Talking to the Hard-of-Hearing


Edited and Updated Mar 25/2011
Meyer Moldeven
This blog has no commercial intent or implications whatsoever. It is for your information only.

PREFACE:  At least 1 in 6 Americans currently has a sensory or
communication impairment or disorder. Even when they are temporary or
mild, such disorders can affect physical and mental health. An
impaired ability to communicate with others or maintain good balance
can lead many people to:

Feel socially isolated.
       •       Have unmet health needs.
       •       Have limited success in school or on the job.
An impaired sense of smell or taste can lead to poor nutrition or the
inability to detect smoke, gas leaks, or foods that are unsafe to eat.



National Forum on Disability Issues ...
Data Source:
Diabetes ...


OBJECTIVE:  Healthy People 2020: Reduce the prevalence and severity of disorders of hearing and balance; smell and taste; and voice, speech,
and language. More at:: 'Hearing and Other Sensory or Communication


These tips are based on suggestions from a public school teacher expert in talking to and otherwise reaching out to and interacting with the hard-of-hearing. The feedback to my previous postings -same subject - described experiences and provided tips and leads from
clinicians and other healthcare professionals in audiology, dentistry, geriatrics and gerontology, and many relevant vignettes from family caregivers and members generally, and the hearing-disabled themselves.

Please consider passing these suggestions along to the HOH at seniors centers, retirement and caregiving communities, teachers at all levels, hospitals and other health care providers, supermarkets and other business entities, and to those in the private, institutional,
commercial, and government sectors where staff and others communicate orally and interact with the HoH and their families. There are presently more than 22,000,000 HOH individuals in the United States alone. You can help them in the following ways:

 1. Whenever possible, face the HoH person directly, and on the same level.

2. Your speech will be more easily understood when you are not eating,
chewing, smoking, etc.

3. Reduce background noises when carrying on conversations -- turn off
the radio or TV.

4. Keep your hands away from your face while talking.

5. If it's difficult for a person to understand, find another way to
say the same thing, rather than repeating the original words again and
again; also try moving to a quieter location.

6. Recognize that hard of hearing people hear and understand less well
when they are tired or ill.

7. Never talk from another room. Get the attention of the person to
whom you will speak before you start talking.

8. Speak in a normal fashion without shouting. Check that a light beam
is not directed into the eyes of the hard-of-hearing person, making it
difficult for the HoH person to see you as you speak.

9. A woman's voice is often harder to hear than a man's, because of the
pitch. Make a conscious effort to lower the pitch of your voice if you
are a female.

10. Speak slowly and clearly.

11. If the person wears a hearing aid, make sure it has batteries, the
batteries work, the hearing aid is switched "ON" and that the hearing
aid is clean and free of ear wax.

12. If you know (or if it becomes evident) from which side the person
hears best, talk to that side.

13. It's better to speak face-to-face: Face-to-face communication in
situations where relatively diffuse lighting is adequate and also
lights the speaker's face. This allows the hearing-impaired listener
to see the speaker's facial expressions as well as lip movements.
Being able to do so helps the HoH understand what is being said.

14. Individuals with hearing impairment can also benefit from seating
themselves at a table where they can best see all parties (e.g., the
end of a rectangular table). Asking people to let you know beforehand
when they are going to change the subject of conversation can also be
helpful, as it can often prevent an unfortunate "faux pas."

15. Sometimes a person who is HoH has a "good" or "better" side --
right or left -- ask them if they do. If they indicate a preference,
direct your remarks to the "good" side or face-to-face, as they wish.

16. If a light is directed toward the eyes of the HoH person to whom
you are speaking (or if it puts your features in deep shadow) change
the position of the HoH person or the light so that you are not
standing in front of it. Also, light from a window may put your head
and/or face in silhouette and makes it hard for the HoH to

17. Avoid abrupt changes of subject or interjecting small talk into your
conversation, as your HoH listener will likely use context to a
considerable degree in trying to comprehend what you are saying.

18. If the HOH person wears an aid, try slightly raising the pitch of
your voice. If the HoH is not using an aid, try LOWERING the pitch of
your voice. Keep trying until the HOH person gets it.

19. If all else fails, rephrase or try to communicate through a
relative whose voice might be more familiar to the HOH person.

20.. Pronounce words clearly. If the HoH person has difficulty with
letters and numbers then say: M as in Mary, 2 as in twins, B as in
Boy, and each number separately: "five six" instead of fifty-six; keep
in mind that m, n and 2, 3, 56, 66 and b,c,d,e,t and v sound alike.

21. Keep a note pad handy and write your words and show them to 
the HOH person if you need to -- just don't walk away leaving the
hearing-impaired person puzzling over what you said and thinking you
don't care.

(Following are the texts of several emails I received after posting
the above tips online.  M.)

22. I have very good hearing but work with a person who not only
mumbles but walks away at the same time he is talking to you. I think
he is so preoccupied with what he is thinking about that he thinks
 everyone will follow him as he goes to whatever he intends doing next.

23. I know exactly what you mean! I've had that problem all my life. I
never considered myself "handicapped" or "disabled" but other people
sure made it hard for me to fit in. I, too, avoided joining clubs and
going to meetings because of the HoH difficulty. That is the problem
with deafness, it is so isolating. As Helen Keller once said, "Being
blind takes away things, but being deaf takes away people."

24. I do agree that other people often just don't think about the HOH
as listeners. I have a so-called friend who, when I once told her that
her extra low voice is hard on me, rolled her eyes to heaven and
sighed. I almost told her to go to hell. That's not friendship, in my
opinion. I once asked a speaker to raise his voice a little. He looked
at me with disdain and said for me just to move up to the first row.
His voice almost got lower after that.

25. I have one relatively dead ear (left) and one relatively good ear --
have a fairly adequate hearing aid in right ear, nothing in left ear
(because no use) -- I have discovered that I lip-read a lot -- which
means that if you talk to a HOH person, face them. If you are around
the corner, or you turn away, you become much harder to understand.
Also, do not hesitate to let people know hearing is a problem. I have
a friend who is too proud to say, "please repeat" or "I missed your
last remark," etc. There are a few controlling, slightly sadistic
folks who won't speak up regardless of whether you ask them to. Not
much you can do about them. On the telephone I often have to ask
people to talk a bit more slowly and usually get prompt and
satisfactory results.

26.  In all fairness, I don't believe people are sadistic; they just
do not relate to hearing problems. They often feel "put upon" if they
are expected to accommodate to our handicap. I have an ‘ear’ doctor who
turns and walks away from me even when he is giving me instructions. I've
asked him repeatedly to face me as he speaks, but he forgets. In small
meetings, I may ask a speaker to "speak up" and they do - for a few
seconds - and then fall back into their normal tones. Some, I hear
perfectly well and others, not at all. Hearing aids are not for
everyone, I have learned to my dismay. For me, they make speech
louder, but not clearer.

27. My mother, in her 80's is extremely hard of hearing. We've all
gotten used to it, but occasionally it creates peculiar situations
when she answers a question different from the one you asked because
she only gets 3 or 4 words in the sentence and guesses at whatever
else was said. For a while, my father thought she was in early stages
of Alzheimer's because she gave these screwy responses. Believe me, we
were all happy to find out that her non sequiturs were the result of
hearing loss. So maybe you should remind people that the hearing
impaired may appear senile because they are only getting part of what
is said and responding as best they can without realizing that their
response may be inappropriate. I love it when my kids come back from
visiting my parents. They plant themselves directly in front of me and
speak distinctly and slowly and they never call to me from another
room. Unfortunately the effect wears off after half a day.

28. As someone who was born with only 50% hearing, I know the
suggestions you've posted will be most helpful to everyone with a
hearing loss. The "keep hands away from mouth" part really helps if
the HoH  person is a lip-reader. I found dangling cigarettes,
gum-chewing, and mumbling are the hardest to "read." I hope with education, people will begin to be less rude to the hearing-impaired. I had a
supervisor once who would turn her back on me because she didn't like
me "looking at her" when she talked. She also wore braces and it was
extremely difficult to understand her. Unfortunately, some people
still equate "deaf" with "dumb." The HOH may have difficulty
communicating but that doesn't mean there's anything wrong with their
ability to think. Don't leave them thinking you lack manners and education.

29. My niece lost her hearing at the age of 10. They never determined
why it happened. The toughest thing for me was to tell her that I
didn't understand what she was saying ... so I stopped. Then one day
my brother asked if I was upset with her. Of course I said "no". Then
he told me that it hurt her when I didn't ask her to repeat herself
until I understood. We began to talk and when we had difficulty with
each other, I would reach for a pencil and pad. It became a game! We
would spend more time working to understand because to write it down
meant we hadn't yet succeeded to complete the bridge between us.
Today, we still have to ask each other to repeat, but never have to
reach for a pencil. She is the mother of two older teenagers, is
employed at the university library and is an avid cyclist ... far from
being "dumb."                     

30.  Dealing with a person who is in the advanced stages of
Alzheimers, where eyesight may begin to play tricks and the victim is
unable to he anything at all. In my experience, I have found that it
is best to not make any sudden moves with hands or objects that might
be perceived as threatening by someone with advanced AD. Try to get
close slowly, perhaps even on your hands and knees, if necessary (if
the AD person is sitting) so that he or she can see you smile, wink,
make funny faces, and just see you as a "friend." If he/she can't see
or hear you, use his/her remaining senses Make them aware that they
are loved, and that you are not someone who wants to make them do
something they do not want to do.

31.  From a parent who has a young son who is HoH: Technically, it
is an asymmetrical loss, a thing I learned on a listserv this spring.
This means loss in both ears, but one different from the other. The
audiologist has always called it unilateral loss, thus minimizing the
impact of the loss in his "good" ear, the left ear. We always sit to
his left when we hold him, read to him or do anything with him. When
we had access to his ALD (assistive listening device) at home, it
didn't matter which side we sat on.

However, he just can't understand what we say if we're on his right.
I'm so used to being careful about sitting on his left that when I sit
next to anyone I'm already checking which side of them I'm sitting on.
When I call to him I always tell him the room that I'm in, not just
say, "I'm here!" In school, we wanted a C-shaped arrangement with him
sitting so that he could lip-read the kids. They, instead, grouped the
tables into four and placed them throughout the room.

The teacher is supposed to use a conference mic but I'm starting to
suspect she doesn't. (He) does say he can hear the children.... but
hearing and truly understanding are often different. He hears but
doesn't always understand. He does automatically turn his good ear to
people now and says "What..." Very typical of the image you have of a
deaf old codger ... except he's a little guy. It's good though because
finally he's advocating for himself and starting to let the world know
he doesn't understand. With all of his "whats" it's a lot harder for
the world to miss his hearing issues.