Masks have been an essential first barrier in the fight against COVID-19, however, for older Australians, especially those with hearing or cognitive impairment, masks can cause a breakdown in communication.
It is a difficult situation not only experienced by elders, however.
Allysa Dittmar, who lives in Baltimore, US, was born deaf, using American Sign Language (ASL), facial expressions and lip-reading to communicate.
In 2015, aged 23, she was completing a Master of Health Science at Johns Hopkins University, with a bright career in public health ahead of her.
But she faced a traumatic incident in hospital that year that would inspire an unexpected move into entrepreneurship.
She tells Aged Care News that after an administration error left her without an interpreter pre-surgery, she was rolled into the operating theatre without the ability to communicate with the masked medical team.
“I was dehumanised,” she says.
“[Because of the masks] I couldn’t lip-read, see facial expressions or catch any visual cues of what was going on.
“I lost my autonomy because I lost my ability to communicate when everyone’s faces were covered up…I wasn’t even able to see a reassuring smile.”
Not only was it distressing for Dittmar: the situation meant that medical staff could not satisfy vital pre-surgery protocols.
“Questions like ‘which side are we operating on?’, ‘what is your blood type?’, ‘what drugs are you allergic to?’ I was unable to understand or answer,” Dittmar says.
“The last thing I remember was panic as the room began to fade: they had started the anaesthesia even though I had asked them to tap me before it began.”
Innovating for change
It was an experience Dittmar, now an adjunct professor at Washington DC’s Gallaudet University, never wanted to go through again, nor something that should ever befall others.
“As soon as I got home, I looked for transparent masks and much to my dismay, there were none for sale in 2015,” she says.
It was patently clear to Dittmar that if anyone was going to inspire change in the industry, it would have to be her.
So, she teamed up with three fellow Johns Hopkins University classmates – Aaron Hsu, Inez Lam, and Elyse Heob – and by 2017, the ClearMaskTM was born: the first-ever fully transparent, single-use surgical mask that is both FDA-cleared and CE-marked.
With a transparent, anti-fog plastic barrier and foam perimeter, their finished product balances visibility with breathability.
It was an innovation that allowed the group to challenge a number of health and cultural disadvantages.
“We all intimately understood the importance of visual communication,” Dittmar says.
“Hsu and Lam come from families with limited English proficiency and Heob comes from a family of audiologists.”
Poised for the pandemic
The COVID-19 pandemic has exacerbated communication difficulties that were already endemic within the older Australian population.
Data from the ABS (Australian Bureau of Statistics) indicates that 1.2 million Australians have some form of communication disability, and it’s common for older people to have difficulties that can arise from either the natural ageing processes or as a result of disease.
Some studies have concluded as high as 95 per cent of older people living in residential aged care have some form of communication difficulty.
Dittmar notes that although this is a problem that affects the deaf and hard of hearing community most, the barriers created by typical masks have a social impact on us all.
“Being able to see facial expressions and connect is what makes us human,” Dittmar says.
Indeed, even for those with perfect hearing, Dittmar notes that non-verbal communication cues are vital.
“During the pandemic with widespread mask usage, many have felt the jarring disconnect with regular masks blocking our faces.
“From young children to older people, everyone subconsciously relies on facial cues, expressions, and lip-reading, and this becomes even more critical in healthcare.”
It is an issue explored in a recent JAMA Network investigation which compared standard masks with a transparent mask, measuring study participants’ sentiment regarding their ease in communicating with healthcare workers, as well as the ability to identify their emotions.
Seventy-eight per cent of the general population could identify emotions being expressed through the transparent mask, versus only 20.1 per cent of the same cohort when observing expression through the opaque varieties.
Subjectively, wearing transparent masks was favoured by the healthcare workers also: 61.8 percent of the general healthcare workers, and 82.2 per cent of deaf/hearing-impaired workers felt positively about wearing transparent masks.
Dittmar points to another JAMA study published back in March, which found that 100 per cent of patients whose provider wore the ClearMask™ brand transparent mask preferred them over opaque masks.
“Transparent masks provide so many benefits, including reducing miscommunication, mistrust, and medical errors,” Dittmar says.
“Compared to standard masks, patients in the study reported improved communication with the ClearMask™ transparent masks, rating their physician significantly higher in providing understandable explanations, demonstrating empathy, and building trust.
“At its core, the ClearMaskTM transparent mask is designed to bring human connection, empathy, and comfort back into healthcare; for patients to feel like they are being treated as a person, not a medical case.”
Hitting the Australian market
The ClearMaskTM is now available in Australia; in fact, it is the only transparent mask listed on the Therapeutic Goods Administration’s (TGA) Australian Register of Therapeutic Goods.
Whilst it is not an N95 mask, it is registered as a class 1 medical-grade device: distinct from other products available online.
“A simple Google search will show you hundreds of masks being made with transparent windows, but these masks are often homemade or have poor or no quality standards, fog up, show only a small part of the face, and simply don’t work,” Dittmar says.
She says the product received Food and Drug Administration (FDA) clearance in early 2020, just in time to “join the fight against the pandemic”, and the European CE-Mark in September this year.
Dittmar says she ‘s proud their product is the only transparent mask on the market to have both the American, European, and now Australian, stamp of approval.
“Having the “stamp” of FDA clearance and CE marking brings enormous integrity into a product, and marks our product as the highest quality in the market,” she says.
“We took great care in making sure we built a product that people would love.”
No hiding ClearMaskTM‘s success
To date, over 18 million ClearMaskTM transparent masks have been sold.
They are currently being used throughout hospitals, schools, clinics, and businesses around the world.
The mask is designed for indoor settings and recommended for use at room temperature in ventilated, low-humidity environments, such as indoor offices or clinics
The mask’s plastic barrier is made of a recyclable material, and can be physically separated from the rest of the mask to be recycled via standard recycling practices
Both adult and child sizes are available.
To find out more about the ClearMaskTM and how you or your organisation can order the product, visit clearmask-australia.com.au.