Aging and Hearing Loss

More than thirty -one million Americans are affected by hearing loss and fully two-thirds are over the age of 55. Among the great chronic health conditions of the 65 and older group, hearing impairments ranks number three, right after arthritis and hypertension. Fully a third of age 50-plus persons in the United States have hearing disabilities. Over age 70 the incidence of hearing disabilities increases to near 50 percent. Unfortunately, loss of hearing is more prevalent than ever in history, yet the gradual course of auditory aging is not the primary cause of this problem. What has changed in our society since 1960′ is the increasing acceptance of loud noise and loud music.

Hearing instruments have continued to advance technologically. The most revolutionary advancement is probably the “Open Fit” (also called open ear or open canal) hearing instruments, which are largely invisible to the observer and can be fitted to people with mild through moderately severe hearing losses. But this new design is especially friendly to seniors with characteristics audiograms that fall off in the high frequencies and physical handling difficulties experienced with some other types of hearing instruments.

Many older persons listen to music, although a hearing difficulty may interfere with their enjoyment. Since a typical hearing loss during the aging tears robs them of higher pitch sounds that are audible to normal hearing people, the hard of hearing tend to increase the volume in order to make the music more audible, sometimes to the discomfort of others. A problem with this adjustment is that when the music is made louder, lower pitch notes become amplified as well, and may register as being too loud for some listeners. Emphasizing just the high note emphasis, if such an adjustment is available on the television set, radio or stereo system.

Another factor that interferes with listening enjoyment is a phenomenon called “recruitment.” This is the abnormal growth of loudness that may occur among some persons with sensory hearing losses. They require special care in the selection of appropriate hearing aid characteristics.

It’s important to know that when you take charge of any sensory limitations with proper eyeglasses, hearing instruments, etc., you’re really taking care of your brain, the single most important organ in your body. When your ears transmit sounds to the brain as electrical impulses, it is the brain that actually hears. And when your hearing aid helps you hear high frequency sounds in music or in speech, there “new” sounds reach the brain and it immediately “plasticizes” the experience.

In its healthy state the brain is plastic, busying itself with establishing natural networks that represent your new activities. Aging behaviors, such as continually seeking comfort, being reluctant to try new activities, ignoring the changes going on around you, and adhering to the “old ways” of doing things fail to release the neurotransmitters that signal plasticity. You’re giving up and so has your brain. You’re on a downhill slope with no skis. In other words, you aging behaviors foster more aging.

Did you know that a loss of hearing might reduce your memory ability? The research going on by Dr. Arthur Wingfield and his colleagues indicates older folks with hearing loss take longer to process spoken messages. Part of the reason for this is that they expend time and energy trying to understand what is being said. Researchers believe that this effort may also impair their memory. They tested older adults with mild to moderate hearing losses and found that so much cognitive energy was spent on trying to hear accurately that they forgot what the message was all about. Even when aging persons can hear the words well enough to repeat them, their ability to remember these words was poorer in comparison to older person with good hearing.

This extra effort of straining to hear during the initial stage of speech perception uses up processing resources that would otherwise be available for transferring the spoken words into our memory. Dr. Wingfield called his study a wake-up call to anyone who works with older people should speak clearly and pause between “chunks” of meaning without dramatically slowing down the speed of talking. The objective is to provide the hard of hearing person with clearer speech and greater time to understand and remember.

Other Influences that Affect Hearing
The amount of hearing loss that we accrue in growing older can be compounded by the consequence of exposure to other events or agents that damage our hearing mechanisms from infancy onward. There include noise exposure, diseases, high fever, head injury, toxic chemicals and drugs, blood supply deficiency, lack of oxygen and genetic influences.

While the Occupational Safety and Health Administration (OSHA) has required noisy industries to provide ear protection since 1970, this partial solution came too late for many who are now retirement age. We live in an industrialized society where noise is seemingly omnipresent. We were endowed with eyelids to keep out most light while sleeping but no “earlids” to suppress background noise sources that are pervasive in our homes. In fact, we are indeed fortunate if we can sit in the quiet security of the living room, close our eyes, and hear nothing.

Improving Your Listening And Hearing Skills
For most of us with hearing loss, its simply a pain, one whose impact we’re constantly trying to overcome or minimize.

We don’t approach the world as “heard of hearing” people, seeking acceptance as a separate social entity. On the contrary, we’re trying not to make the hearing loss a defining element of our personal identity; we do this, not by ignoring it, but by striving to reduce its impact in our lives. To realize our goals of continued engagement with society- with our friends, family, jobs, and interests- we employ all the technological tools we can, i.e., hearing aids and other hearing assistance devices. And we use various communication strategies to reduce the inevitable consequences of hearing loss.

“Communication Strategies” meaning any activity that might increase your ability to understand speech, either generally or in particular situations, not just technological solutions. Of course technology is a key consideration, but the adjustment process doesn’t end there. There are other things you can do to improve your ability to communicate in different situations. When you purchase hearing instruments, you depend upon the hearing health care provider’s expertise to help in making the proper decision. When it comes to communication strategies and making the best use of all types of hearing technology, you have to take the major responsibility. The concept of personal responsibility for your own action underlies the three recurring themes stressed throughout this article: acknowledgment, Assertiveness, and communication strategies.

Acknowledgment
The fist and indispensable step in practicing effective communication strategies is to accept the reality of the hearing loss. Unless and until you can acknowledge its presence, openly and in a matter of fact way, you’re always going to be limited in how effectively you can deal with it. A hearing loss is not something to be ashamed of; its not a stigma that has to be hidden. Its presence does not diminish you as a human being. By denying or projecting your hearing difficulties onto others people’s mouths (“people don’t talk as clearly as they used to!”), you fool only yourself. The point is worth emphasizing. The hearing loss is there. Magical thinking, denial, not “wanting to talk about it,” will not make it go away. If you don’t face up to this reality, unpleasant as it may be, you’re condemning yourself to a life unnecessary stress, anxiety and isolation.

What makes hearing loss particularly difficult for older people is that, initially, they’re truly not aware that a hearing loss may be the main reason they’re having communication difficulties. They can’t very well deny hearing sounds that they’re not aware of! This is the point where many of the conflicts between the hard of hearing person and his/her significant other first arise. It’s not so much denial as disbelief; they know there are times when they can bear well. After a while, of course, the effects of the hearing loss become apparent to everyone, including the person involved. If these are ignored, then someone can truly be said to be “in denial”

Assertiveness
After you’ve acknowledged the hearing loss to yourself and to others, you’re then in a position to assert your communication needs in various kinds of situations. “Assertiveness” is a concept that underlies many of the specific steps. You must be willing to inform and educate others about what they have to do in order to make it easier for you to hear and understand. It may be as simple as asking the waiter in a restaurant to turn down the background music or to provide you with a written version of the day’s selections, or as involved as arranging the seats at a meeting.

Being more assertive about your listening needs by asking others to modify their behavior does not come naturally for many people. It may mean changing the habits of a lifetime, but it can be done and it can be quite liberating. Of course, you don’t have to take giant steps in the beginning. Even little ones, as long as you take enough of them, will eventually get you to your goal.

Note that you can be assertive about listening needs without being aggressive or hostile. ” Would you mind talking a little louder? I have a hearing loss and that will make it easier for me to understand you,” will get better results than, “Would you get the mud out of your mouth when you speak to me!” When we assert our hearing needs, we’re saying to somebody, “yes, I really do want to communicate with you.”

Communication Exchange
Both you and the person with whom you’re talking are equally involved in a communication exchange. Presumably, this person wants to be understood as much as you want to understand. Unlike a monologue, a conversation is a two-way street. When you suggest that a seating arrangement be modified, or you inform your conversational partners what verbal modifications to make so that you can better understand them, it’s as much for their benefit as it is for yours. When you work with and help other people communicate more effectively with you, both you and these others benefit. So, acknowledge your hearing loss, be assertive about your hearing needs, and know that you are a critical half of any communication interchange.