I’ve been deaf all my life so I don’t know anything else. I’ve also always had tinnitus so the concept of a quiet world is just the wildest concept that I can’t even start to get my head around. When I started my counselling training on Saturdays and Sundays, my anxiety usually started around Weds/Thurs. Would I be able to hear? Would I miss something critical and would I look stupid? Shame was a big part of my childhood, of getting things wrong, of being laughed at, of laughing with, but behind the smile, the shame, oh the shame! I knew I had to sort myself out so getting over my (very real) phobia of wearing hearing aids, I got them. They’re brilliant but I still struggle and miss things.
Deafness affects 10 million people and is the second largest disability in the UK. You don’t notice us because it has the disadvantage of being an invisible disability. So my reason for this article is multi levelled. It’s to bring awareness to hearing counsellors about possible HoH (Hard of Hearing) clients. It’s to bring awareness to people in general with HoH in their families. It’s to say to other HoH people, I feel your pain; you’re not on your own. It’s also to raise the awareness to training facilitators, conference and public speakers that in your training groups or audiences you will have people who have a hearing loss and who want to hear you, so what can you do to help them?
To get some idea of what it is like to have a hearing loss, try putting your index fingers firmly in your ears and talk or listen to someone. Your voice sounds muffled and distorted and you feel a vibration in your ears/head. When you listen you can hear sounds but they too are muffled, perhaps you can’t hear anything, you can see people’s expressions but you can’t make anything out. (When I ‘take my ears out’, it’s like going underwater in a swimming pool!)
With deafness, tinnitus often comes along as its partner in crime. Tinnitus experiences can be wide and varied but most commonly it’s described as high pitched radio frequencies or a wind rushing noise. Certain foods, beverages and situations can exacerbate the condition and there’s a myriad of equipment that help mask all with varying degrees of success and failure. Sleep problems, depression and anxiety are common and at the extreme, suicide can, and has occurred.
Communication between hearing people and the HoH can be very frustrating and tiresome for both parties. Even if someone is wearing hearing aids, it doesn’t mean they can hear you perfectly. People with hearing loss often rely on visual cues for information. Some people have difficulty knowing where a sound is coming from. Others hear sounds, but may not be able to recognise the words that are spoken.
For the HoH it can be hugely tiring and hard work to hear. It is tiring being on alert just in case someone talks. People can think you’re aloof or antisocial and it can feel incredibly isolating and shameful not to be the same as everyone else – but it doesn’t have to be.
Following are tips for hearing and HoH people that can help minimise frustration and support more relaxed communication.
Get Their Attention. Make sure the HoH person knows you’re talking to them. Touch them gently on the arm (never their head); wave or say their name until you have their attention before starting the conversation.
Make the Subject Clear. Establish the subject at the start of the conversation and whenever you change subjects.
Don’t shout: Raising your voice doesn’t help and the HoH person may think you’re angry with them. It’s the consonants that most Hard of Hearing people miss, and shouting only makes the vowels louder.
Don’t exaggerate your Lip Movements: Speech reading is difficult; only about 30 percent of the sounds are clearly recognisable. Exaggerating lip movements just interferes with speech reading, however, try to make it clear when letters sound the same e.g. p/t, m/n, c/d and so on….
Use Appropriate Gestures. Your head motion can clearly indicate “Yes” or “No”. Shrugged shoulders indicate uncertainty; a pointing finger calls attention to something.
Use Appropriate Facial Expressions. A smile, frown, raised eyebrow, or a furrowed brow all convey meaning that can help.
Cut Out Background Noises. Try to avoid people talking at the same time and turn off the background noise like the tv. If you’re a counsellor and have a fan on in your room, you may just want to be aware its possible effect as HoH people are usually not able to filter those sounds out to hear your words clearly.
Face the Person You are Talking With. Even people with normal hearing use speech reading to fill in what they don’t hear and HoH people tend to be locked onto faces and need a clear view of it. Talking and eating should be avoided and if you have a bushy beard and moustache, it might be trendy, but if your lips and mouth are camouflaged not only can we not hear, we can’t see what your saying either. Try not to cover your mouth with your hands and don’t start talking then turn your head to the side or look down.
Rephrase. Don’t just repeat slower and louder, try rephrasing in simpler words
Use Sub Titles on The TV. If you ask a HoH person they will usually say they don’t need them out of embarrassment. Avoid this by just putting them on (without them a HoH person will make up their own version of what they think is happening or being said in a programme!)
Ask for Confirmation. HoH people rely a great deal on context, sometimes they may not understand exactly what is said, but will not interrupt the conversation, hoping that what you say next will clarify what they missed. Don’t ask Yes/No questions, if what you said is important, use open ended questions for confirmation to get enough of a playback to assure that your message was understood.
Don’t Say: “He/she can hear when they want to.” That’s usually not true and it can be embarrassing or easily anger and upset someone who is struggling to hear as well as they can …also …please, please don’t ask ”have you got your ears in?” ..and while I’m at it try your best to refrain from going into gobbledegook comical sign language – trust me, it’s really not funny 🙂
Don’t Talk from the “Other Room”. People with hearing loss, haven’t yet mastered the art of seeing and hearing through walls. They don’t just not hear loud enough, they usually have difficulty with directionality too so they may not know where you are.
Be Patient: Saying ‘never mind’ or ‘it’s not important’ can make a HoH person feel frustrated, that they’re not important and a burden.
Try Not Laugh or Ridicule: HoH people often have a great sense of humour and often laugh at themselves first; they’ve had to develop a soh to get through some of the mistakes they’ve made. Don’t underestimate though that laughter can often hide a sadness at not being able to do something ‘as normal and simple’ as hear.
And For the Hard of Hearing Amongst Us…
Don’t Bluff! This tip is important because many HoH people try to hide their hearing loss. This is a BIG mistake and doesn’t fool anyone. Most people are happy to help someone with a hearing loss.
Ask for Help. Tell people that you don’t hear well. If they forget (as they often do) remind them, don’t give up reminding them, tiring though it is.
Be Specific. Be specific when telling someone how they can help you better understand. For example:
• Tell them you can miss things if you don’t know who is talking.
• Ask them to get your attention before starting to talk.
• Tell them that you can’t hear if more than one person is talking at the same time. Ask that only one person talk at a time.
• Tell them that quick topic changes often cause you to lose the thread.
• Tell them that you read lips, so it’s important for you to be able to see their face.
• If you didn’t hear something, don’t just say “What?” or “Huh”. Tell them what you DID hear and ask them to repeat the part you missed. E.g. “I heard you are going on a trip, but I missed when you are leaving.”
• Say, “I don’t hear well in noisy situations, let’s move over to this quiet corner”.
Subtitles. Use them on the TV, everyone else will get used to them.
Pick your best spot. Choose a position that’s quiet, and has good lighting. If you hear better in a certain ear, consider that when choosing your position. Arrive at meetings or social situations early and sit where you can hear (and see) best.
Anticipate. Think ahead and plan for what is likely to follow. It’s easier to hear, when you expect it.
Have regular checkups. Even if you were hearing aids, have regular checkups, they may need re-tuning as your hearing needs change.
Pay Attention. Concentrate on the speaker. Even people with normal hearing use visual cues of facial expressions, body language and lip movement to help them understand better. As a HoH person, learn to use these as effectively as possible.
Show Your Appreciation. When someone goes out of their way to help you, be sure to tell them how much you appreciate their help.
Remember, It Takes Two People To Communicate…
It is the Hearing person’s responsibility to be heard and understood and the HoH person’s responsibility to say when they can’t, or haven’t been able to hear.