During the COVID-19 pandemic, wearing a face mask or other cloth face covering has become a requirement in our clinic for both our staff and our patients. Based on current evidence and recommendations from the Centers for Disease Control, it’s the best way to reduce the transmission of this virus.

But, wearing a face mask for someone who has hearing loss can be a communication challenge in a couple of ways. Probably the most obvious is that the mask covers the mouth, making it difficult for the individual with hearing loss to receive visual cues from the wearer.

These speech reading cues, like lip movements, provide someone with hearing loss with important information when trying to interpret what the other person is saying. In fact, research has shown that those with hearing loss have significant improvement in accuracy of interpreting the spoken word when visual cues are present. Visual cues also may improve hearing in noise.

Face masks also can reduce or muffle the sound from the wearer. Researchers found that a simple face mask can reduce volume from 3 to 4 dB, and an N95 mask can decrease the high frequencies by 12 decibels. A surgical mask also can reduce sound by 12 dB. As a frame of reference, a whisper registers about 20 dB.

No wonder wearing masks can present substantial communication challenges for many individuals, including hearing aid wearers and persons with hearing loss. Mask usage reduces the intensity of the talker’s speech. Someone with normal hearing could easily experience about a 30% decrease in audibility when wearing a properly fitted N95 mask. Add background noise and the lack of visual cues, and it becomes obvious that masking can present some unique challenges for those with hearing loss.

Further confounding the problem is that most conversation takes place at about a 3-foot distance.  Social distancing recommendations advise keeping at least 6 feet from others. Though this is a necessary mandate to help reduce the spread of the virus, doubling the distance in which normal conversations take place reduces the speech signal received by the listener even more.

The result is individuals with hearing loss may have more problems than usual understanding conversations with friends and family, but even more important, this may be an important issue to recognize when visiting health care providers or others who are trying to discuss important issues, such as an attorney or financial advisor.

How can we accommodate for the combination of masking and social distancing as the “new normal” in our daily routines, and yet hear the important information others are trying to convey? Here are a few important tips:

• Stand 6 feet apart, but face the other individual when talking.
• Consider wearing an approved clear face shield to maximize lip/facial cues. There are clear face masks now available on the market, and these can be very helpful.
• Speak slowly and clearly.
• Rephrase rather than just repeat what was not heard.
• Minimize environmental noises like the air conditioner, fans, etc. These sounds can drown out or muffle speech.
• Be prepared to write answers down to the questions the listener has. This helps minimize communication errors.
• If you wear hearing aids, ask your audiologist about programming them for a “mask” situation. This can help address the “muffled” effect the mask has on speech, and may help make it easier to hear.  If you have adjustments, such as on new advanced hearing aids, you can provide temporary increases or increase the treble slightly to accommodate for the mask effect.

In addition to adjusting your hearing devices for a mask situation, consider talking with an audiologist about a spouse mic/remote mic that streams the conversation partner’s voice directly to the wearer’s hearing aids.

The conversation partner simply clips a discreet remote mic onto their clothing, or places it on a table. The individual with hearing loss may or may not need to wear a wireless Bluetooth accessory around their neck, depending upon their hearing aid model. The mic has a 20 to 30-foot range and the mic and receiver work best when they are within sight of one another. In some cases, this device also can be used to stream calls and music. It is especially helpful in one-on-one conversations in difficult listening environments, like when wearing masks.

If you are struggling with communicating with others when wearing a mask or are stressed by hearing loss, schedule an appointment with one of our doctoral-level audiologists.