Refusing to Admit to Hearing Loss

I have been asked to address the difficulties people face when they begin to lose their hearing as they age, and especially the common reluctance of older people to admit to their hearing loss or their need for hearing aids.

This is such an important and delicate subject that it will require a longer essay than I usually write for this website. I hope you will be patient, especially since I need to start out at a point that may seem pretty far from the subject at hand.

When my son Michael was nine years old, he was devastated to learn that he needed glasses. "I'm going to look like such a geek!" he wailed.

Can you imagine how much more geeky he would have felt if he had been told that he was going to have to get hearing aids, too?

Fortunately, such dismay is not inevitable. I have a twelve-year-old friend who found out recently that he needs both glasses and a hearing aid (just one).* Since he is still growing, it will be a behind-the-ear aid, which is far more noticeable and awkward-looking than a tiny in-the-ear aid.

But my young friend James is taking the news in stride, even though as a twelve year old he is at what is probably a more socially vulnerable age, an age when a child's self-image and his status with his peer group seem to be particularly fragile.

I think part of the reason for James's equanimity concerning his need for glasses and a hearing aid is that he grew up in my home daycare. He came to me at two months and stayed with me until I ended my daycare ten and a half years later.

That means that James has always been around someone with a severe hearing impairment--someone that he loves and looks up to. As far as he is concerned, the fact that I wear hearing aids is just part of who I am. He has never seen me treat it as a reason for self-consciousness or embarrassment, and he has never seen anyone mock me because of my hearing aids.

My son, on the other hand, lived in two families as a child. He spent much of his time with me and his sister in my apartment, but they both also spent time with their dad and his current wife, plus a (step)sister and two half-brothers.

My daughter first got glasses at age six, and from that time on she was teased by her siblings at the other house. Her sister got glasses at age eight, and she too was teased. I would not be surprised if they were also teased at school. In fact, I'd almost bet on it.

So when Michael had to get glasses, he felt sure that he was going to be mocked for being, as the phrase was at the time, a "four-eyed window-head." As it turned out, he looked very good in glasses and actually got a lot of compliments. But his fears were based on what he had seen his two sisters go through.

Unlike my own children, who spent just over half of their nonschool time with me and the rest with their other family, James spent almost all of his nonschool time with me. Until he started school, he was with me fifty-five hours a week, and sometimes on evenings and weekends as well. Even after he started school, he was with me quite a lot. Furthermore, at his own home no one ever teased anyone about wearing glasses or anything like that.

Thus, when James found out he would have to wear glasses and a hearing aid, those instruments struck him not as marks of shame or hopeless geekhood, but merely as solutions to a couple of problems that had made it harder than it needed to be for him to do well in school. His positive attitude was quite obviously the result of the accepting attitudes he had observed all his life.

Such people go through life hearing normally--sometimes even better than normal. Then, and to them it might seem quite sudden, their loved ones are telling them that they're going deaf and need to get hearing aids.

From the family's point of view there's no problem. Or rather, there is a problem, but it's with Dad, or Grandma, or Uncle Bernie. They can't hear, and if they would get hearing aids the problem would be solved.

In the first place, his hearing loss has probably been quite gradual, so much so that for a long time he has just assumed that a lot of people were mumbling out of laziness or carelessness.

After awhile that could get pretty annoying, don't you think? Remember, now, he doesn't think his hearing has changed, but it does seem as though people are being rather rude. Maybe he even gets testy with them, demanding that they speak clearly and stop slurring their words.

As for the television set, it's easy enough to think that he's adjusting it to the same volume level he normally uses. If other people are watching with him, they probably won't say anything until the volume is turned up loud enough to really bother them. Unfortunately, at that point what they are likely to do is get angry, complain forcefully, and then lower the volume to suit themselves, so that he is unable to watch TV at all.

Very seldom are families prepared to deal compassionately with the awkward situations created by the gradual diminishment of one member's hearing. At first, both the person who is losing his hearing and those who must deal with him are probably not even aware of what is happening. What they are aware of is what seems from each side to be the rude, snappish, and inconsiderate behavior of the other
person.

By the time the rest of the family realize that Dad's hearing is going, a fair amount of ill will has already accumulated around the subject. Dad feels as though he's being picked on, and sometimes even that he is being deliberately excluded from conversations. And he might not yet realize that he is losing his hearing, though everyone else has figured it out.

But even if he does know, he might not accept the fact, and the potential reasons for such denial may be unexpectedly complex.

To start with, someone who has always had normal hearing may feel genuine grief over the diminishment of that sense. One of the books that Dr. Neil Bauman offers on his hearing loss website is called Grieving for Your Hearing Loss.

How appropriate! Most people would readily agree that someone would have reason to mourn a progressive loss of vision, especially if he could not know when, or even if, his vison would stop getting worse.

Don't forget, not only is Dad going deaf, he is probably going deafer, and at some level, conscious or unconscious, he is all too aware of that fact.

Besides, the older you are, the harder it is to adjust to drastically changed life circumstances. Even for those of us who have coped with a hearing impairment all our lives, it is not easy to deal with the social impediments created by our inability to follow conversations, television shows, movies, plays, lectures, etc. How much harder it must be for someone who has always fully and comfortably participated in such things to suddenly find that he is shut out from them.

As one whose hearing impairment has grown significantly more severe over time, I can attest to the pain this can cause. I have always had trouble at plays and lectures and even in classes when I was a student. But with a lot of effort and strategic placement at the very front of the room, I used to manage fairly well.

Not any more. It has been many years since I could go to a play, a lecture, or any other such event and understand even one word.

In September and October of this year, the university I teach at is offering a series of historical, linguistic, and cultural lectures on Ireland. I practically drooled over the brochure for the series, and I want desperately to sign up. But I won't, because I know I would not be able to follow the lectures. Even fifteen years ago I would have managed, but now there's no chance at all that I would be able to understand the speakers, no matter how far I turned up my hearing aids.

I encounter such frustrations constantly, especially on a university campus where all sorts of interesting intellectual and cultural events are going on all the time. Perhaps if I had never been able to attend such things I wouldn't feel like crying every time I see one advertised. But what inevitably happens is that I see the ad or the poster, I get all excited about it, and then I suddenly remember that I can't go. It breaks my heart, and it never gets any easier.

I am certain that it's far worse for someone who has never had to think about whether his hearing would be up to dealing with this or that situation. How could it not be cause for mourning?

So not only does Dad find himself more and more left out when friends and family get together, but he also finds that many things he used to enjoy are no longer available to him. He may not even be able to watch TV without upsetting everyone because he has it turned up too loud. No wonder he begins to feel isolated, alienated, marginalized--and very, very sad.

But what his family sees may not be the sadness. They might only get to see the part where he blows up and snaps at everyone for not speaking up or for whispering behind his back.

And by the time they are ready to broach the subject of hearing aids, he may already be too upset, sad, angry, and frustrated to want to hear a single word on the subject.

But there's even more to it than this. Remember my son Michael? He dreaded wearing glasses because he was sure that he would be teased about them. Where did he get this idea? By seeing how other kids were teased about their glasses (and probably by remembering how he joined in the teasing whenever he was someplace where he could get away with it).

Hearing loss is generally perceived as a sign of aging. Ours is not exactly a culture that treats aging as a positive, or even a neutral, condition. All by itself aging tends to marginalize and alienate people in this society.

Remember how Bill Clinton resisted the idea of hearing aids when he was president? He finally gave in, but it was obvious that he hated having to use something that marked him as "old." (Maybe he was afraid it would interfere with his ability to pick up young women.)

A lot of people refuse to admit that they are getting old. A friend of mine who became a grandfather at age forty-nine says he doesn't want the child to call him "Grandpa," because it makes him feel old. (By the way, he also needs a hearing aid, but of course he won't consider one. A grandchild and a hearing aid? Not likely!)

So the dread of getting old is sufficient to scare a lot of people away from hearing aids. And for some people (especially men, I think) there is also the fear of seeming weak or inadequate. Add to that the dread of being treated the way the hearing-impaired are typically treated--which, let's face it, is pretty awful--and you can see why Dad might not want to admit he needs hearing aids.

But even if he does finally agree to have his hearing tested, and even if he does admit he needs hearing aids, there are still problems.

First of all, many insurance plans don't cover the hearing test, while those that do may cover only part of the cost. And I have yet to see an insurance plan that actually pays for the hearing aids themselves.

My in-the-ear aids cost $1500 in 1994. I'm sure they'd cost more now, and the new digital aids are even more expensive. A lot of people avoid dealing with hearing loss simply because it is so expensive to get it taken care of.

Then, once you get those costly hearing aids home, there is still the problem of adjusting to them. People who don't wear aids have no idea what a bother they are. In several of my articles on this site** I go into some detail concerning the way hearing aids can distort sound, amplify background noise to the point of discomfort, and irritate the ears. And on top these disadvantages, hearing aids don't work all that great.

Most people who wear glasses or contacts get pretty much complete vision correction from their prescription lenses. But most people who wear hearing aids do not get comparable correction from their aids.

The humor page of my favorite deaf and hearing-impaired e-zine has this funny but painfully true line:

Thus, when someone gets hearing aids, he usually finds out that they are uncomfortable, annoying, and hard to get used to--and at the same time he is very disappointed to discover that they are much less helpful than he thought they would be.

Even worse, people with normal hearing assume that hearing aids fix everything. Just this past summer a coworker reacted with surprise when I asked him to speak up and face me directly so I could read his lips. "But I thought you wore hearing aids," he said. I told him that I do, but they only help a little, and I still can't understand speech unless I am very close to someone, he is speaking very clearly, and I can read his lips.

Unfortunately, though, once Dad has gotten his hearing aids, he is assumed to have lost the "privilege" of being hard of hearing. If he asks people to speak up, or if he turns the TV up too loud, history will repeat itself. His family members, knowing he has hearing aids, assume he can hear better than he really can, so they start getting impatient and snappish all over again.

And since everyone now assumes that all is well when he's got his aids in, they stop making any effort at all to help him understand or to include him in conversations.

Then, when he won't wear his expensive hearing aids, they think he is being a stubborn old coot, and they treat him accordingly.

So if someone in your family is starting to lose his hearing as he ages, try to understand how frightening and sad it can be. And try also to understand how much a reluctance to admit one's hearing loss may stem from the all-too-obvious contempt those with normal hearing typically have toward the hearing-impaired.

It may not seem like a big deal to you for Dad to admit that he is losing his hearing and needs to wear hearing aids, but I assure you that to him it is a very big deal indeed.