I had an interesting experience yesterday that brought home the reason why we always ask for a family member to attend a hearing test. The Patient scored themselves very lowly on their hearing handicap form, while the family member scored them rather highly according to their perception of what was going on. When I began to discuss this with them, it was obvious that there was a large disparity between how good the Patient thought their hearing was and what everyone else thought. The reason why is relatively simple and it isn't the most obvious one of pure denial, there is a bit more going on than that. Let's talk about why.
Hearing Loss is a Family Sport
Hearing loss affects every member of the family, not just the person who suffers from it. Communication is a problem, often frustrations creep in. Family members may feel that the person with hearing loss is in denial or just ignoring the impact of the hearing loss. If the person with hearing loss has withdrawn from their social circle, family members may be concerned about their well-being. Hearing loss tends to have an effect on the entire family.
Denial is Not Just A River in Egypt
A great old Dublin saying, "De Nile is not just a river in Egypt", usually uttered as someone shakes their head and throws their eyes to heaven. There is a lot of talk about denial in hearing loss and there is certainly an element of denial involved in many cases. However, denial is fed by a misunderstanding of how hearing loss works.
Cultural Understanding of Hearing Loss
Firstly, most people really don't understand how acquired hearing loss works or how it will affect someone's ability to hear. Most of our understanding of hearing loss is formed by TV, Radio and Theatre. In that world hearing loss is not just something to laugh at, it appears to be all about raising the volume. "Speak Up, Speak UP, What Did You Say?" It is all very Monty Pythonesque.
Hearing Loss is Rarely About Pure Volume
Run of the mill acquired hearing loss is very rarely about volume, it is nearly always about balance in sound. In fact, hearing loss that is about pure brute force volume is quite rare and it is usually something that is present from, or related to something, from birth. In normal, run of the mill acquired hearing loss, there is an imbalance in the ability to hear sounds. Some sounds can be heard quite well or even normally, while other sounds may not be heard at all. Ruth Kirkham, one of our contributors here on Know, talks about her own realisation about hearing loss here.
I Can Hear The Voice!
Quite often, someone with hearing loss can hear someone's voice very clearly, they just can't really understand what some of the words are. If you think about that for a minute, you can see why it is easy to think that the problem is, in fact, the speaker, not the listener, if they can hear the voice, surely the problem is that the speaker isn't speaking clearly enough?
The actual problem is that more often than not, someone with hearing loss can't hear consonants in speech. So basically words sound indistinct and mumbled. The person isn't mumbling, you just can't hear them properly. However, you can see why it is easy to think that the problem is the speaker rather than your own. That is in fact why people take so long to realise they are having problems. It is also why they are loathe to release the idea that it isn't them, it's everyone else.
Helping You Make a Realisation
When family members attend a hearing test, they will often help their loved one towards a realisation in relation to their hearing ability. It is the family who really understands the effect of hearing loss on the person who has it. They see and understand when there are problems, even clearer than the person who is suffering them. Don't forget, as a person with hearing loss, you don't miss what you have missed. Or to put it another way, you don't know what you don't hear.
People around you do. While you may be unsure about the depth of the problems you are having, the people around you tend to see them clearly. I have often witnessed a Patient come to a clear realization of their problems simply through the testament of a family member. Quite often, it is the first time that the discussion about their hearing loss is undertaken in a clear and focused manner.
More often than not, it also leads to the sharing of worries that have been unsaid. Concern that has often been unvoiced.
Keeping You Honest
The other thing that a family member will often do, is to keep you honest. I have spoken elsewhere on the site about not fooling yourself. As I said, family members tend to see what is really happening and generally aren't afraid to give you the unvarnished truth. Nor are they afraid to speak up when you are lying to yourself.They have a way of telling you how it is. I find the reaction to hearing loss a very strange thing, it seems to be one of the few health issues that are surrounded by personal stigma.
Hearing loss is not a statement on you, it just is!
People will outright lie to themselves about their ability to hear in order to protect themselves from the thoughts in their heads! It never fails to surprise me, I have said it before, and I have no doubt I will say it again, hearing loss is not a statement on you, it just is.
Helping Them Understand
Your family doesn't really understand hearing loss any more than you do. Attending the appointment will also allow them to understand the issues. It will also allow them to become familiar with your hearing loss and the effects it has on your ability to communicate. The hearing test will make it very clear to them exactly what the issues are and why you have the problems you do.
If you move forward with hearing aids, the involvement of your family with your ongoing rehabilitation plan is important. They need to understand the advantages and limitations of the hearing aids you have chosen. They also need to understand how they can help you, especially during the early stages of rehabilitation.
A Better Understanding of Progress
As you move forward with hearing aids, family members can also help to assess your progress. They can also help identify areas where you are still having issues with your hearing. I love when family members are involved in the process, they are a secondary source of information which allows a full picture of what is going on. They are also a validation of the problems. Let me explain that.
When someone has an issue hearing they automatically think it is their hearing loss and the fault of the hearing aids. Sometimes, it isn't. There have been times where a Patient has spoken about problems with a particular situation or a particular person. The family member has chimed in and said, I hadn't a clue what they were saying either! Or I couldn't really make it out with all the noise going on either. In essence, if they can't hear, neither should the Patient be able to.
In contrast to that, some Patients may think they are doing pretty well in some situations and the family member may be able to point out where there are some deficiencies. All in all, the inclusion of the family in the process has to be seen as a good thing for both the Patient and for them.
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Posted by Geoff
Geoffrey (Geoff, anything else makes him nervous) Cooling is an Irish hearing aid blogger and has been involved with the hearing aid industry for over ten years. He has worked in private practice dispensing hearing aids and as a manufacturer's rep. He has written two books and they are both available on Amazon. He loves technology, passing on knowledge and is legendary for many other things, primarily the amount he curses, his dry and mischievous sense of humour and his complete intolerance of people who are full of themselves. Please feel free to connect with him
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