Most people that live with a hard of hearing (HOH) person believe that 100% of the communication difficulties in their world come from the person who has a hearing problem. This leads to the prevalent belief that once a HOH person is fit with hearing aids (HAs), the problem will simply go away. They will be able to talk from another room, they will be able to communicate perfectly well in the car, while doing the dishes, with their back to the listener, or when they are surrounded by background noise. Unfortunately, this is simply not the case. A hearing loss is a very complex thing, and while HAs are part of the solution, they do not give back a person’s natural hearing. A major part of being a successful HA user is an improved approach to communication from BOTH the hard of hearing person AND the people who speak with them. This article will attempt to outline some common conversational pitfalls and shed light on the difficult world a HOH person lives in every day.
When working with my clients and preparing them for the difficult journey that is hearing with HAs, I often hear the partner/spouse/family/friend say things like “I can’t wait until you get HAs so I don’t have to repeat myself anymore.” This can create a really troublesome starting point for all parties, as there are unrealistic expectations present even before we begin the process. Sure, the communication partner should definitely have to repeat less, conversation should be easier, the TV should be turned down lower, but HAs do not give a person back the hearing they had as a teenager. The vast majority of hearing loss comes from nerve damage, and HAs do not repair nerves. HAs function to amplify incoming sound, which gives your brain more volume to try and sort out what words and sounds mean. This improves a person’s hearing ability, but it does not correct all the problems that come from having a hearing system working with less than 100% sensitivity due to nerve damage. Here’s an analogy, if you lost three fingers on each hand you would be hard pressed to do many things that are simple right now. However, if you put on a pair of gloves, it would look like you have all 10 fingers, and people might assume you could do everything with your hands that they could. A person with hearing loss doesn’t have all their fingers (per se), so we can’t presume they’ll automatically revert to being a perfect communicator as soon as HAs are placed in their ears.
If you’ve read my other Choices After 50 articles then you might remember an important topic I previously discussed, the learning process of hearing aid use. As we are dealing with a deficient system, we cannot expect it to perform at 100% capacity right from the start. We have to gradually introduce the sound and allow the HA user to adjust to hearing through artificial amplifiers. If we provided the user with too much sound all at once, then they would be overpowered by noises in the world around them and likely reject the HAs. This gradual process of acclimatization can take 6 months (sometimes even longer), and how appropriately we increase the sound typically goes hand-in-hand with how successful a HA user they will become. Thus, it is very important for those people communicating with the new HA user to be patient, and understand it takes time to become proficient with these unnatural devices. HAs work if they are fit properly, worn regularly, and if consistent follow-up appointments are made to gradually adjust the sound being directed into their ears.
Perhaps the most important factor in being a successful user is wearing the HAs regularly in a variety of environments. Regularly wearing HAs is rarely something any man/woman wants to do, but it is the most critical element of success. Family/friends/ spouses often get on the HOH persons case to “go and get a pair of HAs,” so WE ALL want them to be used on a consistent basis. However, if things don’t immediately change to the liking of the communication partners, they sometimes badger the HA user to the point that the user gets frustrated and gives up, puts them in the drawer or returns them, and no one is any better off. I sometimes hear users tell me their wife/husband says “What’s the good of those HAs, you still can’t hear me.” Yet, many times they are speaking from another room, or with lots of background noise around. We (myself or the hearing instrument practitioner as well as the HA user) needs you to be patient, and not curtail the process by insisting upon immediately perfect results. We have a 90 day trial period to work out the kinks, but this is much more difficult if we don’t have the support of family and friends. If we can’t make them happy users then we will gladly take them back and refund your money. ALL hearing aids come with a trial period and you CAN return them if it’s done within the trial period. But, that assurance aside, the most important component of this paragraph is that we need those communicating with the HA user to support their use of the products and encourage them to keep using them. They WILL become better users if we work together, but if we aren’t all on the same page then no one is any better off.
In this paragraph, I would like to outline some of the things a communication partner can do to help a HOH person hear what’s being said much clearer. First off, it is very important to get the HA users attention before speaking to them. If you start talking and their focus is on something else, then they will likely miss the beginning of what you said and have to ask you to repeat it. It’s easier to say their name, get their attention, then start speaking, they should hear you much better. Another common example is in the living room when the television is turned on, perhaps the lights are turned down, and where you’re looking at the TV and not the HA user. The TV is a distracter, the lights make it hard for the HA user to see your face, and they aren’t paying complete attention to what you’re saying. Thus, get their attention, tap them on the leg or say their name, and then begin speaking. You can also mute the television or turn up the lights to give them an even better chance of hearing what’s being said. Most HOH people cannot hear people from another room, which is a factor of having hearing loss and not something HAs or surgery can typically correct. So, make it easy on both of you, go into the same room as the HA user before asking your question or saying what you intended to say, there’ll be fewer communication breakdowns and everyone will be happier. People regularly say that talking in the car is quite a challenge, so here’s what you can do. Turn down the radio and fan (removes extra noise), put up the windows (removes interference from the wind), and look straight ahead or towards the person when speaking. I often hear “I do OK in the car unless my wife/husband talks to me while looking out the window.” They will struggle to hear unless you take the steps to make it easier for them, and these examples will hopefully illustrate how you can improve that. In general for all environments, decrease the noise, decrease the distance between you and the HOH person, and get their attention before speaking, you’ll be less frustrated in the long run if you do.
I hope this article helps you to appreciate some of the difficulties a HOH person has in our world. This world is LOUD, and people rarely follow all the best rules of communication (i.e. face the person, speak slowly and clearly, sitting in a quiet environment). This is an unfortunate fact of our world, but we can make subtle manipulations to help the HOH population hear more effectively. The HOH person has done their part by getting HAs, now it’s your turn to play ball and communicate more appropriately to afford them a better chance to hear. It is not easy to get used to HAs, it requires patience and commitment to a long process that most people are not excited to undertake. But, with hard work by the audiologist/dispenser, support from the family/friends, and consistent use by the HA user, we are successful much more often than not. I challenge you all to do your best to help the HA users in your life to hear better. After all, they got the HAs because everyone said they had a problem hearing, so now you need to take responsibility for speaking in a more appropriate fashion. Good luck and happy hearing!!
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