How to wear masks with hearing devices

How to wear masks with hearing devices


Mallary Saltzman didn’t need to wear a face covering for long before she came to a realization: “Hearing aids, masks, hair and earrings don’t go well together.”

Saltzman, 62, who has moderate hearing loss and relies on hearing aids, quickly became familiar with the logistical headache of trying to keep the devices on her ears while dealing with mask ear loops. There had been at least two instances in which her hearing aids were partially dislodged as she removed her mask, and those close calls, she said, were enough to prompt concern.

“I’m really, really super careful now,” said Saltzman, a part-time librarian who lives in Westfield, N.J. In addition to being critical for communication, her hearing aids cost $3,000 each. “I lose a mask, that’s fine, but I don’t want to lose my hearing aids,” she said.

For Saltzman and many people who use amplification devices such as hearing aids or cochlear implants, wearing masks — and now double-masking — to curb the spread of the coronavirus can be a “frustrating” experience. Audiologists say their patients frequently mention struggling to position mask loops, hearing devices and glasses on their ears, when masks have already made communicating more challenging for those who are hard-of-hearing or deaf.

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“Unfortunately, what a lot of them have resorted to is not wearing their hearing aids because they get frustrated, which is exactly opposite of what those in the communication field want for the patients for their quality of life,” said Casey Rutledge Roof, an audiologist at University of Louisville Health in Kentucky.

Instead, Roof and other experts say there are a variety of solutions you can try that should allow you to more comfortably wear your hearing devices while masked, and not fear losing or damaging the expensive hardware.

— Handle with care

It’s common for people to remove masks in one swift motion, similar to how you would take off a pair of glasses, but those using behind-the-ear hearing aids or cochlear implants need to be more careful, said Elizabeth T. Meyer, a clinical faculty audiologist at Northwestern University.

“If you were to rip your mask off or take it off haphazardly, then it will cause the hearing aid to fly out,” Meyer said.

Hearing devices can come equipped with GPS locators, and loss and damage are often covered by warranties. You may also be able to extend protection by purchasing coverage through a third-party company or adding the device to your homeowner’s or renter’s insurance policy, experts said.

Still, Meyer suggested making it a habit to carefully take masks off in a “safe environment,” such as inside your home or car.

Donna Smiley, chief staff officer for audiology at the American Speech-Language-Hearing Association, agrees. “Have a standard place that you take it off” at home, Smiley said. That way, if your hearing aid or implant falls out, “you have a space in which you can find it.”

After Saltzman dislodged her hearing aids, she said she started taking her mask off one ear loop at a time and checking that the devices were still in place.

But experts noted that developing those habits may not always be easy for everyone.

“At least for me, I’m wearing a mask all day long … and I’m ready to take that thing off as soon as soon as possible,” Roof said. “I know patients probably feel the same way.”

— Free up some ear real estate

Reducing the number of things occupying the limited space behind your ears is one way to avoid having to regularly untangle hearing devices from mask ear loops, and can also help alleviate pain, experts say.

“The majority of people that we see are older adults, and we’re talking glasses, hearing aids, cochlear implants and then masks on top of that,” said René Gifford, a professor of hearing and speech sciences and director of the Cochlear Implant Program at Vanderbilt University. “You can imagine that the ear fatigue is real.”

Experts recommend switching to masks that don’t have ear loops, such as coverings with ties or those that fasten around the wearer’s neck, or using mask extenders, known as “ear savers.”

“Anything that doesn’t have to stick behind your ears is going to be better protection for your hearing aids,” said Kristen Rubin, an audiologist and owner of Keystone Audiology in Rhode Island.

Saltzman, who is now double-masking, said she has started using plastic extenders on both her masks if she plans to wear them for long periods of time.

“They’re much more comfortable, but they’re not easy to use,” she said. “They take finagling when you’re putting them on to make sure you have them in the right tightness. It’d be much easier not to use them, but it’s worth it.”

— Secure your devices

Beyond altering how you wear a mask, there are modifications that can be made to hearing devices to more securely fit them to your ears and lessen your chances of a mishap.

Try using double-sided wig or toupee tape to affix hearing aids or implants to the side of your head for an “added layer of protection,” Rubin suggested.

You can also talk to a hearing professional about accessories such as retention clips or cords, which function much like straps and chains for glasses.

“The nice thing is these are not expensive pieces of equipment and accessories to get,” Gifford said. She noted that most patients using cochlear implants should have retention devices in their kits.

Though these strategies are commonly used for young children, experts say they can be helpful for adults, as long as they don’t mind dealing with another piece of equipment.

Changing the body style of your hearing device from a behind-the-ear model to one that is completely in-ear could be another option, Meyer said. But people should keep in mind that different device styles may be better suited for certain types of hearing loss. A molded in-ear piece can add more bulk inside the ear, Meyer said, which may impact the wearer’s perception of sound.

“Those work really well for someone has mid- and low-frequency hearing loss, but might not sound as natural for someone who has high-frequency hearing loss,” she said.

— Prioritize communication

Experts emphasized that the “worst thing” people can do during the pandemic is to let their frustration and anxiety keep them from regularly wearing their hearing devices.

“Something I think audiologists fear is that patients will just make decisions like, ‘Oh, I just can’t manage all this, so I’m not going to wear my hearing aids,’ ” Smiley said. “We definitely don’t want that because in this time it’s even more important that their amplification be on and working because communication is so much more difficult.”

Choosing to forgo wearing hearing aids or cochlear implants not only poses safety risks, but may also lead to long-term impacts on health and well-being, experts said.

People receiving treatment for hearing loss make progress the more they wear their amplification devices, Meyer said.

“If you don’t wear your hearing aids, you regress in terms of your ability to process in more complicated listening environments” such as a crowded restaurant, she said. So when life starts to return to normal, those people are probably “going to be struggling.”

Rubin added that people’s brains need auditory stimulation to stay active.

“When we kind of leave the brain dormant, a lot of negative things can come from that,” she said. “Auditory deprivation can cause a lot of things that we can’t necessarily get back.”

On top of all that, missing out on conversations can increase feelings of isolation and loneliness, which is why Saltzman said she hasn’t considered going without her hearing aids during the pandemic.

“It’s not fun,” she said of having to deal with ear loops and mask extenders. “But I’m grateful that I have hearing aids that can make me less isolated … To have that extra added thing of not being able to hear people is just very frustrating.”



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