Getting it into Perspective
If you have perfect hearing, conversation will be pretty straightforward but have you ever wondered what it must be like to have hearing that isn’t perfect? Try getting in a bath, lying down and then submerging your head until your ears are full of water. Now speak words to yourself and you’ll see that the sound has become distorted. Take it a step further and, the next time you’re waving someone off who has just got on a bus or a train, ask them an ordinary question. Before you started that question, you already knew that the receiver of your information was most likely going to pull a face of ‘not understanding what you are saying’, and you yourself doubted they would understand, anyway.
That’s hearing loss.
While a person with a hearing loss might, unknowingly to them, have already started to read lips, your being in a position of not knowing about this loss might cause you to hold a conversation which is going nowhere. The result? Frustration, a belief that the receiver isn’t interested in what you’re saying and then an uncomfortable feeling of why bother. That’s how you feel. But how does the person with the hearing loss feel? Imagine.
Being on the edge of communication is a very lonely place to be. Yet the fact is that only twenty percent of our understanding of a communication comes from the actual words being spoken. So where is the other eighty percent hiding?
Well, it’s hiding in plain sight, as its use is so common to us all that we don’t even think about it. It’s body language, facial expression, the use of your eyes and eyebrows to show feeling and, when these all come together without any real effort on the part of the speaker, your message is almost delivered. Look at those people on the bus or train, when the noise of the engine drowns out voice and you’ll see that that eighty percent helps you pick up on a lot that is being conveyed and the emotions attached. Hearing the spoken word then gives the clarification you need.
Whilst some people are born deaf, some develop a hearing loss from the industry in which they worked and some develop an illness that brings on deafness, the overwhelming majority of people with hearing loss are elderly. We are talking about older generations, our parents and grandparents, people for whom we have the highest of respect and have, in most circumstances, become who we are.
So, what can everyone do about delivering good communication when a hearing loss or impairment has to be managed?
Let’s start by looking at what hampers successful communication:
• Bad lighting – we’re all quick to switch the light on when we can’t see what we are doing, so don’t expect someone with hearing loss to be able to read lips in a bad light. Place yourself in a position where the light in the room is coming from a source behind the person with the hearing loss. If it’s coming from behind you, the receiver will be squinting, or turning away from the communication.
• Make sure you are indeed facing the receiver of your words – think what it’s like when you’re watching the television and the speaker in your favourite programme isn’t facing the camera. Even a person with perfect hearing might lose that part of the communication.
• Shouting from another room does nothing for either communication or a good rapport. Most of us ask for one or two re-runs and then tempers start to fray.
• Believe it or not but rooms which have no soft furnishings in them (sofas, cushions etc.) can cause an echo over words spoken.
• Don’t speak while you are eating or chewing something. We all do this but, when talking to someone with a hearing loss, badly shaped and badly pronounced words don’t support understanding; nor does sucking on a pen whilst talking, or talking from behind a book or magazine.
Now let’s look at the good points to take into consideration when trying to support successful communication:
• Take on board the points mentioned earlier.
• Let your body do the talking; continue with the same body language, facial expression and use of eyes and eyebrows.
• Speak at a normal pace. Slowing down speech really doesn’t help and talking too fast makes comprehension difficult for us all.
• And to top up that eighty percent delivery, speak clearly.
Hearing loss in the elderly is quite often in the form of reduced hearing; this means that something can be heard but it doesn’t make the eighty per cent of communication given by your body language and facial support up to one hundred percent perfect understanding.
Lipreading isn’t easy but it can be learnt and, as mentioned before, a person with hearing loss may already be looking at the speaker’s mouth, rather than looking at the eyes, the latter being something which they might have been doing earlier on in their ‘hearing better’ life.
While lipreading one word on its own gives no clue to context, lipreading a sentence is easier. Some letters are very easy to read (a – easy, unless it’s at the beginning of a word), e, i, f, l, o, r, u, v, y and w), whilst others are more difficult (b, c, g, h, m, n, p, s, t and z). Some words are very easy to read (hospital, birthday and happy), whilst others are difficult (apathy, annoy, heat, here and scissors). Some words can be confused for others (beat, meat and peat look the same on the lips, as do crumble and grumble), so context becomes so important.
If the word is too difficult to lipread, support the first letter by drawing it in the air at eye level, as if drawing that letter (in lower case) on a window e.g. peat (so it’s not beat or meat), crumble and not grumble, or heat and not eat). The receiver will see that letter from its opposite side and still know what it is, so that word will become easier to lipread. You could also consider changing a somewhat confusing word for another e.g. use difficult instead of challenging, or even reword the whole sentence. Lipreading.org puts everything into perspective, as to how to maintain communication in a slightly changed aspect of family life and into the world of hearing loss as a whole. Not only will the person with hearing loss benefit from learning how to lipread but so will those who wish to perfect their delivery of their important and meaningful words.
What else can we do to support communication?
As we get older, we may also experience changes to our eyesight, so getting the right distance from the receiver (‘long arm disease’ is a phrase that elderly people sometimes use when their eyesight means that they have to hold a newspaper further away than before, in order to get the focus right), or sitting slightly to the left or right (loss of peripheral eyesight or tunnel vision) but still being within forward focus of the person who is looking at us, may also need to be considered.
The importance of successful communication can never be overstated. Anything but can lead to confusion, misinformation, making wrong judgements, alienating and damaging, or even losing or foregoing close and important relationships. And, without communication, where would we be?
We have learnt so much from older generations. In a world which is constantly changing, why allow a monumental loss to family life, in what is our and their time of changed reality?