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Understanding Hearing Loss

By: Cindy Erdos, Au.D., CCC-A

Hearing loss can have serious consequences for individuals who experience it, as well as their loved ones.  We know that hearing loss has a negative impact on social, psychological, cognitive, and physical health.  Hearing is crucial to developing meaningful relationships and fully enjoying life.  People who cannot hear well are often cut off from their family, friends, and community.

seniors talkingAccording to the Hearing Loss Association of America (HLAA) approximately 48 million American have hearing loss; 30% of adults 70 or older have hearing loss; and 16% of adult 20-60 have hearing loss.  It is estimated that 1 in 5 America teens have some degree of hearing loss.

Based on this information, you should not be surprised to find yourself in a conversation with an individual with some degree of hearing loss.   Many people believe if you have a hearing loss, getting a hearing aid will fix the problem.  But not everyone with hearing loss is a candidate for hearing aids, and not everyone with a hearing loss is ready for hearing aids.  It may be a surprise to learn that hearing aids are not the only solution for individuals with hearing loss.

As an audiologist, I hear these types of comments from patients and family members almost daily:

  • “I don’t need a hearing aid, everybody mumbles”
  •  “I hear better with my glasses”
  • “Everyone yells at me so I can’t understand”

Let’s look at each statement to try understand what might be happening.

“I Don’t Need a Hearing Aid- Everybody Mumbles”

Understanding hearing loss can help us understand this comment.  There are two main types of hearing loss, conductive hearing loss and sensorineural hearing loss.  Conductive hearing loss is often hearing loss caused by a medical problem such as fluid in the ears or even wax in the ear.  Conductive hearing loss mostly affects how loud sounds are heard.  Conductive hearing loss typically can be medically corrected.

Sensorineural hearing loss is often caused by damaged nerve cells in the inner ear most commonly due to age, noise exposure or hereditary hearing loss.  Sensorineural hearing loss typically cannot be medically corrected and is most likely permanent. For many individuals starting to develop a sensorineural hearing loss, the low frequency sounds are heard at normal or nearly normal level (or volume), but they gradually start losing higher frequency sounds.  For understanding speech, high frequency sounds, or consonants provide a lot of meaning.

Besides the Listener’s hearing loss, another key factor that contributes to the “Everybody Mumbles” comment is caused by the speaker.  Many of us speak very quickly during conversations which causes us to blur our speech.  For an individual who is missing key sounds, conversational speech often compounds the difficulty understanding and can make it nearly impossible to follow the conversation.  Here are two examples of how conversational speech is delivered and received.

“The shiplef ona twowecruise.”   (The ship left on a two week cruise)

“We’re lookin for a whitruck tabuy.” (We are looking for a white truck to buy)

One of the most important things we can do when speaking to someone with hearing loss is to slow down a little bit, speak clearly, and pause between phrases or key words. 

“I Hear Better With My Glasses”

pexels-photo-432722.jpegAlthough only 30-40% of the English language is visible on the lips, most people, whether they realize it or not, speech read to some extent.  Relying on lipreading alone can be extremely difficult, but speech reading can be a nice supplement to hearing and understanding a conversation.  And fortunately, a lot of the consonant sounds that are difficult for many hearing impaired individuals to hear can be “seen.”  For example, “death” and “deaf”.  The sounds “th” and “f” look very different on the face.  Speech reading is more than simply lip reading, or using what you see on the speaker’s lips, it involves watching facial expressions and gestures to understand conversation.

When speaking with someone with a hearing impairment, remember they may benefit tremendously by being able to watch your lips as you speak. To assist them make sure you are within 3-6 feet; face them ensuring the visible features of speech are available; do not cover your mouth with your hands other objects; and make sure there is good lighting.  Remember, “I hear better with my glasses on” because I can see your face better.

“Everyone Yells at Me so I Can’t Understand”

Having hearing loss does not mean someone can tolerate sounds louder than someone with normal hearing.  There are a few reasons louder is not always better for someone with a hearing loss.  The first is due to something called “recruitment.”  Related to the damage to the nerve cells, all individuals with sensorineural hearing loss have recruitment.  Very simply, recruitment is when we perceive sounds as getting too loud too fast.   Just as loud sounds can be uncomfortable for someone with normal hearing, loud sounds can be very uncomfortable for someone with hearing loss.

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Typically, we yell or speak loudly to someone when we are upset or frustrated.  Speaking very loudly to someone with hearing loss can give the impression that you are angry with them.  No one enjoys being yelled at and it can make the person feel embarrassed about their hearing loss.

If you find yourself in a conversation with someone with a hearing loss, remember it “Takes Two to Tango.”  Your part is to deliver your message in a way to maximize your communication partner’s ability to understand.   Some key points to remember:

  1. Make sure you are within three to six feet from the listener
  2. Get the listener’s attention before speaking
  3. Make your face is visible and look at the listener
  4. Speak slowly and clearly, but do not exaggerate
  5. Louder is not always better

If you are concerned that you or a loved one may have hearing loss, contact an audiologist at Easter Seals DuPage & Fox Valley for a complete hearing evaluation and more information on communication strategies. For more information, visit: http://www.easterseals.com/dfv/our-programs/adult-services/.

 

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