Sunday, November 26, 2017

WHAT DID YOU SAY? - 5 Tips for Communicating with Your Hard of Hearing Relatives and Friends During the Holidays

You’ve just spent Thanksgiving with a house full of noisy relatives along with your eighty-year-old Aunt Olive who mostly sits alone in the corner. You assume this is because she’s feeble minded or anti-social, but then you get stuck in the old folks section for dinner and realize she’s actually quite quick-witted and entertaining when she can hear what people are saying and take part in the conversation. She is also full of fascinating stories. She’s about half way through a tale of hitchhiking across Europe in her thirties and spending time in a hippie commune when, oops! Her ride is leaving and she has to go.

You’ll have to hear the end of the story at Christmas.

This little vignette isn’t just about Aunt Olive though. Your relatives in their 40s, 50s, 60s, and 70s May also be experiencing some degree of hearing loss. You might even find yourself having difficulty catching all of the conversation in these loud, crowded communication environments.

I recently had a lengthy conversation with my father about how difficult it is for people with hearing difficulties to take part in large family gatherings. Interestingly, while my daughter was visiting from college she asked ME if my hearing was getting worse. This has given me the opportunity to look at the issue from both sides (listener and speaker) and to explore what can be done about these communication mishaps. It's prime time to talk about hearing loss because this issue will continue to grow as baby boomers age. At times we've all experienced communication breakdowns, but it's not always clear to us what we can do to repair them.

There are several small practices each party in the verbal exchange can employ to make communication smoother. This week I will discuss tips for the speaker and next week I will talk about tips for the listener. Note - I'm not an audiologist. These are my personal observations. If you have concerns about your hearing, contact an AN ASHA CERTIFIED AUDIOLOGIST.







Let's explore each of these in more detail:


When speaking to anyone, first be sure to get their attention. "Hey, Bob!" When you have their attention, establish eye contact. Then say what is on your mind. This is valuable not only for people who are hard of hearing but also for children who  may have attention deficits or even for creative people who tend to daydream and may not realize you are even speaking to them until you are half way through your message.


When someone says they didn't hear you, it may be tempting to raise your voice which might not be that helpful, especially if you end up shouting at them. Instead, increase your volume a little and focus on clearly enunciating the ends of words. These sounds often get so minimized during connected speech that they may be dropped completely. It's easy to observe this if you listen to someone speaking a foreign language. The words seem to run together and it is difficult to determine where one word ends and another one begins. This makes it difficult to distinguish the word boundaries. This is also why children often misunderstand spoken phrases in humorous ways.  Here are a few Christmas classics which I found at ABC News and Most Misheard Holiday Music Lyrics:

"Deck the halls with bras of holly."
"With a corncob pipe and a butt and a nose."
"Bells on cocktail rings."
"Olive the other reindeer."

Just be careful not to OVER enunciate which may have the effect of making your hard of hearing relatives feel like you are talking down to them.


People who have hearing difficulties often consciously or unconsciously rely on visual information to help them interpret a message. Facial expression can help us understand the emotional content of a message and lip reading gives important information about sounds. Some sounds are more visual than others. Those made at the front of the mouth /m, p, b, v, f, w, th/ are easier to see than those made near the back /r, k, g/. This small amount of visual information can make the difference in understanding whether Uncle Joe had a "fifth" or had a "fit," and whether Grandma is planning to serve "ham," "spam," or "lamb." My husband has tinnitus, a constant ringing in the ears. An audiologist told him that hearing aids would not help at this point, but that he should advise me that, “If you can’t see me, I can’t hear you.” (UPDATE: THE AMERICAN TINNITUS ASSOCIATION REPORTS THAT HEARING AIDS DO HELP RELIEVE TINNITUS FOR SOME PEOPLE. SEE THEIR POST).With my husband's gentle reminders I have been surprised by how often I try to start conversations in another room, or how I start a conversation and then walk out of the room, or how I try to multi task by talking to my husband while my back is turned to him and the water is running because I'm washing dishes. I'm not saving time if I have to repeat myself.



If someone has asked you to repeat yourself once or twice and you have tried the above tactics and it hasn't helped. Try to rephrase your message. Instead of continuing to repeat, "How ya doin'?" twenty times, louder and louder, think about how to restate the same question. "I heard you had heart surgery. Are you feeling better?" By rephrasing the question you are using different words and therefore different sounds, some of which may be easier to understand than others. Some sounds are quieter because they are unvoiced while others are louder simply because they are voiced. Say the following sound pairs and listen to the difference (/s,z/ /f,v/). Sounds that continue also offer more auditory information than sounds that stop. Listen to the difference between sounds like /z/ that can be held out and sounds like /b/ that stop more abruptly. Also, sounds have different pitches. The /s/ sound has a higher pitch than the /g/ sound. If a person has a high frequency hearing loss, they may not hear sounds that naturally have a higher pitch. See the Speech Banana Chart to get a better idea of what this looks like. Also, rephrasing a comment might make it longer which may give additional clues about the context of the message.


If a joke is worth telling, it's worth telling well. Have you ever missed the end of a joke and turned to a friend who was laughing his head off to ask, "What's so funny?" only to have him say, "I have no idea." Just because a room full of people laugh at your funny stories doesn't mean they all got the punch line. Slow down for the punch line, make sure you have everyone's undivided attention, then nail the ending. There is nothing worse than being asked to repeat the end of your joke. The timing is all wrong at that point. On the other hand, it's also uncomfortable to feel that everyone got the joke but you. My father pointed out to me that people have a tendency to rush through the end of a joke and actually lower their voice so they can barely be heard, but a professional comedian would never do this. They know how to build anticipation in their audience, so be a pro, don't kill your own joke.

As a speech-language pathologist working in the public schools, I specialize in communication difficulties, but that doesn't mean I intuitively know how to consistently practice good communication at home. I took courses in audiology for my master’s degree, so as I was contemplating this article, I looked up resources on the American Speech-Language and Hearing Association (ASHA) website. ASHA offers a poster that provides tips for communicating with people who are hard-of-hearing. The poster makes four broad suggestions with more specific actions outlined in each category.

1) Get and keep the person's attention.
2) Help yourself be heard.
3) Say it another way.
4) Make sure you were understood.

See TIPS FROM ASHA for additional examples under each category.

Finally, let's look at some signs that your family members are not understanding you:

- They frequently ask you to repeat yourself or to "speak up."
- They may complain that you mumble, though your friends seem to hear you just fine, thank you very much.
- They complain about loud restaurants or opt to stay in while “you kids go out.”
- They nod and smile and laugh, but their eyes tell you they have no idea what planet you are on.

Okay, that is a lot of advice for the speaker, but what about the listener, the person who is hard of hearing? What can they do to educate their family members about their difficulties and ease the communication exchange for everyone? First off, share this post along with the suggestions at the ASHA website. It can be a great way to open up the conversation about your hearing difficulties.

I will talk about more specific tips for the hard-of-hearing in next week's post. In the meantime, practice the communication suggestions outlined above. They are good ways of communicating with anyone, not just the hearing challenged. Also, focus on going out of your way to spend a few quiet moments talking with people who have communication challenges. That way when you see Aunt Olive at Christmas, you'll be ready to hear the rest of her story.

Do you have other tips for better communication? If so, please leave your comments below.


  1. This is excellent material, which I can attest to as a genuinely hard-of-hearing person who's just come off a huge family Thanksgiving weekend. Oy! The only thing I would add for the speaker is ... please try to be patient, although I understand that it's annoying to deal with someone who isn't all together tuned in. And please don't ask with that edge in your voice, DO YOU HAVE YOUR HEARING AIDS IN??? This question sounds/feels more of an accusation than a genuine query. I look forward to reading the tips for the listening next week.

  2. Patience is very important. Thanks for you comments.


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