Silence

by Bob Buddemeier

I am deaf.  Not Helen-Keller-hear-no-sounds deaf, but impaired enough for my deafness to be a life-changing handicap.  That’s life-changing (and not for the better) both as I experience it and as a statistical prognosis – according to the wellness and aging pundits, people with hearing or visual impairments are more likely to develop dementia. The usual explanation for that observation is lack of mental – including social – stimulation.

A year or two ago, my hearing loss changed rather decisively.  To explain, a few words about the basics of hearing: the basic audiology test has two components.  One is volume sensitivity as a function of frequency (pitch); the other is word recognition.  If you can’t hear the sounds of a word you won’t recognize it, but some hearing disorders result in failure to recognize even when volume is (or should be) adequate.

As an example, the joke about the three geezers sitting on a park bench —

Geezer #1:  It’s windy today, isn’t it?

Geezer #2:  No, today’s Thursday.

Geezer #3:  I’m thirsty too, let’s go get a drink.

At least two of the geezers have word recognition problems

My hearing recognition has dropped severely in the last 1-2 years; my volume sensitivity is reduced, but not to a corresponding degree. This has created social isolation. I have recognized that I need to get out and associate with people more, but hearing problems both create the need and interfere with meeting it.

What factors, in general and at RVM, contribute to hearing-induced isolation?  A lot depends on the people one is trying to communicate with. Someone who enunciates carefully, and speaks with high enough volume and slow enough speed, can be understood even by those with substantial hearing impairment – if the setting is appropriate.  Those speaker characteristics are all too rare, and appropriate settings too uncommon. Background noise, especially in a setting that is acoustically “bright” (lots of reflective surfaces) can swamp out the meaning of even clear statements. Parties, full dining rooms, events with audible music, and multiple concurrent conversations are all situations that make anything but the most basic communication impossible.  Ironically, the defining problem of many kinds of deafness is not silence, but noise.

An example of my experience – I participate in a discussion group and a book club, both of which meet in a Manor floor lounge and usually number 6-10 attendees. With a group of this size, it is hard to understand much of what is being said. I can track the general flow of discussion by interpolating and extrapolating from what I hear, but not well enough to engage in point-by-point discussion.  A specific example is missing humorous remarks, since the punchline is usually effective because it deviates from expectation.  I am seldom tracking well enough to get both the lead-up and the conclusion. I wonder how many other people living at RVM have similar experiences.

Are there any solutions?  For the most part, the onus is on me to enlist people whom I want to associate with and who are willing to associate with me individually or in very small groups and in quiet places.  I am not very good at taking this kind of social initiative. Perhaps seeking out other deaf people would be a logical starting point – judging by the number of visible hearing aids adorning residents, there should be a fairly wide field to choose from.

Is there something that can be done for the hearing-impaired on an institutional basis?  We take mobility limitations as standard, we have a low-vision center, but what about hearing?  One workable possibility is switching as many meetings as possible from in-person to Zoom, or some other video format.  Zoom is less subject to environmental noise and sidebar conversations, and offers everybody a face to face view of the speaker(s).  It can also be recorded for subsequent review, if needed. This combination of features makes it more user-friendly for the hearing-challenged, compared with a roomful of people seated in a rectangular layout and communicating without amplification.

Krista Amundson, RVM Foundation Director, reminded me that several years ago RVM invested time and money in the installation of a radio frequency broadcast system (Auditorium, Sunrise Room, and a mobile option).  Residents who wore a receiver and a headset could control the volume of the received broadcast, but interest in using the system dropped off in the face of the need to wear equipment, and the fact that volume correction was at all frequencies rather than selected for the needs of the wearer.  Discussions of wiring the auditorium and Sunrise Room for broadcast specifically to hearing aids has continued, and Scott Wetenkamp (Chair of the Residents Council Communications Department) has said that plans for hearing aid antenna loops are still “penciled in” to long-range plans for replacing the auditorium flooring, but that wifi or bluetooth may prove to be a more practical solution.  More recently there has been discussion of having screens with transcriptions of verbal presentations, but I’m not aware of anything of that sort in the planning stage.  In all cases involving volume enhancement, the issue of signal-to-noise ratio is a critical factor.

One institutional action that would help is developing design standards for common areas that would favor sound absorbing surface treatments  (wall, ceiling and window coverings) and furniture.  A good test case would be a review of the Arden design and function — I find it impossible to participate in a conversation there unless it is very early or very late in the evening, when few other tables are occupied.

Recently a New York Times article entitled “Honey, Sweetie, Dearie: The Perils of Elderspeak” was circulated on the RVMList. [To read or download a pdf of the article, Click Here]  The subtitle is “A new training program teaches aides to stop baby talk and address older people as adults.”  I think most of us can support this as a generally good idea, but one statement in the article brought me up short: “Sometimes, elderspeakers employ a louder volume, shorter sentences or simple words intoned slowly.”  These are exactly the steps to take if you want to facilitate understanding by the hearing-impaired, and I do not think that they should be generically discouraged as part of elderspeak.

Classes for both staff and interested residents in techniques and principles of communicating with older adults could be an interesting and useful addition to RVM educational offerings – provided that anti-elderspeak training does not run counter to the steps that can be taken to improve communication with the hearing impaired.  Such a class would be most effective if it included deaf people as active participants, and could be offered to the general population as well as targeted audiences (e.g., inclusion in staff training). As anyone who has been trained in singing, acting, or public speaking can testify, optimizing vocal communication is not something that comes naturally to most people, but it can be learned and is useful in general and not just for interacting with the deaf.