“How can I help you hear?” The transforming power of six little words
BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h184 (Published 18 February 2015) Cite this as: BMJ 2015;350:h184
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Enunciating and speaking clearly is often the most important factor for hearing accurately, especially for high tone hearing loss. Competing noise becomes increasingly difficult with aging. Speaking louder does little to overcome this, as opposed to waiting for other noise to subside (passing vehicle, jet, food cart in a hospital corridor, competing mobile phone conversation, etc.). Unfamiliar accents are also more difficult when speech is fast.
Young people, and especially those who speak very fast with poor diction, can be encouraged to decide whether they wish to be understood. If not, most people can live with that, and ignore them. If communication is important, then they should be encouraged to ask the proposed question and listen to the answers.
In people taking anticholinergic drugs (now a huge range of medications), diction is improved immediately by a sip of non-alcoholic liquid and a mouth rinse to lubricate the tongue and lips.
Tom Perry, M.D.
Competing interests: Sometimes I prefer NOT to hear what people are saying.
Thank you for this article. It is great to hear from a person who remind us all of the problems associated with hearing loss. I am an academic whose job entails multiple meetings and constant interaction with colleagues. I have a significant hearing impairment and lip read extensively. Long ago I learnt to be proactive in managing meetings and interactions with people.
In meetings: I work out where the meeting's chairperson will be sitting, and try to position myself near them and in full view of all participants (hard with some table configurations). I always sit with my back to windows to prevent lipreading silouetted figures. If there are windows behind a speaker, I will adjust curtains or blinds before the meeting commences. My colleagues are all aware of the problem and I never have a problem with them helping me.
Clinical encounters are usually not troublesome because they are usually in quiet rooms. If a person with a tone of voice that is hard to pick up is the patient, I confess my problem and they nearly always comply.
So the key is self disclosure - for patients that would mean to reception staff and clinical staff.
Competing interests: No competing interests
While I was writing this article I was thinking about whether 'how can I help you hear?' would be suitable to submit as an NHS Change Day action. The nurse who first asked me this wonderful question has encouraged me to do so, noting that improving care doesn't have to be doing difficult stuff". This has now been submitted, and accepted, as an NHS Change Day action and I hope many health professionals will try this with their patients (and friends, relatives and colleagues!) with hearing loss. You can see the details here http://changeday.nhs.uk/user_action/how-can-i-help-you-hear-howcanihelpy...
The response on social media has been really encouraging and it has been very good to hear from health professionals who are committed to trying it and from patients who are using it to seek better communication with their clinicians.
Competing interests: No competing interests
Restoration of normal hearing without hearing aids in age related hearing loss by our non-invasive and painless "Dr. Arulrhaj Technique".
Dear Editor,
We have read with deep interest this article by Sarah Chapman {1]. There indeed remains much to be done, and correct guidance through the medical system is one of the foremost requisite. There must be arrangements in place, proper directions and guidelines, which ensure that every patient knows what to expect, and whatever needs to be done or followed. As far as possible, do listen to what your patient or the care givers convey by means of speech, by expressions, or by signs, etc. Do not be dismissive or be impolite or in a hurry, as you don’t know what all troubles has the patient already taken to get an appointment and then to keep it.
It has been quite some time since we talked about reversing hearing loss in presbycusis, and that we are perhaps wrong in considering the inner ear, cochlear issues, sensorineural hearing loss, as the only cause for presbycusis [2]. As nascent or incomplete as our innovative technique for reversal and restoration of hearing loss in age related hearing loss (presbycusis) may be, we have recently restored partial hearing in an elderly patient with presbycusis for over two decades not helped by hearing aids without any assistive devices or any further need of hearing-aids, etc.
Our innovative technique that we had named after our mentor as, “Dr. Arulrhaj Technique” for restoration and reversal of hearing loss in presbycusis [2-3], helped this patient as well to hear (although partially) without any external aids or hearing aids. This is a non-invasive and painless technique, which has been presented in our book that contains 14 innovative medical techniques for chronic medical conditions [4]. But then much more needs to be done from now on by the global fraternity for this technique. Alone, without any help or encouragement whatsoever, we couldn’t do anything more. We would definitely want the world’s scientists and medical fraternity to take on from here, without being over critical, outrightly dismissive, or persecutive in any manner. We would like to state that we must be actually wary of using this technique independently, and not until large scale trials are done at some well established medical and research centres, and not until the worthiness and efficacy is established for sure, and that this technique is made absolutely safe even in the hands of a novice.
Best regards.
• Dr (Lt Col) Rajesh Chauhan
Hon’ National Professor IMA CGP, INDIA
• Dr. Ajay Kumar Singh Parihar
• Dr. Shruti Chauhan
References :
1. Sarah Chapman. “How can I help you hear?” The transforming power of six little words. BMJ 2015;350:h184.
2. Chauhan R, Parihar AKS, Chauhan S, Chauhan SPS. Age related hearing loss or presbyacusis: are we prepared to listen and think differently for a tenable solution? BMJ 20 April 2013. Available at : http://www.bmj.com/content/344/bmj.e615/rr/641987 (Accessed on 05 March 2015)
3. Chauhan R, Parihar AKS, Chauhan S, Chauhan SPS. Re: Cost effectiveness of strategies to combat vision and hearing loss in sub-Saharan Africa and South East Asia: mathematical modelling study. BMJ 25 May 2013. Available at : http://www.bmj.com/content/344/bmj.e615/rr/647159 (Accessed on 05 March 2015)
4. Chauhan R, Chauhan S, Parihar AKS. Restoration of natural hearing in age-related hearing loss by ‘Dr. Arulrhaj Technique’. In : Innovative medical techniques showcased at international medical conferences. Lap Lambert Academic Publishing; 2014. Pp 14 -22.
Competing interests: These are our own personal opinion and views, and have no bearing whatsoever to any organization or institution. This technique is part of the 14 innovative techniques that were recently published in our book that is titled, "Innovative medical techniques showcased at international conferences".