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Coping with a Hearing Loss
From an article by by Mark Ross, Ph.D. under a grant from the National Institute of Disability Rehabilitative Research.
Are you in denial?
The first step in coping with a hearing loss is to acknowledge --openly-- that it exists. This statement is not as simplistic as it might appear. Our society is full of people who deny to themselves the fact that they are hearing impaired, while still others, who are aware of their hearing problems, do their best to disguise its presence to the world at large. Without self-acceptance, a successful adjustment to a hearing loss is impossible. By successful adjustment, I do not mean the elimination of the communication problems associated with the hearing loss, but rather their reduction insofar as it is humanly and technically possible.
The association of hearing loss with increasing age and infirmity and the psychological blow that this may entail to one's self-esteem are examples of the hurdles that must be confronted and overcome. The way we use our language also plays a role. A "hearing loss" is equated with "deafness," and "deafness" associated with being "dumb"; and, after a lifetime, who wants to accept this as a label describing themselves?
Most Hearing Loss is Gradual
The hearing loss is gradually progressive, and it takes a number of years before the effects become apparent. What the hearing-impaired person is aware of is not the hearing loss itself, but the fact that people seem to be talking less clearly than they once did, or that the world is apparently much noisier than it used to be (which is true, but the noise disturbs normal-hearing people less than it does someone with a hearing loss).
Do you Blame Others?
In the beginning, there is a tendency to blame others for one's hearing problems. ("If you'll just take the mud out of your mouth, maybe I'll be able to understand you!" or "Why are you always whispering to me?") There is a point, however, when it is apparent that other people in the same situation are able to get along just fine, and when the extent of the listening problems become so great, it becomes very difficult to deny the reality of a hearing loss, at least to oneself.
Higher Pitches Fail First
The nature of the most common hearing losses are such that it is the higher pitch sounds which are the most impaired, while the lower pitch tones may be affected much less or not at all. Unfortunately, it is higher pitch sounds which are most important for the understanding of speech. (Many important consonants, for example, are comprised mainly of the higher pitch sounds.) When spoken to, the person with this kind of hearing loss can hear that speech is taking place on the basis of the better low-tone hearing acuity, but cannot understand what is being spoken because of the greater impairment in the higher-tone hearing acuity.
Family and Friends Know You Are losing Your Hearing
People in contact with a hearing-impaired person are aware that a problem exists. They can note the misunderstood words, the unusual or irrelevant responses to a spoken comment, the repetition in a conversation of what has already been covered, the lack of responsiveness in some situations and the avoidance of other situations, and the frequent recourse to dominating the conversation (if one talks all the time, it is not necessary to listen). They can see, in other words, the effects of the hearing loss. If they are not aware of the primary cause of these effects, then they will attribute the behavioral excesses or abnormalities to other causes, such as senility, aloofness, ignorance, or mental illness.
Be Assertive With Your Hearing Loss
Assertiveness is the attempt by hearing-impaired people to modify the communication situation as realistically and as efficiently as they can in order to improve their ability to participate in it. These situations can be anything from a personal or group conversation, to being a member of the audience in a lecture, theatrical performance, or as a congregant in a house of worship. Assertiveness means taking a personal responsibility to enhance one's comprehension in these situations, and not just blaming others for communication breakdowns and problems. It does not mean being aggressive.
The Hardware Solution
The first step the hearing-impaired person should take is to ensure that he or she has the proper hearing aid(s) and that they are properly adjusted to one's hearing loss. After fitted with a hearing aid, one may find that the problems in many communication situations can be reduced or eliminated for a number of years.
Taking Control
Most hearing-impaired people are quite aware of the consequences of their not making an assertive effort to improve their communicative reality. The resulting anger, frustration, and isolation are all too well known to people with hearing losses. Taking what control one can of one's problems is a healthier and more mature response than just doing nothing. It is not necessary to make a big deal of it. Just the comment that "I don't hear very well" or "You know I have a hearing loss" or any similar statement lets a person know why a specific request is being made. Actually, most people will be pleased to know what they can do to improve the communication situation. If they are interested in talking to you, they are interested in being understood by you.
Ask for Changes in Your Environment
The proper kind of assertive behavior in this situation is to ask that the competing sounds be reduced, if at all possible. In a social situation, it is not necessary to have the TV blaring a few feet away. The car radio does not have to be on when one is talking to another person in the car. The host can wait to turn the dishwasher on until after the guests have left. The serious conversation at a table can be deferred until after everyone has shuffled all the chairs in the dining room and gotten seated. The sound system in a restaurant need not be turned up so high. And so on. If the hearing-impaired person makes no comment about these difficult listening situations, nothing will be done. A request, politely expressed, with the reasons included, can work wonders. Even unsuccessful requests will help sensitize people for similar future requests.
Be Assertive
One of the biggest problems faced by hearing-impaired people in a small social gathering (not a party) is the amount of cross talk which takes place. It is extremely difficult for people with impaired hearing to participate in a group discussion when more than one person talks at a time. Assertiveness in this situation means that the group be informed of this fact and for the participants to try to refrain from too many side-conversations. They will find this difficult, and it will be necessary to remind them of this fact from time to time, but it must be done if the hearing-impaired person is to fully participate in the conversation. As a bonus, group cohesion is enhanced when all the members can participate in the complete conversation, either as a speaker or as a listener.
It is not sufficient to say "What?" when something is not understood. This does not indicate to the speaker the source of the communication breakdown. Did the hearing-impaired person not understand. Did he or she miss someone's name or a particular location? Lacking specific information, the speaker does not know what should be repeated, and if other people are involved in the conversation and the What?" happens too many times, a feeling of general annoyance is soon generated. The better strategy is to frame the "What?" as a specific request, such as "What was that name again?" or "Did you say that happened in Podunk or Poland?" or "I missed the last sentence. Would you repeat it?" Such a strategy is flattering to the speaker - someone is actually listening - and can expedite the conversation.