How Hearing Loss is Isolating
Many people with hearing loss often suffer from isolation due to the difficulty they experience trying follow conversation. This isolation can be gradual like the insidious nature of hearing loss itself.
Our high frequency hearing sensitivity typically declines first. This is usually due to natural physiological changes and mechanical ‘wear and tear’ of the auditory system as we age. It can be exacerbated by noise exposure and chemical agents.
The term ‘Presbycusis’ is used to describe natural age related hearing loss. This is largely a type of inner ear nerve related (sensori-neural) hearing loss that commonly occurs with age. This high frequency hearing loss initially impacts our ability to follow conversation in any environments with competing background noise. This is because the ‘unvoiced’ consonant sounds of speech have relatively low energy levels that diminish quickly across distance and are easily masked over by background noise that carries more energy. You may hear the deeper lower frequency vowel sounds ok because their energy levels are relatively high and they occur in the frequency range where the hearing sensitivity is better. However, the high frequency speech sounds which carry most of the speech information is lost.
The following Audiogram shows an example of a high frequency hearing loss in which the hearing sensitivity clearly dives beneath the higher frequency speech sounds (shown in red) occurring at average conversational levels.
The soft consonant sounds of speech typically occur at the beginning and ends of words so they carry lots of information helping us differentiate words from one another, singular from plural et al. People with good low frequency hearing sensitivity that mainly have hearing loss toward the high frequencies often perceive people to be “mumbling” more than they actually are. In my clinical work, we often hear people say “my spouse is particularly softly spoken” or “kids these days just don’t pronounce their words properly”. It can also give an individual with high frequency hearing loss the false perception that their hearing is good because they can hear a car engine revving a kilometer down the road even when their partner with supposedly ‘normal’ hearing can’t.
Examples of environments with competing background noise that commonly pose communication difficulty include; outings to café’s, restaurants, family gatherings, sports clubs (golf, bowls club etc.) Bridge clubs, Probus meetings, Church social gatherings and many more. People may not be fully aware that their level of enjoyment of such places is being effected due to communication difficulty. They may gradually develop avoidance tendencies due to negative feelings such as embarrassment of misinterpreting what’s being said or worry about seeming uninterested or disengaged from conversation. It may even subconsciously just seem easier not to go. It really can be a progressive negative spiral into social with drawl and isolation.
Even those people who have hearing aids may still have challenges in certain situations, especially if they haven’t been programmed optimally or the wearer hasn’t been coaching in their effective use and management for different environments.
But, here are some strategies and tips that can be implemented to alleviate or minimize these challenges so everyone can enjoy social events.
These tips will make it easier to communicate with those who have hearing loss:
1. Because most hearing people with hearing loss lip read to some extent, try to face them when you are speaking to them. Avoid covering your mouth or eating when speaking. I know not always practical in every day domestic life, but please at least try to avoid speaking into the fridge or kitchen cupboard lol.
2. Make sure you have their attention before you start to speak. Call their name and pause to see you have got their attention before delivery what you have to say.
3. If after several attempts the person you are speaking with still can’t understand what you are saying, try to rephrase your sentence.
Some words are more difficult to make out than others, sometimes just using different words will make it easier for them to understand you.
3. When entertaining at home there are several things you can do to make communication easier;
a) Arrange the furniture so the person with hearing loss is sitting close to everyone and can face them.
b) Keep the lights turned up so they can easily see the people they are talking with and
c) keep background noise to a minimum.
4. If you are going to a restaurant find one that is more acoustically friendly i.e. quiet. A lot of modern restaurants have poor acoustic design with their reflective hard surfaces creating reverberation and as my mother says “awful doof doof” music. There are still some classic style restaurants with carpeted floors, drapes, table clothes and other sound absorbing materials that are conducive for more intimate conversation, where people aren’t trying to out yell one another in a venue that’s trying to sound more popular than it really is. A sports bar may not be the best place since they are usually very loud. Also, eating out at off peak hours will lead to a less noisy environment.
5. One last tip, even though you may feel it is past time for your loved one to acknowledge their hearing loss, it may be best to hold off on any interventions until you can talk to them in a private setting.
There are many fears and mistaken beliefs associated with hearing loss and hearing aids.
It is important to learn the truth so you can make an informed decision about how best to deal with hearing loss.
If you or a loved one need help with hearing loss and you’re not sure how to broach the subject please feel free to call me. I’m happy to provide you with tips and information to help make the conversation easier.
Andrew Mackendrick (Audiologist)
Harmony Hearing & Audiology