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Clear speech, patience can help people with hearing loss

The importance of hearing and communication is made obvious each and every day. Communication is saying hello to a long-lost friend. It's a mother praising a child for a job well done. It's a senior citizen volunteering as a museum docent and answering visitors' questions.

But communication is a two-way street. Without hearing, it becomes significantly more difficult, and if hearing loss goes undetected and unaddressed, communication may cease.

Hearing loss is one of the most common disabling chronic conditions, affecting at least one out of three older adults. It usually comes on gradually, and many are unaware of it until the loss is severe. Hearing loss affects not only the person with the hearing difficulties, but also families, friends and acquaintances.

Mark Ross, an audiologist who is hearing impaired, often makes the point that when someone has a hearing loss, the whole family has a hearing problem.

The National Council on Aging recently reported significantly higher rates of depression, anxiety and anger in older adults who do not wear hearing aids. Several studies have linked hearing loss with depression and dementia.

Hearing loss is most pronounced for higher-pitched sounds. The "th," "s" and "sh" sounds, for instance, will be much harder to understand than lower-pitched sounds such as "m," "g" and "n." That's partly why older adults may "hear" a word but not understand it.

For example, the word "leash" may sound like "leak." As an audiologist, I have heard the following statement countless times: "I can hear people talking, but I can't make out the words." Many seniors report that they can hear speech quite well, they just can't understand it.

Can hearing aids help? Yes. There have been phenomenal advances in hearing-aid technology, resulting in improved speech discrimination abilities. What else can help? Lipreading can be a huge help, although it's no substitute for hearing. My own research has shown that while some people are easy to lipread, others are nearly impossible.

One of the best ways to improve communication with older adults is to use clear speech techniques; that is, speech that is spoken carefully, but not exaggerated. It's speaking a bit slower and louder than normal, not monotone, and most important, full of distinct, meaningful pauses. Research we have conducted at the University of Florida shows that just about anyone can learn to produce clear speech with a little effort and practice.

Recent research has also shown that pauses are even more important than careful production of individual sounds. In fact, the conversation partners of individuals who are hard of hearing should make every effort not to talk too loudly and not to exaggerate their mouth movements. It is likely that the pauses give the hard-of-hearing person time to process what the speaker is saying.

If you have a loved one with a hearing loss, here are some tips for making communication better:

Use communication strategies, such as repeating once when necessary, then rephrasing.

Use clear speech, particularly pauses between phrases.

Consider sources of communication difficulties, such as poor lighting or noisy conditions and make modifications.

Be patient.

The ability to communicate empowers older adults to maintain their integrity and well-being. A few adaptations when communicating with older adults can make a world of difference.

_ Patricia B. Kricos, Ph.D., of the University of Florida is associate director of the Institute on Aging, interim director of the Center for Gerontological Studies and director of the Joint Audiology Program.