This blog for #DeafAwarenessWeek considers the new obstacles to communication thrown up by the pandemic and tips for improving face-to-face communication with deaf people.

Blog updated 08 May 2021

This week is #DeafAwarenessWeek and its theme this year is ‘Coming Through it Together’, the unnamed ‘it’ being the pandemic. It doesn’t take much to work out that’s what ‘it’ is but my first thought (well, second; the first was that surely a pandemic warrants a capital letter!) was that there’s no coming through deafness and hearing loss. More like Getting On With It. But, of course, our getting on with it is hugely impacted by external factors and other people’s understanding and behaviour. Two things about that: awareness-raising seems terribly important and masks are a communication nightmare.

Mishearing, or plain not hearing, has always had heaps of potential for making the deaf person appear rude or stupid, but this has gone to a whole new level with the arrival of mask-wearing (and, indeed, social distancing). Every encounter is newly hazardous. I stepped onto a bus recently, quite unaware that I’d been asked to wait until someone had got off, embarrassing my daughter Liv and prompting me to send off for a sunflower lanyard, which signals that the wearer has a hidden disability. (Mind you, of the pair of us, it wasn’t me who on our recent train journey pressed the button to open the loo door and inadvertently revealed to the entire carriage a man in a rather compromising position…).

Over-the-counter conversations

As someone who relies on lip-reading, masks have rendered me largely incapable of managing a conversation with someone wearing one. If I have to go into a shop, I rely on the person at the till asking me only three things: do I have a loyalty card? would I like a bag? and do I want the receipt? The order of asking these can trip me up though. Which reminds me that Liv once, during her time doing a Saturday job at Boots, absent-mindedly called forward the next person in the queue with a loud “DO YOU WANT A BAG?”, wrong-footing the poor customer.

If the person talking to me ventures beyond those three questions, I am really stuck. It’s only at that point that I say I’m deaf and need to lip read, as I begin these transactions hoping to wing it. Disruptions to communication cause embarrassment, don’t they? Of course, there’s plenty of scope for awkward misunderstandings (Them: “My aunt just died.” Me: “How lovely!”) but the social dance of conversation is so easily wrecked for both when one of you can’t hear, even without such faux pas. The linguistic equivalent of taking to the floor with a new partner and immediately stepping on their feet. Which brings me on to speech-to-text apps. Might they be an answer?

Speech-to-text apps or sex in the library

Not an obvious choice, you’re thinking. My deafness often produces such odd mishearings that it threatens to distort my perceptions of the world. This is my excuse for my otherwise baffling response to the hapless young man preparing my drink in Costa, when his straightforward enquiry “would you like cream on the top” triggered a departure of all my senses as I replied (after a pause) “where else could I have it?”.

But speech-to-text apps seem to be as confused as me. In theory, they are a great solution. Download on the phone, or open online, tap the microphone icon and they turn speech into a live transcript. The trouble is, so much of it is complete nonsense. I use one for a weekly online work meeting, but keeping a straight face is sometimes more than I can manage. Take last week’s meeting.  I don’t think the professor actually mentioned sex in the library or confessed that “my last experience of bliss was, fortunately, some time ago”, but there it was, along with some sensible commentary on the health evidence we were discussing. I have occasionally had to turn my camera off while I recover my composure.

I tried using a speech-to-text app in a retail setting for the first time last week. What should be a simple matter, changing my phone contract, is complicated when I’m too deaf to phone customer services and can’t conduct a face-to-face conversation in the shop due to the mask problem. In this way, the pandemic has increased my dependence on others. I went into the phone shop with Liv, knowing I would mostly have to leave her to manage it all, but I suddenly remembered the speech-to-text app. This would surely help me follow the conversation. What I hadn’t anticipated was that it would pick up snatches of speech from conversations the other staff member was having with people at the door and lyrics from the piped music (which admittedly was quiet enough that I hadn’t noticed it). This made for an extremely odd transcript indeed and during a lull in which the person helping us had gone to get something I saw Liv glance down at it, just as the app was rabbiting on about pants, spiders and fifteen freaking pounds, at which point we had to switch it off and work hard to control our mirth.

Deaf life is often funny, but so much of the time I haven’t a clue what’s going on! I enjoy the absurd and sometimes play the fool. I wonder how much losing my hearing has to do with this?

Clinical encounters

Something I hadn’t anticipated at all was that the requirement for masks would prevent me from donating blood. I booked an appointment at a donation session last year and told them on arrival that we’d need to support our communication with writing things down, gesture and perhaps the speech-to-text app on my phone. Well I’m sorry to say that I was very rapidly shown the door – they couldn’t take my blood if I was unable to hear what they were saying. Whilst I understand that donor safety is rightly a priority, this left me frustrated and cross that they wouldn’t make these adjustments and that they were missing out on a donation. I was told later that clear masks were on order. I really must try again…

I have attended ENT outpatient appointments in the past year, where the staff have switched to clear masks on request, and at vaccination appointments we have managed with writing things down, gestures and the vaccinator removing their mask. It must be very hard to be a deaf inpatient under current circumstances and I want to just flag here the existence of CardMedic, a website and app that provides digital flashcards designed to improve communication between healthcare staff and patients. Such a great idea and produced at speed during the pandemic in response to the communication problems created, or exacerbated, by the need for healthcare staff to wear masks.

Healthcare staff please note that, masks aside, the confidential tone is a nightmare for the deaf, and that asking someone ‘how can I help you hear?’ can be empowering and practical. I’ve written more about that here.

I have just discovered this comprehensive Deafness and Hearing Loss Toolkit from the Royal College of GPs in collaboration with the RNID and led by Dr Devina Maru, RCGP Clinical Champion for Deafness and hearing loss. It’s really worth delving into and has lots of useful information and resources for those of us with hearing loss, as well as GPs and other healthcare professionals.

What can you do to improve face-to-face communication with a deaf person?

  • Use a clear mask if you can
  • Consider offering to remove your mask if you’re both comfortable with that and circumstances allow
  • Enable the use of communication aids such as writing and apps
  • Offering written information and/or diagrams can be really helpful
  • Be aware of lighting – it’s hard to lip-read someone who has a light source behind them; the light needs to fall on your face
  • Only speak when your mouth is clearly visible
  • Don’t shout but do speak clearly and perhaps a bit more slowly than you might otherwise
  • If you’re asked to repeat something, especially more than once, consider rephrasing what you just said
  • Providing some context can help – conversations often start in random places but this can make it harder. Deaf people are constantly piecing together clues!
  • It can be helpful to check understanding
  • You could ask ‘how can I help you hear?’
  • If there is recorded music playing, you could offer to turn it down/off
  • If it’s an option, move the conversation to a quieter place
  • Allow more time for the conversation

What other tips would you add to this list? Do tell me in the comments. I’d also be very interested to hear if anyone has experience of using CardMedic, as healthcare staff or patient, and how they’ve navigated being a deaf patient. There are more tips here and news of some research that’s going on at the moment that you might be interested in 

Photo by Tonik on Unsplash