Hearing loss and Stigma

Last week (on LinkedIn), I shared some of the reasons why not getting support for hearing loss can be so harmful ( isolation, increased risk of developing dementia etc).  This week we explore some of the reasons why people choose not to get support for their  hearing loss. 

• Stigma- quite complex 
• Lack of self awareness on how their hearing is affecting them and/or are in denial of change.
• Anxious about whether hearings aids will help them
• Technology is too complicated 
• Costs

Stigma 

There is still a perception that hearing aids or other hearing equipment are not cool. This is sad because wearing glasses does not have the same stigma and so many people walk around with equipment in their ears because they are listening to music or talking on their mobile phones. It is helpful to make wearing hearing aids like glasses or headphones which enable individuals to take part in activities that are important to them. It may also be useful to explain how hearing aids work and how hearing aids can protect their cognitive health. 

We do NOT need to promote small hearing aids as such but whatever equipment is right for them. Hearing aids and/or other hearing equipment need to be manageable for dexterity and functionality. 

In education and employment any jokes or rudeness about hearing aids/equipment should be discouraged. It is not acceptable given the harm this does in the uptake of hearing aids. 

We know in the UK up to 6.7 million would benefit from hearing aids but only 2 million use them. This illustrates that we have a long way to go to encourage  people to wear hearing aids in the same way as glasses are routinely worn.

Stigma has not been helped by the medical model of disability.  We need to respect choices and recognise that some people do not get the same benefits from hearing equipment but it is important that individuals are able to make informed choices. The timing needs to be right too. 

Lack of self awareness 

Hearing loss can come on quite gradually. Therefore, for some this makes it more difficult to notice the loss and its impact.  A common statement that reflects this is “ my hearing isn’t that bad”.  Even with people whose change of hearing is more sudden they may resist support because the change has been a shock. This can lead to denial/anger (not too dissimilar to grief cycle) which results in not accepting help.

This is where family/friends/professionals can help. Encouragement through highlighting the benefits of getting support:

• Strong relationships with people is easier when both the individual and their friends/family can hear each other.
• Able to hear the TV better without increasing the volume so much we disturb our neighbours.
• Continue going out to places they used to enjoy to go to but had dropped because they no longer enjoyed them now that they were hard of hearing.
• Enable them to hear better in the workplace which could reduce misunderstandings.
• Revisit support options when person is ready or at acceptance stage (see below)

Anger and Denial: 

Anger and denial are normal emotions when anyone experiences significant change. We need to be supportive of friends/family/colleagues in these stages. Often just a listening ear helps and by providing information for later. It is important that the information is revisited to help individuals to identify the different choices available to them.

 Encourage them to explore the different options for themselves. Providing some information can help individuals to research more. There may be other options not considered. Individuals are more likely to take ownership if they take on the ideas themselves. Work with these individuals when they have moved to the acceptance stage. 

I believe this is another really important factor in the low uptake of hearing aids and/or hearing equipment. People are often offered advice and support at the wrong time. I know personally I really struggled to accept help when I had a change of hearing from severe to profound loss. I was not ready to explore the different options available to me. I was lucky to have an extremely supportive husband, who did some research and found some practical tools that helped me. When I was ready, he then shared and explored with me further options that I could look at. 

Anxiety

Anxiety about whether hearing aids will help.. This is something where again we can all play a role.. Encourage your family member or friend to see an audiologist to have an audiogram. Go with them if they are anxious. The tests will identify what would help. Not everyone needs or will benefit from hearing aids but may benefit from other support and equipment. 

Do your research.  Read testimonials, chat to others who have used the service, and get recommendations. Even when using a private supplier , there should be options to trial hearing aids to check suitability and to test them in different environments. 

If using the NHS all hearing checks and aids are free. I personally, as a severely deaf person, have never had any problems with the hearing aids provided over the years. The choices were sometimes less. Perhaps for some levels of hearing loss, going  private could be better. For example, bluetooth technology is fantastic and is offered more frequently when equipment is purchased privately.  

With my change of hearing, I now use a cochlear processor which again is from the NHS. The choices there are not much different to private ones though private clients have the option of both ears which is not offered for adults on the NHS.  But you have to think long term- processors need replacing so it is not a one off cost. 

Hearing aids do help- but with differences:

Hearing aids and other hearing devices are unlike glasses because they will not correct hearing to the same as before. Nevertheless,  they do boost speech sound as close as possible to the areas of loss that need boosting. Hearing through hearing aids is a different experience and improves hearing with persistence and practice. 

The ear and the brain need to adapt to different noises. Therefore, it is worth trying them in different settings. Too often the hearing aids are taken off where there is background noise. You will always notice background noise more than before but in most circumstances you can learn to cope. This is why learning skills such as lipreading can help. Some may choose to learn sign language. Friends/family/colleagues can  also help by asking venues to turn down background music where possible. 

Providing choices here is key. With children I believe sign and lipreading should both be offered. This is important for the development of the visual and auditory processing parts of the brain.  Acquiring a language is critical in the first five years. They will pick up what is right for them. 

All hearing devices whether cochlear , bone conduction etc will require practice and patience at learning to hear sounds in a different way. 

Costs, “I can’t afford them”:

Costs put some people off but from many studies it is clear that this is not the biggest factor. For example, in Norway with the highest uptake of hearing aids and where aids are free for everyone still only 42.5% of people who would benefit wear them.

Private purchases can be made affordable like glasses/lenses with monthly payments. Costs should also be given with the wider context of the benefits individuals gain from wearing hearing equipment. 

In the UK Access to Work provides funding for hearing equipment in the workplace. 

Summary

• Encourage hearing checks earlier rather than later
• Share the benefits of support with hearing with things that matter to that person. 
• Support at the right times and ongoing when needed.
• Discourage and challenge any negative comments about hearing aids/equipment
• Be an ally
• Encourage practice and support individuals with their new hearing devices in different settings. 
• Choices – eg sign language and lipreading are both important for communicating. 
• Provide information- NHS and Private for individuals to make choices.

To find out more about hearing loss and how to improve access for individuals in all settings – call or email rachel.barber@living4moments.com