult time hearing over excessive noise. Keep in mind that small rooms with no carpeting or curtains tend to have poor acoustics and can distort voices.
• Make it easy to see everyone's faces. If you will be in a group setting, choose a location—or if you're at a restaurant, a round table —where the person with hearing loss will have visual access to everyone's faces to facilitate better communication. 

Here are a few examples of using the above tips to pick an appropriate environment for communication:

• If you're planning a dinner out, pick a restaurant that you know has ample lighting, does not play loud music and has decent acoustics. Choose a restaurant that you have been to before, where you know the noise levels do not get too loud. Another good tactic is to select an off-time: Rather than having dinner at 7 p.m. on Friday or Saturday night—the busiest dinner hours—opt instead for a late lunch or early dinner, between the hours of 3 p.m. and 5 p.m. when restaurants are likely to be the least busy.
• During a group gathering at your home, if you'd like to have a conversation with a friend or family member with hearing loss, invite him or her to speak in a different, quieter room. Turn off the TV and any other sources of noise.

Hard of hearing communication tips

Here are some do's and don'ts you can keep in mind to help facilitate better conversations and include someone with hearing loss:

• Make sure you don't cover your mouth. Don't talk through a yawn or while chewing gum. (For deaf and hard of hearing people who use American Sign Language and lip reading, this is especially important.) 
• Don't speak from another room or when your back is turned to the person. Don't shout in any situation.  
• Sit or stand close to the person with hearing loss, but not so close that he or she can't easily switch focus between maintaining eye contact and speech reading.
• If the person with hearing loss hears better in one ear, take note of that and try to speak more toward their right or left side.
• Before starting a conversation, say the person's name so you can get his or her attention. Wave or gently tap them if they don't hear you.
• When giving specific information, like an address or time for a meeting, write the important information down or ask the person to repeat the specifics to you so you can make sure they got them right. 
• Pay attention to the listener's cues. People with hearing loss sometimes feel embarrassed or get tired of asking others to repeat themselves or clarify. If the person looks a bit puzzled, find a tactful way to ask if he or she understood you.
• In group settings, make sure to avoid speaking over each other.
• Don't talk about a person with hearing loss as if she or he isn't there. Instead, talk directly to that person and do your best to use the above and below tactics.

How hearing loss affects communication

Sometimes, there will be a breakdown in communication. Here are some things that you can do to get back on track for successful conversation with your friend, family member or colleague:

• Speak at a normal level. Sometimes it's tempting to speak too loudly to someone with hearing loss, but this can distort the words.
• Provide the topic of conversation or key word to someone having difficulty understanding, especially if there has been a topic change.
• Spell a tricky word. For people with hearing loss, many consonants sound the same, which can trigger misunderstanding. Write it out on paper if necessary.
• Use gestures if they might help.
• Speak more slowly, but still clearly.
• Rephrase what you have said.
• Shorten your sentences and use less complex phrasings.
• Change environments if the location is giving you problems.
• Ask the listener what he or she needs you to do to facilitate better communication in the event of a break down.

The impact of hearing loss

Many of these problems can be improved if the person wears properly adjusted hearing aids. If you or a loved one needs a hearing test, you can find can find trusted hearing specialists and audiologists near you with our directory. 

Hearing aids are beneficial in many situations. However, there are some listening events where hearing aids alone cannot provide enough benefit. In those situations, communication partners can help the person with hearing loss be more successful in hearing. Remember, communication involves at least two individuals: a talker who sends the message, and a listener who receives the message. You, as a member of this communication pair, can improve the conversation by following a few simple strategies.

Gain attention

Gain the listener's attention before you begin talking, for example, by saying his or her name. If the person with hearing loss hears better from one ear, move to that side of the person. Also consider touching the listener's hand, arm or shoulder lightly to gain attention. These simple gestures will prepare the individual with hearing loss to listen and not miss the first part of the conversation.

Maintain eye contact

Face the person who has the hearing loss. Make eye contact. Your facial expressions and body language add vital information to the message being conveyed. For example, you can "see" a person's excitement, joy, confusion or frustration by watching the facial expressions or body language.

Keep hands away from face

When talking, try to keep your hands away from your face. You will produce clearer speech and allow the listener to make use of those visual cues by keeping your mouth and face visible.

In addition, most listeners can improve their perception by watching the talker’s face – also known as speechreading. Speechreading helps to improve speech perception. Many sounds can been seen that are hard to hear. For example, the sound /s/ is very difficult to hear but easily speechread. It is important to not over exaggerate your talking, talk with food in your mouth or chew gum when talking to a person with hearing loss. Keep in mind that heavy beards and moustaches can also hide your mouth.

Speak naturally

Speak distinctly, but without exaggeration. You do not need to shout. Shouting actually distorts the words. Try not to mumble, as this is very hard to understand, even for people with normal hearing. Speak at a normal rate, not too fast or too slow. Use pauses rather than slow speech to give the person time to process speech. Give clues when changing subjects or say “new topic."

Rephrase rather than repeat

If the listener has difficulty understanding something you said, repeat it once. If they are still having difficulty find a different way of saying it. Use different words with the same meaning. For example: “I am going to the grocery store." Repeat once and then rephrase. “I am going to the supermarket," If he or she did not understand the words the first time, it's likely he or she will not understand them a second time. So, try to rephrase it. Another option is to ask what the person did not understand and just repeat that phrase or word. For example, "grocery store" is what was not understood, so just repeat those words "grocery store."

Talk away from background noise

Try to reduce background noises when talking. Turn off the radio or television. Move to a quiet space away from the noise source. When going to a restaurant or making dinner reservations, ask for a table away from the kitchen, server stations or large parties.

Good lighting is important

A person with hearing loss can speechread to assist in hearing so lighting on your face is important. When in a restaurant or other social gathering, sit where there is good lighting so that your face can be more easily seen. Poor lighting may cause shadows on the face of the talker. Conversely avoid sitting with strong lighting coming from behind, such as through a window, as that will cause difficulty looking into the bright light.

Use an app to translate from spoken word to written word, or use texting

There are numerous apps that can be downloaded that can allow you to speak into a smart phone and have your words show up on the screen for the person with hearing loss to read. One such app is called Dragon. The use of texting is also an efficient use to supplement communication.