Communicating With Residents Suffering From Hearing Loss

Caring for elderly residents is a rewarding career path, but it comes with many challenges. One common source of confusion and frustration can happen when trying to speak with residents that are hard of hearing. It’s important to be patient and flexible in these situations and to understand the specifics of their condition and treatment. That way you can customize your communication style based on their needs and limitations and, as always, address concerns with the attending physician or specialist before making changes to a resident’s individual health care plan.

Causes of Hearing Loss

One of the most common forms of hearing degradation in the elderly is a condition known as presbycusis. This just refers to the age-related loss of hearing that gradually occurs as people get older. It is unknown why presbycusis affects some individuals more than others, but research suggests a genetic component.

Noise-induced hearing loss is the condition where hearing worsens from repeated exposure to excessively loud noises. People who work in jobs with constant loud noises tend to suffer from hearing problems much earlier than is normal. Those jobs include construction workers, farmers, musicians, airport workers, yard and tree care workers, and individuals in the armed forces.

Viral or bacterial infections, heart conditions, head injuries, tumors, and certain medicines can sometimes lead to hearing loss. The severity, treatment, and type of hearing loss that someone suffers from are different with each case. There are some types of hearing loss that affects a particular range of sounds which might make it harder for an individual to hear rings or whistles, but doesn’t affect how they hear human speech.

Electronic Aides

Hearing aids are probably the most popular treatment for hearing loss. However, there are quite a few misconceptions about the devices that should be clarified. Hearing aids intake sound through a microphone, amplifies the noise, and plays it through a speaker in the wearer’s ear. Hearing aids don’t increase all sounds equally and often need to be adjusted by an audiologist based on feedback from the individual.

Unlike a hearing aid, a cochlear implant is a small device surgically implanted in the inner ear. This treatment method is for individuals with a severe hearing disability. These devices are similar in their effectiveness and limitations as hearing aids, and the same guidance can be applied when working with residents that have them.

When considering a resident for a cochlear implant, the positive and negative consequences should be heavily weighed before moving forward. Surgical procedures can have greater effects on the elderly individual. Changes in the body’s metabolism can prolong the effects of anaesthesia, magnify potential reactions to pain medications during the healing process, and potentially increase recovery time from the general stress of the surgery on the body.

Even so, sounds can get muddled and garbled together through either device, similar to having a call on speaker phone. Be aware that some residents with electronic device assistance still struggle with normal conversation volume, while others could have the sensitivity turned up and be annoyed by shouting. If you’re unsure, be direct with the resident and confirm they’re comfortable with the manner you speak.

Customized Solutions

If your residents continue to struggle with everyday tasks, there are assistive listening devices that can help. Some apps and devices exist for telephones, cell phones, tablets, TVs and other electronic devices to increase the volume beyond what the standard functions would allow. Headphones may be an option, too, to direct the sound to their ears and also cause less of a disturbance with other residents.

Places of worship, theaters, and cinemas often offer wirelessly transmitting audio devices that provide a clearer sound to those in need. Another increasingly popular device is an induction coil loop which allows for the event to be broadcast directly to the viewers hearing aid or cochlear implant. If you are planning outings or events on the premises for your residents, consider coordinating in advance to ensure these devices will be made available.

Sign Language and Lip Reading

If one of your residents is dependent on sign language for communication, it’s recommended you learn a few key phrases. This gesture will go a long way in alleviating stress from your resident’s life and will take a lot of frustration out of the day to day interactions. There are many online resources available for teaching the basics.

Individuals with hearing impairments often learn to read lips to understand conversations better. With practice, it’s possible to gauge a great deal based on lip movement and body language. When used in conjunction with hearing devices or sign language it can make communication much more seamless. Be aware whether or not a resident uses this technique; further, be aware of your own body language and the tone/attitude you are conveying. You can go a long way towards assisting them by ensuring you face them, have a relaxed or open body posture (indicating a welcoming or neutral attitude) and enunciating your words.

Residents With Reduced Cognitive Abilities

Hearing loss is just one barrier to communicating with your residents. Combine this with reduced cognitive function due to dementia or other health issues, and the challenge is compounded significantly.

Still, dealing with a resident affected by dementia and hearing loss can be similar to dealing with a resident possessing no cognitive impairment.  Approach them gently and use their name to address them verbally. If they don’t hear you, gently place your hand on their shoulder or arm to get their attention. Make sure they are looking directly at your face when communicating. Speak in simple sentences, again, enunciating clearly and at a voice level above normal, but not shouting. Simple gestures can also help convey a message, e.g., making motions that mimic eating then pointing at them, as if to ask, “Do you want food? Are you hungry?”

In fact, research suggests that hearing loss is a contributing factor to dementia and Alzheimer’s. The earlier an individual receives treatment for hearing loss, the more they reduce their risk of developing dementia later in life.

The Ultimate Goal

If you need to communicate to a group of residents at once, make sure you’re aware of their limitations and take the time to address those who struggle the most, individually and in a respectful manner. Often those with hearing troubles will feel embarrassment or shame and not ask for clarification. They may feel as if they’re drawing attention to themselves or feel like a nuisance. Go out of your way to make sure everyone is treated well based on their needs.

The bottom line is to ensure you’re direct and open with residents about their hearing requirements. Treat them with respect and practice patience when misunderstandings happen. Ask them about their communication preferences. They will more than likely appreciate your honest interest in their well-being.

Assisted Living Education’s Promise

At Assisted Living Education, our number one priority is providing the highest quality education and educational resources for those who care for our senior population. We offer RCFE courses & certification, as well as online courses and continuing education. We believe that experience is critical to success, which is why we only employ instructors with extensive experience in the industry and have a reputation for creating engaging and real-world learning environments. Explore our website, or visit our contact page to learn more!


About Assisted Living Education
Assisted Living Education has been operating in and improving the growing senior care industry for over 15 years. Founded by certified RCFE administrators, Jane Van Dyke-Perez and Bill Perez, we have licensed more than 1,100 assisted living facilities and built close relationships with the California Department of Social Services, assisted living managers, owners and industry professionals. As senior living care educators ourselves, we strive to contribute our knowledge and skills to continually improve senior care and the satisfaction of those working in the industry.