There is an additional choice for communication that I use and thankfully do not find it exhausting. That is the Captel phone. (There is another company that functions the same as Captel but at the moment I don't recall the name.) While the transcription on the Captel phone is not perfect, I am satisfied with its functioning. I can always ask the person speaking to repeat what they said, speak slower, or whatever, and sometimes I say to them "I'm relying on transcription, here's what they claim you said - could you correct it, if needed?"