As I entered my mid-60s, I gradually began to notice that I struggled with discrimination of sounds in my environment and experienced the presence of tinnitus, an ongoing ringing sound in both ears. This included misinterpreting the meanings of conversations and developing a sensitivity to loud noises. At one point, I contacted my television cable company to complain about the loudness of the background music, which was interfering with my ability to understand the conversations in a program. When I finally listened to the concerns of my loved ones related to my worsening deafness, I began the journey toward diagnosis and treatment.
As an occupational therapist, I had significant experience providing therapy for students with varying levels of hearing loss. I also spent a large part of my career working with students who experienced auditory defensiveness related to autism. As I learned that I was suffering from a 40% hearing loss in both ears, I was able to objectively identify the nature of some of my difficulties. At this point, I realized I knew very little about the onset of age-related hearing loss.
After receiving hearing aids from a qualified Medicare provider, the first thing I noticed was that I had been peacefully enjoying my quiet life. Suddenly, with the new devices, all sounds, including chewing and shuffling feet while walking, were front and center. Also, along with the quietness had come struggles with word finding, mispronunciations, and even misspelling written words. From this, I began to understand the connection between hearing loss and cognitive decline. I came to know that without proper intervention, I would risk not remaining cognitively intact. At least I knew that others around me may perceive me to be confused.
As I embarked on my journey of what living with hearing loss means, I found mainstream knowledge to be severely lacking. Although health care professionals were kind and caring, the information provided was limited in comparison to my own knowledge of the auditory processing system of the brain.
Creating a Healthy Environment of Personal Responsibility
Instinctively, filling in the blanks in conversations is a common adaptive technique for those with hearing loss. The confusion this creates affects all those in social communications. Reading facial expressions and lips naturally becomes a part of compensation when trying to engage with others. I learned the importance of communicating my individual needs with close friends and family. Others have kindly helped to accommodate my requests, which include speaking directly to me so I can focus on their face, and not talking to me while walking away. I cannot expect others to know or understand my disability, including difficulties with clarity versus volume and painful noise versus loudness. Helping others understand that I have difficulty localizing where noise is coming from is also an important factor to consider when involved with socialization in different environments.
Navigating the Emotional Components of Hearing Loss
After spending two years utilizing my original hearing aids, I was no longer able to achieve a sense of wellness or effectively adapt to my hearing disability. The devices broke twice within the first year, requiring repair and loss of availability. An app installed on my phone and set up to regulate the noise in different environments proved ineffective.
The constant anticipation of navigating social environments and needing to adjust the hearing aids on a phone app created a new level of anxiety. Having to leave certain situations related to loud noise or the inability to experience clarity of speech became a constant source of fear and frustration. Additionally, explaining these issues and concerns to others affected my self-esteem and contributed to feelings of inadequacy. Shedding tears was not unusual, as hopelessness became a part of life. The fear of losing the ability to participate in my favorite activities with family and friends was hard to ignore.
By early evening, I would fall asleep on the couch, my brain being exhausted trying to discern the auditory information coming in that it could no longer process. In my quest to learn how to navigate this situation, coupled with my faith and belief that I still had an active life with purpose to live for (2LIV4!), I searched for new resources.
The Importance of Effective Hearing Devices
Needing medical support to look at the entirety of my disability, I found a center that focused on hearing and the brain. I knew instinctively that my brain would not continue to function at an optimal level if language and information were not continually presented in the correct volume and clarity. Recognition of the importance of the reception and processing of auditory information in the brain was critical to my sense of hope.
Receiving care at Hearing and Brain Center involved a cognitive assessment and a detailed hearing test, which resulted in specifically prescribed hearing devices that changed my future. On my first day using the new hearing aids, I immediately felt them doing the work for me. These sophisticated devices provide protection from the pain of loud noises, clarity of language sounds, discrimination of foreground and background noises, and overall ease of auditory integration within the brain. I now have a renewed confidence for participating in my life.
Today, my hearing impairment does not interfere with my life on most days. I still proactively decide whether or not I will attend certain events, such as concerts or plays. In restaurants, I consider the acoustics and ask for specific seating in a quiet area when possible. Since I fly out of state to visit family regularly, I have discovered that both Southwest Airlines and American Airlines offer accommodations, allowing me to have priority seating away from the loud engine noise.
To successfully adapt to a hearing impairment, so many factors need to be addressed. Learning to identify specific areas of difficulty, clearly communicating needs with others, finding effective hearing devices and supportive care, and using all available community resources are the cornerstones of living a meaningful, purposeful life with an auditory disability.
Important Factors to Consider
Many of us are affected by hearing loss. This is often our experience with elderly parents and relatives, though it may include others of all ages with hearing impairments and other processing issues related to autism, brain injuries, and learning disabilities.
Relevant factors for acquiring hearing loss later in life can be exposure to loud music, attending concerts and events, and working in a loud environment, such as a manufacturing plant. Age-related hearing loss, medically known as presbycusis, is the third most common health condition affecting older adults (1). According to NIH, the understanding of the biochemical processes and molecular biology underlying this condition is limited.
A recent study at Johns Hopkins University found that participants who utilized hearing aids had an almost 50% reduction in the rate of cognitive decline compared with people who only received health education (2).
Although many people with hearing loss do not openly talk with others about their difficulties, considering that it may be a possibility in any social setting can prevent miscommunications. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), one in three people in the US between the ages of 65 and 74 has hearing loss. Nearly half of those older than 75 have difficulty hearing (3). Showing considerate communication with others, regardless of hearing abilities, creates an environment where acceptance is present.
Keys to Effective Communication
When speaking to others, it's important to face the person, allowing them to see your lips and facial expressions. For all, our brains process information more effectively when provided with both visual and auditory stimuli.
Speaking louder does not always improve understanding. Often, it is slow, clearly enunciated speech that provides the most meaningful conversations.
Be aware of the volume of background noise in a variety of environments, making adaptations as needed to maintain effective conversational skills.
Consider the noise levels of certain events prior to offering to include someone with a hearing loss. A discussion may be needed before confirming attendance.
Asking a hearing-impaired person what is needed promotes acceptance and an opening for meaningful conversation.
Success on the Journey
While adjusting to my hearing impairment over the last three years, I have experienced many ups and downs that have ultimately brought me to a level of success I began to doubt would ever happen. There is freedom in understanding our disabilities and power in exercising a level of control within our limitations. Knowing that I can have a meaningful effect on the quality of my life experiences moving forward gives me a measure of hope and anticipation for things to come.
Resources
(1) Bowl, M.R., Dawson, S. J., Cold Spring Harb Perspect Med (2019) Age-Related Hearing Loss. Retrieved May 15, 2024, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6671929/
(2) Reynolds, S., (2023). Hearing aids slow cognitive decline in people at high risk. Retrieved May 15, 2024, from https://www.nih.gov/news-events/nih-research-matters/hearing-aids-slow-cognitive-decline-people-high-risk
(3) (2023). Age-Related Hearing Loss. Retrieved May 15, 2024, from https://www.nidcd.nih.gov/health/age-related-hearing-loss
Where Denise receives care (Phoenix area): Hearing & Brain Centers of America
Disclaimer: The information provided in this article is for educational and informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment.
Denise Fisher is an occupational therapist with 40 years of experience working with people with disabilities. She has a master's degree in allied health education and served as an assistive technology specialist for 15 years in the public school system. Her emphasis has been on working with youth, focusing on incorporating assistive technology to maximize each person’s potential. She is the owner of Horizons Therapy Services, providing both treatment and professional training.
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