Successful communication is absolutely necessary to carry out our work in our day to day environments and routines. Yet the presence of noise in the surroundings may have a deleterious effect on the ability to understand messages accurately. The presence of a face mask and hearing loss may further affect speech perception. There is considerable evidence showing that when auditory information is degraded, there is a greater need for visual cues to make up for this diminished signal (Kawase et al, 2005), but due to the face mask, this may impair the ability for some people to communicate with ease because it prevents lip reading and it can reduce the audibility too, making the speech sound muffled. In consequence, interacting with one another can be extremely daunting in various settings. For instance, in a hospital setup if the patient is hearing impaired there is a high probability to misinterpret information, as they may not be able to comprehend the advice given by the medical practitioner nor convey specific information that is asked for leading to a communication breakdown.
At the very least, removing visual cues can make communication more taxing for individuals with hearing impairment because of the mental exertion required to listen, especially when there is background noise. As a result, even if a person can follow what is said, they have fewer mental resources left to think about and recall what they heard. An unintended consequence of wearing a face mask might be that social distancing is replaced with social isolation and poor mental wellbeing in older adults with hearing loss.
There are a wide variety of face masks that are currently available in the market today, as the use of them is mandatory to reduce the spread of the virus thus demand for them increases by the day. In a study conducted to quantify the potential impact on the listener's comprehension at the acoustic level posed by variety of face masks worn by healthcare professionals found that simple face masks act as low pass acoustic filters that will reduce the high frequencies between 2000Hz-7000Hz by 3 to 4d B and about 12dB for N95 masks (Goldin et al,. 2020).
Therefore, although the N95 and FFP3 respirator masks for frontline health care workers can filter 95% of tiny particles, they are much more likely to distort and reduce the level of speech. This makes communication particularly difficult for the patients with hearing loss at a time of heightened anxiety and when the content of conversations is novel and unpredictable.
Research has also shown there are beneficial effects of wearing surgical masks made from a transparent material that allows the mouth to be seen and this will aid to pick up the visual cues, but these aren't widely available. The only FDA registered transparent face mask is 'The communicator' but they have a tendency to fog up and thus render the visual cues invisible.
Strategies that may be used to communicate with hard of hearing individuals:
• Speak slowly
• Reduce noise and obtain patient's attention
• Ask how they would prefer to communicate leg: written form)
• Make sure hearing aid wearers are using them
• Rephrase remarks if not understood
• Do not use exaggerated words while talking
• Avoid speaking to them while walking
• Consider using a portable hearing amplifier.
In addition, another major issue with wearing face masks along with hearing aids is that it is prone to fall off from the ear as it may get entangled with the straps of the facemask. Therefore, reportedly there is a considerable amount of people who have lost their hearing aids. As hearing care professionals, we make it a point to advise the patients to only wear their behind the ear hearing aids if they have a tight fitting ear mold or remove their mask when safely back at home and in an area where a flung device could be easily found.
Conclusively, with the need to cope up with the new reality of using a face mask and the hassle that is bound with it for individuals with hearing loss is inevitably frustrating. Therefore the need of implementing convenient communication strategies, initiating the use of hearing aids and proper counselling on how to manipulate the hearing aid is crucial.