Hearing Loss: The Silent Epidemic
According to the National Institutes of Health (2001), hearing loss is one of the most prevalent chronic health conditions in the United States, with approximately 28 million Americans experiencing a hearing impairment. Hearing loss affects people of all ages and across all socioeconomic levels. According to the Hearing Loss Association of America (HLAA), one in ten Americans has a hearing loss. Hearing loss among Baby Boomers has increased markedly; about 50 percent of those aged 45-64 have a hearing loss. The greatest incidence of hearing loss occurs in people over age 65, with some 30 percent or 314 of 1,000 adults affected. Although the incidence is lower, children also experience hearing loss, with about 17 of 1,000 children under the age of 18 affected.
Types and Causes of Hearing Loss: Conductive and Sensorineural
Hearing loss, which can range from a mild loss to complete deafness, may be caused by a number of factors, including aging, heredity, disease, trauma, medication, or long-term exposure to damaging noise. Hearing loss may be either conductive or sensorineural. In a conductive loss, sound is prevented from reaching the inner ear. This type of hearing loss may be caused by an infection, fluid in the middle ear, wax build up, or a damaged eardrum. A conductive loss can often be medically or surgically treated. A sensorineural or nerve hearing loss on the other hand is caused by damage to the auditory nerve or hair cells in the inner ear. A sensorineural loss usually cannot be reversed but the use of a hearing aid may be helpful. Sometimes a hearing loss can be both conductive and sensorineural.
Many individuals with hearing loss instinctively learn lip reading (or speech reading) to compensate for a hearing loss and to be able to continue communicating with others, especially within a family. Lip and speech reading is using what appears on a speaker’s lips, along with his or her facial expressions and gestures, to understand conversation. Training in speech reading is available and helps when people with a hearing loss can hear sounds, but are unable to discriminate speech, which is the key to communication.
To Better Communicate with a Hearing Impaired Individual
A few simple guidelines can help you better communicate with an individual who has a hearing loss. While these tips are not effective with all individuals, they can enhance conversation with most individuals with a hearing loss.
In order to better communicate with an individual with a hearing loss
- Make sure you have the person’s attention before beginning to speak (depending on the individual, you can address him or her by name or tap the person on the forearm).
- Use facial expression and gestures as well as speech when conversing.
- Face the person to whom you are speaking.
- Make the hearing environment as quiet as possible. Find a quiet corner of the room if possible and allow the person with a hearing loss to have his or her back to the wall.
- Speak clearly and not too rapidly.
- Repeat information when requested to do so.
- Be understanding. Mishearing information sometimes results in inappropriate responses. If a response seems inappropriate, repeat or clarify the information.
- Write out important instructions, directions, or information for the person with hearing loss.
Equally important in communicating with a person with hearing loss are things to avoid.
- Don’t exaggerate lips when speaking, which makes lip and speech reading more difficult.
- Don’t chew, eat, or smoke while speaking to a person with a hearing loss.
- Don’t cover mouth with hands (or pull on chin) when speaking.
- Don’t shout when speaking to an individual with a hearing loss. Shouting causes distortion of words and makes understanding speech more difficult.
- Don’t turn your back on the listener or turn your head to the side. Make sure your face is fully visible to the listener.
- Don’t change subjects abruptly. Context is important to a person with a hearing loss.
Be aware that individuals with a hearing loss sometimes have more difficulty understanding (and especially lip or speech reading) a person with facial hair (mustache or beard). A noisy background and conversations by more than two people simultaneously also make discrimination (understanding speech) more difficult. While most hearing people tend to re-phrase when asked to repeat, it is not always necessary. Understanding is not the problem; the information just wasn’t heard!
A wide variety of hearing aids, now available with sophisticated digital programming to automatically adjust to noise in the environment, may aid those with a sensorineural hearing loss. Generally, hearing aids can be worn behind the ear, in the ear, in the ear canal, or on the body. However, even the best hearing aid does not completely restore hearing in the way that glasses can provide “20/20″ vision. And while hearing aids can often improve hearing, they are quite expensive. Most hearing aids cost at least $1,000 and many are priced at $3,000 to $5,000 and require a special battery that runs about $1 each and has a life of 10 days to 2 weeks. Most people require two aids to balance sound.
Moreover, not everyone with a hearing loss can be helped by a hearing aid. Cochlear implants, which work with the brain to compensate for the auditory nerve, have been found helpful for individuals with severe to profound hearing loss who are not helped by hearing aids. American sign language, which uses the hands to communicate, is another option for individuals with severe or profound hearing loss or deafness.
Because the Baby Boomers are numerous and important (they might be your parents or grandparents), understanding how to more effectively communicate with those who have a hearing loss is imperative. Who knows? As you age, you too might be part of the silent epidemic.
