I find that I shout constantly now and I feel that it is starting to become a problem!
At work I notice that some staff speak in almost normal tones, although they are naturally soft spoken people and so what sounds normal to me may actually be shouting for them.
I find that when dealing with older people with hearing loss THE most important thing is to pronunciate, not necessarily to be loud. In fact, one of the best things to do, is to spell out key words. It is easier for elders to understand letters than the whole word. However, when I am tired and forget this I always start to shout, thinking that if I speak the same slurred words louder somehow they'll be audible. Sad.
I naturally have a pretty loud voice, though when at work, when I try to talk "normally", people tell me that they cannot hear me. Well, I should reiterate, most people usually can hear me, but there are always one or two who cannot in every group and they are VERY vocal about not being able to hear me . . . so I shout.
My mom noticed the difference in my speaking volume immediately after I started working with elders. The first week of work, I called her and left a message on her machine which she said she could hear across the house (my mom has hearing problems as well, so I often have to speak up for her).
The worst though was this morning, Saturday morning, when I should leave any thoughts of hearing loss far behind me, I was AMAZED when I said something in a regular voice and non of my roommates said "What??" I was equally amazed by how difficult it was for me to leave my shouting voice behind and that I unintentionally shout now, terrified I will not be understood. ;)
The last fear I have is that I, too, will start suffering hearing loss. It is natural for therapists and other human service workers to sometimes internalize/personalize their clients' fears and pains, but I swear that my fear is justified!
Because it is a serious problem if a member of the memory impaired unit wanders off the ward, there is a VERY loud piercing alarm at every door that goes off if the door is opened for more than 2 minutes. However, when I am leading elders out of the door for activities it usually takes much more than 2 minutes for them to make it and the alarm inevitably goes off. Then all the PCAs(Personal Care Attendents) yell at me to "use your key!" to turn the alarm off, but because I'm an intern no one has given me a key for the alarm. So . . on the three days that I work, I have to stand directly under a piercing and EXTREMELY loud alarm for up to five minutes, often more than two times a day.
When I lose my hearing I ask only one thing . . . please do not shout at me ;)