The use of face coverings is likely going to be in use for quite a while and this can present an additional communication barrier for caregivers. It is now compulsory to wear face coverings in hospitals, on public transport and in places where social distancing is not always possible. This increases the importance of us all finding new ways to communicate with each other, effectively.

This is crucial in health and social care. It is important to be mindful and quick to recognise communication difficulties, while becoming innovative in overcoming them to treat patients effectively.

Most of us find the use of face coverings an extra challenge, some will find it more difficult than others however, especially those who are deaf, have dementia or cognitive impairments, learning disabilities or other conditions such as, COPD, asthma or strokes.

The barrier to communication has been made even more challenging in the health and social care setting as most people are required to attend appointments or seek medical help alone, meaning they cannot have an individual there to provide help and support with communication.

Wearing a face covering can alter the sound and quality of a caregiver’s voice, prevent visual prompts and can make even mild hearing difficulties more apparent. Individuals who are deaf, have slight hearing loss and the elderly can rely upon lip reading to fill in gaps of speech that they miss, this cannot be done whilst a caregiver is wearing a face covering. This means many individuals will be at risk of not understanding basic information or instructions being given to them by caregivers or medical professions. For some, it can cause mental exertion as they try to hear and understand over background noise.

Some people can feel uncomfortable acknowledging they have missed what someone has said and can be embarrassed asking someone to repeat themselves. Being hard of hearing, cognitively impaired or suffering with Dementia can already feel isolating to some people, particularly when now it is harder to understand what those around you are feeling or saying. It can be extremely useful to relay important messages through pictures or written communication in these situations.

Face coverings come with other struggles too. They can make a lot of us feel uncomfortable as our glasses steam and we become hot and bothered. For those that wear behind-the-ear hearing aids, there is a risk of becoming tangled, and the increased risk of losing aids or damage after they have become tangled in the elastics.

All this becomes apparent in an already stressful situation and can in turn make patients feel more anxious or agitated. This is where caregivers can show their understanding and learn new techniques of communication to help resolve and overcome these barriers, helping to eliminate added stressors on their patient.

Unspoken communication has always provided unique opportunities and can be an effective way of connecting with someone. The use of face coverings unfortunately hides people’s feelings of sadness, frustration, pleasure, fear and annoyance – our emotions show on our faces without the need of verbal communication.

People who are living with Dementia or those who are deaf, are often skilled at interpreting facial signals and someone’s feelings so rely on this ability.

It is our responsibility to become more aware of how we come across when people cannot see our facial expressions and when we cannot see theirs. We all must learn to pay greater attention to patients and our own non-verbal cues.

How to communicate effectively:

• Be self-aware – when we are stressed this becomes reflected within our voice, body language and eyes. It is important to think about the information you need to relate and whether you need to use any other additional tools; drawing, writing, visual cues etc. Focus on your patients’ needs and allow enough time to complete interventions without rushing patients or ourselves.

• Show respect – use your eyes, eyebrows and smile. Even when a person cannot see your mouth, your smile will be reflected in your eyes. Use your body language positively to create a calm situation and try not to move suddenly.

• Speak clearly… but don’t shout – our lives can be noisy environments and background noise can make it difficult for people who are hard of hearing. Pronounce words more clearly and speak loudly enough, but without the use of a raised voice as this can change our tone and shouting can feel patronising to some individuals.

• Use friendly body language – as most of our faces are hidden behind face coverings, our body language can be used to show calm and friendliness. This can be comforting if you are having to give difficult, upsetting or sad messages to the patient.

• Observation – look carefully, listen to your patients and take note of what they are trying to communicate to you. This can be used to help you communicate more effectively and used to shape your behaviour accordingly.

• Embrace technology – you can make use of specialist apps that have been created such as a speech recorder on smartphones which can turn your voice commands into written text.

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