When communicating with a hearing-impaired patient, which of the following actions is best?

Communicating with a person who has a hearing loss can be stressful for both parties. Even when hearing devices are used, proper communication strategies are essential for maximizing the experience. Follow these simple tips to improve communication with your hearing impaired friends, family and co-workers:

• Maintain eye contact with the hearing impaired individual, facing them directly. Do not attempt to hold a conversation from another room. Lip reading and facial expressions play a large part in communicating for both sides of the conversation.
• Make sure you have the person’s attention before beginning a conversation. Try saying the person’s name, touching their arm or using a gesture to get their attention.
• Speak naturally and clearly – don’t shout. Speak clearly, at a normal or slightly slower speed and enunciate your words. Speaking in a slightly louder voice may also help your listener understand, but be careful not to shout. Shouting distorts the sound of your words and can make lip reading more difficult. Pause between sentences to ensure what you are saying is understood.
• Do not cover your face with your hands or other objects. Individuals with hearing loss rely on visual cues to help follow the conversation, and sometimes find lip reading helpful. Avoid eating and drinking while conversing, as well.
• Try to find a quiet area free of background hearing impaired individual to miss out on noise. This can be distracting and cause the much of what you are saying. Turn off the television/music, move away from noisy areas and if you’re in a social environment, try to find a quiet place to sit or a seat in a restaurant that is away from the kitchen or large gatherings.
• Repeat yourself if necessary. Try using a different word or rephrasing your sentence if it is too confusing.
• Pay attention to the listener. If they look confused, offer to clarify what you have just said.
• Talk into their “good ear.” Many people who suffer from hearing loss tend to have one ear that is stronger than the other. Look for cues as to which ear that is, ask them if appropriate, and situate yourself on that side of your listener.
• Be understanding. You may feel understandably frustrated when interacting with the hearing impaired, but keep in mind how it must be for them on a daily basis. Be patient. Communicating with hearing loss is a cooperative effort and requires understanding from both sides.

Below are tips for those with hearing loss to follow for improved communication:

• Let people know you have hearing loss. Alerting them to your hearing loss allows them to use some of the above tips.
• Maintain a clear view of the speaker. Make sure the speaker’s face can be seen clearly to improve sound quality and provide visual clues and lip reading.
• Take pressure off the speaker. Repeat back the part of the sentence you did hear instead of making the person repeat the whole sentence.
• Clarify by asking the speaker if you heard their statement correctly. Restating the sentence can help avoid confusion on the topic.
• Consider your environment. Make sure there is adequate lighting for lip reading and facial clues. Do your best to have your communication partner in front of you and background noises behind you.

Communicating with a hearing loss can be frustrating for all parties, but simple adjustments to communication can help. The goals are to retain the involvement of the person with hearing loss and reduce the frustration of verbal communication.

If you suspect that you may have some degree of hearing loss, contact the Pennsylvania Ear Institute. Our expert audiologists will assess your hearing and make recommendations on how to address your hearing needs. For more information on PEI’s services or to make an appointment, call 215.780.3180.

Communication tips for talking to people with hearing loss

Contributed by Joy Victory, managing editor, Healthy Hearing
Last updated November 16, 2020

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.

Restaurant background noise is one of the
most common challenges when talking to
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.

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. 

Joy Victory, managing editor, Healthy Hearing

Joy Victory has extensive experience editing consumer health information. Her training in particular has focused on how to best communicate evidence-based medical guidelines and clinical trial results to the public. She strives to make health content accurate, accessible and engaging to the public. Read more about Joy.

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