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Stages of Hearing Loss |
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Audiologists confronting hearing loss in people on a daily basis often find it baffling that vision loss can be immediately rectified with a doctor's visit or the purchase of glasses. However, hearing loss is often "lived with" or ignored for years after the first realization of the problem. This fact is especially amazing since vision loss just concerns the individual but hearing loss affects the whole family, often causing a profound interpersonal communication handicap. As one grandchild said to his grandpa, "Gramps, it would be so much more fun to talk to you if I didn't have to repeat everything." What makes this common attitude destructive is that many hearing losses are easily treated in the early stages. In addition, some hearing losses can signal another physical problem which needs immediate attention. Dr. Oscar E. Armero, an audiologist at the Miami Veteran's Administration, has identified six stages of grieving which may accompany a hearing loss. He states that a hearing disability or handicap cannot be predicted from a hearing test because many older individuals perceive the problem as a stigma affecting their self-image and often resulting in fears of inadequacy and aging. Stage one: DENIAL or PARTIAL DENIAL People in this stage often admit to having a communication problem; however they are convinced that it is not "bad enough" for intervention. They may assume that it is "normal" for an older person not to hear well. Unfortunately, as Dr. Sam Trychin says, physicians or other professionals may give erroneous and harmful information, such as, "It's only a mild hearing loss, don't worry about it unless it becomes severe." Or "nothing can be done for your hearing loss" (meaning no medical or surgical treatment will help but taken to mean by the patient that there are no remedies for the hearing loss). This stage of denial may persist for years, according to Armero. Married couples in crisis due to a hearing impairment frequently report years of conflict caused by the lack of adequate communication. The spouse or family members fall into the role of "hearing aid" for the person in denial by repeating or interpreting conversations which are not understood, or speaking in a loud voice, or isolating the family member. Stage two: ANGER Anger may follow or accompany the stage of denial. The hearing impaired person may project their frustrations and anger toward family members for "not speaking clearly" or "mumbling", a maladaptive behavior described as a displacement of responsibility. This anger may result in frequent family arguments, resentment, and other relationship destroying emotional conflicts. According to Sam Trychin, people who have hearing loss are often completely unaware of the effects of it on other people. Stage three: AWARENESS Awareness is often the stage which allows the hearing impaired person to confront the problem which is restricting his/her life. This stage is often the hardest to reach. Empathic listening of the hearing professional may help; but often, it is a life event when the hearing loss problem presents itself in such a way that it can no longer be ignored. One man told me that he realized "how bad" his hearing loss was when his boss turned away still speaking and he did not understand the message. Awareness often surprises individuals out of the stages of denial and anger. But how the person with the hearing loss reacts to this new awareness is very important. Stage four: DEPRESSION Depression often accompanies awareness because the individual is unsure of the solutions to the problem. The person may feel a specific sense of loss: loss of youth, or they may see the reflection of their restricted lifestyle and isolation caused by their hearing loss. Often just rephrasing the emotions of the person with the hearing loss and answering their questions by a sympathetic professional will empower this individual to make decisions which will dissipate the depression. Stage five: BARGAINING Bargaining may be a last ditch effort of the person with the hearing loss to avoid the inevitable as long as possible which is counter-productive to a rehabilitation plan. Bargaining can be helpful because it can provide the person time to overcome their emotions and transcend into the stage of acceptance. In this stage, the individual will say, "If YOU would not yell at me, I will...." Or "Ok, I will go get my hearing testing if you will....." etc. Stage six: ACCEPTANCE Acceptance signals the hearing professional and the family that the individual has overcome their denial of the hearing impairment and that they are willing to subscribe to the rehabilitation process. Hearing aids should be considered as only a partial solution to a hearing problem. In fact, hearing aids may not be appropriate to all people with hearing loss. Every person needs a comprehensive rehabilitation program which has been customized to that individual's communication needs. When a person with a hearing loss receives a comprehensive plan of action, it does not signify personal weakness. Rather, it demonstrates a willingness to confront a problem and work on the solutions together with the professional and family members. According to Dr. Armero, even a marginal hearing impairment in an older adult can result in reduced independence, decreased emotional well being, and other social limitations which are not seen in normal hearing individuals. They may show poor or unacceptable telephone habits, a loud speaking voice, embarrassment in public, and a lack of participation in social activities. Sometimes, the simple first step of a hearing evaluation is the step that will change lives. The Mid-East Tennessee Regional Speech and Hearing Center has prepared a Communication Complication Guide based on the different levels of hearing loss and how it affects communication. It is available FREE by sending a self-addressed stamped envelope to: The Mid-East Tennessee Regional Speech and Hearing Center, PO. Box 258, 391 Main Street, Dayton, Tenn. 37321 RECOMMENDED READING * The Consumer Handbook on Hearing Loss and Hearing Aids: A Bridge to Healing * Missing Words: The Family Handbook on Adult Hearing Loss * Coping with Hearing Loss: A Guide for Adults and Their Families * Coping with Hearing Loss and Hearing Aids
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