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Hearing Loss and Social Isolation: How IP CTS Can Help

Steve DeMari, MS

March 22, 2022

Interview with Stephen DeMari, MS, Director of Business Development & Education, on how Internet Protocol Captioned Telephone Service (IP CTS) can help those with hearing loss.


AudiologyOnline: Is there a link to depression and hearing loss?

Stephen DeMari: In recent years, many studies are revealing a relationship between hearing loss and social isolation. In addition, untreated hearing loss can lead to a higher risk of depression, cognitive decline & dementia, risk of falling, memory loss, along with greater anxiety and frustration leading to them withdrawing from social interaction. It’s long been demonstrated that hearing loss has a negative impact on quality of life. In the NIOSH Science Blog on the Centers for Disease Control and Prevention website, Dr. Elizabeth Masterson writes, “more people have hearing loss than diabetes, cancer or vision trouble” (Masterson, 2016).  Further information on this topic can be found in the Whitepapers and Articles section of the CaptionCall website. 

AudiologyOnline: Can using hearing aids and assistive devices reduce these risks? 

Stephen DeMari: Yes, and there is no downside to using a hearing aid, captions on TV or telephones, or any other ancillary amplification device. We suggest that people with signs or symptoms of hearing loss who are feeling the frustration of having to deal with a hearing loss, make an appointment with an audiologist for a hearing evaluation. Many people wait too long to address hearing loss issues and withdraw from conversations rather than deal with the problem directly. The bottom line is that using ancillary devices to help you hear and communicate is less conspicuous than the hearing loss itself. Connecting and conversing with your friends and family will help your brain stay younger and keep you involved in life. Social Isolation, especially during the time of this pandemic, has seemed to increase and become more common. A recent study by Rogers et al. entitled, The Effects of COVID-19 and Social Isolation on Depression and Daily Stress, states, “Humans are social beings by nature, in addition to food and water, we also need social interaction to be healthy” (Rogers et al., 2020). More information on this topic can be found on the CaptionCall Blog.

AudiologyOnline: What is IP CTS (Internet Protocol Captioned Telephone Service)?

Stephen DeMari: Captioned telephone service allows a person with hearing loss but who can use his or her own voice and has some residual hearing, to speak directly to the called party and then listen, to the extent possible, to the other party and simultaneously read captions of what the other party is saying. Current captioned telephones use the internet to send captions to the phone. This is an improvement over earlier devices that required multiple phones lines or calling a second phone number to relay the phone call. To be eligible for captioned telephone service, you must have hearing loss and need captions to use the phone effectively.  To a refer a patient online, please visit: Online Certification CaptionCall.

AudiologyOnline: How are the Americans with Disabilities Act (ADA) and the Federal Communications Commission (FCC) involved in IP CTS?

Stephen DeMari: The Americans with Disabilities Act was passed in 1990 and impacted those with hearing loss as it led to the development of relay and captioned telephone services. More specifically, Title IV of the ADA required assistive services be made available to qualified end-users in any state, at any time, at a cost no greater than what a person with normal hearing would pay for telephone services. As technology advanced, telephone relay services (TRS), Internet relay, and video relay were developed, enabling those with hearing loss to communicate effectively and naturally with hearing individuals. You can read more about this topic in the article, CaptionCall and the ADA Fight for No-Cost Captioning, on our website.

AudiologyOnline: Why is IP CTS important?

Stephen DeMari: People who are hard-of-hearing are at a distinct disadvantage compared to normal-hearing people when communicating on the telephone. Necessary visual cues needed for effective communication are not available to the listener on a normal telephone. Captioned telephones that are customizable to deliver a speech signal based on the unique needs of the hard-of-hearing, while quickly displaying the speech in text format, would appear to offer a viable functional solution to those with hearing loss. Hearing loss, if left untreated, has a significant impact on a person’s ability to stay connected. This inability makes face-to-face interactions difficult and using the telephone extremely frustrating, which often leads to loneliness and isolation—the precursors for many serious health risks. Read more about this in the article, Caption Phone Without Internet: No Internet, No Problem, on our website.



Masterson, E. (2016, April). Measuring the impact of hearing loss on quality of life (blog). Available at: 

Rogers, A., Pearson, V., Ashley, C., & Lamar, A. (2020, Nov). The effects of COVID-19 and social isolation on depression and daily stress. Available at:

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steve demari

Steve DeMari, MS

Director of Business Development and Education

Steve has been an audiologist in a variety of professional positions for over 30 years.  His passion for the industry began during his early years in Syracuse, NY, with his sister, who is deaf.  Steve earned his Master of Science in Audiology from Syracuse University, then completed a clinical and research audiologist fellowship at the Department of Veterans Affairs Medical Center in Long Beach, CA.  Steve’s most recent positions were VP of Sales and Account Management and Director of Audiology for United Healthcare Hearing. Previously, he was Director of Government Services and Business Development for Phonak, Starkey, and Sivantos. 

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