It is Deaf Awareness Week from 4-10 May. Susan Griffiths is the ASD occupational therapy lead in Children’s Therapy Services at Poole Hospital NHS Foundation Trust. Susan is a hearing aid user and lip reader, and she is raising awareness of the vital communication barrier that face masks are currently posing to the hearing loss community, and many others who rely on facial expressions and facial cues for effective communication.

There are 12 million people with hearing loss across the UK – that is one in six of us. I am one of those people. I am a hearing aid user and lip reader and I rely on both to be able to communicate effectively with people, especially in my role as an occupational therapist.

As a Deaf person and as an OT, I have always been aware of the impact the environment has on our disability. If we do not get the environment right then our environment can be our worst enemy. At the beginning of April 2020, one single change to the environment has made me more disabled than I have ever been in my life – the introduction of face masks.

I work in Children’s Therapy Services at Poole Hospital NHS Foundation Trust and as a result of the coronavirus, my colleagues and I have been asked to support on the adult in-patient wards.

After spending two weeks completing all the training required to be able to support on the adult in-patient wards, I found myself on the orthopaedic ward surrounded by staff and patients all wearing face masks.

I could no longer use my lip reading skills to help me determine between different sounds and words to ensure that I interpret what I hear accurately. To give you an insight, I am able to interpret 95% of what is said using both hearing and lip reading. With hearing alone, I can only interpret around 30 – 40% of what is said, and only if the environment is quiet.

I had seriously underestimated how much I rely on lip reading until that ability was taken away from me. As a result, I am no longer able to work directly on the wards to support my colleagues and work with patients.

I had so many emotions running through me. Guilt that my colleagues are putting themselves at risk every single day whilst I am office bound. Frustration because I know I can do so much to help as an OT, but I can’t because the face masks prevent me from using my lip reading skills to be able to communicate effectively.

I have so much anxiety about the future. Will wearing masks become the new norm and how will I overcome this communication barrier? I also feel a sense of disappointment as I have been let down by society. This pandemic has really highlighted the lack of Deaf awareness in our society. Why has it taken a pandemic to realise that face masks are a significant communication barrier, not just for the hearing loss population, but also for people with dementia, learning disabilities and very young children.

As an OT, this has made me realise that if I am struggling with masks, how many out of the 12 million people with hearing loss living in the UK are also struggling. Currently the government are not recommending face masks to be worn in public but this could change at any time. The impact of this on our ability to engage in everyday activities such as shopping, meeting friends for coffee and attending medical appointments will be devastating.

The single flaw in the design of face masks is the fact that they are not see through. On Twitter, an American college student generated a lot of interest after she shared a homemade clear mask that she made. However, this is only beneficial if it is recognised that every single mask needs to be replaced by a see through mask and worn by every single person in society. In addition, for see through masks to be used in health environments, they have to be economical and meet stringent standards to ensure they are safe and protect us from viruses.

The reality is that this is not going to happen, at least not now during the pandemic when face masks and other PPE equipment are scarce. However, I do hope that in the future, this is something that we can learn from and hope that see through face masks become the norm.

What can we do?

Check with your employer if you can purchase see through masks such as the ClearMask or The Communicator Surgical Mask.

Check with your family, friends, colleagues and patients who are lip readers and ask them how they prefer to be supported.

If you work with patients, ensure there is a plan in place on how you are going to communicate with them, especially if the removal of masks or see through masks is not an option.

Use gestures and sign language. If you don’t know how to use sign language, now is the time to learn. Many of the online BSL courses are being offered for free during this pandemic so make the most of this opportunity.

Write things down using pen and paper. If you are working on the wards, then use a mini white board which is easy to clean. Alternatively, text or type to your patient using your phone, tablet or computer.

Use communication apps that convert speech to text such as Google Live Transcribe or Otter. For BSL users, use the ‘Now Interpreter’ app where you can video call a BSL interpreter for free.

Use video calls. If you work on the wards, then go to a room where you can safely remove your mask and then talk to the patient via video calls. If possible, use video conferencing apps with live caption functions, for example, Microsoft Teams or Google Hangouts Meet. This means that automatic transcribed closed captions (also known as subtitles) will appear on the screen as people talk.

For people that can use their residual hearing, ensure the environment is quiet, speak loudly and clearly.

Finally but most importantly, please continue to raise awareness of the communication barriers that face masks pose for the people who rely on reading facial expressions and lips to support their communication.

You can follow Susan on Twitter at @SusanGriffiths5

Image: prostooleh/Freepik

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