Nearly one out of four Canadian adults has some form of hearing loss, a condition that can negatively impact physical and emotional well-being. So why are we reluctant to talk about it?
A few years ago, my almost-daily check-ins with my now–63-year-old mom shifted from phone calls to text messages. At first, I didn't think much of it; I assumed it was for convenience or because she finally got the hang of her smartphone. But when I learned she'd been fitted for hearing aids last winter, it dawned on me that our modern method of communication might have more to do with the fact that she'd lost 30 percent of her hearing—a revelation that was news to me.
Perhaps I shouldn't have been surprised. A 2016 Statistics Canada survey found that 78 percent of adults aged 60 to 79 have some form of hearing loss, as do 40 percent of adults aged 40 to 59. The kicker? About three-quarters of adults with hearing loss don't even know they have a problem. What's more, it takes seven years, on average, for affected individuals to seek treatment once they realize they have a problem, says Rex Banks, a Toronto-based audiologist and director of hearing health care at the Canadian Hearing Society.
A lack of understanding around hearing loss is partly to blame. "The definition is the diminished ability to hear sounds," says Mae Hernandez, a Victoria-based audiologist at Connect Hearing. An impairment can be partial or slight, making it difficult to detect, says Hernandez, adding that these milder cases are often downplayed as an inevitability of aging, rather than a condition that can be treated and improved. There's also no real indicator of whether you're at risk. Certainly, age and genetic predisposition can play a role, and noise-induced damage is something that can be protected against, but hearing loss often results from a combination of factors that are hard to isolate or pinpoint.
So how do you know your hearing is impaired? One indicator is difficulty understanding speech, particularly in noisy environments. "Lower frequencies let us know someone is talking to us," says Banks, "but higher frequencies bring clarity and meaning to sound." Higher frequencies are the first to fade with hearing loss, interfering with communication. You may find yourself asking people to repeat themselves, trying to read lips, increasing the volume on televisions and audio devices or—you guessed it—avoiding phone calls.
My mom's turning point came when she realized she was reading lips and gauging reactions to determine how she should respond in workplace conversations. "I thought, This isn't right; they could be telling me something horrible or something good," she says. "I can't avoid colleagues coming into my office to tell me things in confidence. That's when I realized I needed to do something about it."
Overwhelmingly, the best course of action is a hearing aid. "Ninety-five percent of hearing losses can be solved with a hearing aid," says Banks. And yet, the adoption rate is only 20 percent. Why? Hearing loss is considered a problem among "old people," so many feel they're too young for a hearing aid. There can also be a sense that the condition hasn't progressed enough to warrant treatment; people tend to wait for hearing loss to start concretely and negatively affecting their day-to-day lives before seeking help. (This was true of my mom, who saw warning signs as early as three years ago but didn't see an audiologist until her ability to understand and connect with her colleagues was impacted.)
Despite these reasons, the low adoption rate probably has more to do with the negative stigma associated with hearing loss. "People would rather get eyeglasses, take medication, use a walker—anything but wear a hearing aid," says Banks. This is partly an issue of vanity (unlike glasses, "there's nothing attractive about a hearing aid," says my mom), but it's also because people are afraid of appearing old or not in control of their faculties. On the contrary, the poor communication and inappropriate responses that result from forgoing a hearing aid are likely to make you seem less in control than the presence of one ever will. Even more troubling, an inability to effectively communicate can cause feelings of frustration, as it disrupts the natural flow of conversation. "Clients often report that their hearing loss is embarrassing and isolating," says Hernandez, who notes a link between untreated hearing loss and the development of both dementia and depression, which can result from reclusive behaviour brought on by the condition and the associated stigma.
To make matters worse, eschewing a hearing aid in the early stages can make it more difficult to adopt one later on. "The longer you deprive your brain of opportunities to sort through different types of sounds, the harder it will be to get used to wearing a hearing aid," says Banks. "That's why early intervention is key." Regardless of when you start wearing one, there's always a learning curve. "When I first started wearing them, I absolutely hated it," says my mom. She, like other hearing-aid users, had to adapt to both having an object in her ear all day and hearing sounds that she hadn't been hearing. But the adjustment period is temporary. "The goal is that, in a period of three to six months, your brain is accustomed to hearing sound again," says Banks.
The good news is that hearing aids can make all the difference. "A lot of research shows that most people—more than 90 percent—are really helped by hearing aids," says Banks. "Satisfaction is higher now than it's ever been." While my mom is still in that acclimatization period, she's well on her way to joining the 90 percent. "Just the other day, a client called me, and I felt OK, so I picked up the phone," she explains. "And he said, ‘You're one of the few people who actually picks up the phone; most people just tell you to text.' " She pauses thoughtfully before adding, "I almost didn't pick up, but now I feel comfortable enough that I can."
If you want to support a loved one with hearing loss…
1. Offer reasonable repetition and clarification.
2. Face your loved one when speaking and use a clear voice.
3. Include him or her in conversation to help prevent feelings of isolation.
4. Learn and understand how his or her hearing device works and how it needs to be maintained.
5. Accompany your loved one to appointments or information sessions to learn more.