The Social Implications of Hearing Loss

According to the National Council On Aging, hearing loss is the third most common chronic health condition in the United States. By 2060, the number of people experiencing it is projected to double. Unaddressed hearing loss can have a detrimental ripple effect, impacting relationships with friends and family members and daily activities. Thankfully, there are actionable steps people experiencing hearing loss and their partners can take to cultivate social connections.

Hearing loss that occurs gradually as a natural progression of the aging process is known as age-related sensorineural hearing loss or presbycusis.

Stephanie Jaffe, an audiologist at HearUSA in Augusta, Georgia, explains that this results from "the wear and tear within the hearing organ itself." The cochlea, an inner ear organ, contains hair cells that convert sound waves into electrical energy that is transmitted to the brain and received as sound.

"Sensorineural hearing loss can be a result of these hair cells becoming fewer and shorter, causing a disruption in the reception of sound," Jaffe says. "This is a sneakier kind of hearing loss because it's in the high pitches and tends to move lower and [become] more severe as we age. Patients with this kind of hearing loss tend to report difficulty understanding speech rather than hearing speech [and] difficulty hearing in background noise."

During conversations, hearing loss can result in mental fatigue and the perception of frustration or dismissal from others. This can cause disengagement over time and lead to social isolation.

Carrie Ritchie, doctor of audiology at Kaiser Permanente West Los Angeles Medical Center, explains that for people with hearing loss, trying to keep up with conversations can require a lot of mental energy. "When someone is trying to have a conversation and they have a hearing loss, they're trying to fill in the gaps and guess the conversation and that can be frustrating."

Jaffe explains, "A lot of times we hear reports of people coming out of group conversations feeling more tired than typical and that's because they had to put more effort into simply hearing that conversation."

When many of Jaffe's patients ask others to repeat what they've said, their communication partners often think they need to shout. "But as the listener, you don't hear them until they're yelling at you, so you perceive that frustration from others," Jaffe says.

Other times, those asking for the information to be repeated receive a response such as, "Ugh! Forget about it!" Marquitta Merkison associate director of audiology practices at the American Speech-Language-Hearing Association says, "Dismissal [and] sensing frustration all can contribute to communication breakdown [and] withdrawal."

Identifying hearing loss is the first step to improving communication and social engagement. "If you identify that you have hearing loss, then it will open the door to opportunities," Ritchie explains. "You can be proactive."

She shares four key signs that may indicate someone isn't hearing optimally:

• It sounds like people are mumbling when they speak.
• People complain that your TV is too loud.
• You have trouble hearing conversations in noisy places such as at parties or restaurants.
• You have trouble hearing over the phone.

A hearing screen is a tool that can determine whether someone's hearing is within the normal range. Hearing screens may be done outside of the clinical setting such as at health fairs and many are free, available online and can be self-administered. These screenings give a pass or fail result.

Merkison recommends people get their hearing screened annually. She explains if someone does not pass their hearing screen, a hearing test is the next step. This is a more thorough evaluation that can determine if there is a true hearing loss or another cause for the failed screening. If a hearing loss is identified, it can be addressed and screenings are no longer necessary.

Communication strategies to improve understanding can be beneficial, even for people who don't have any hearing loss. For people with a hearing loss, Merkison recommends:

• Have conversations in areas with minimal background noise.
• Check your understanding by repeating what you think you’ve heard.
• Be specific when asking someone to repeat words you didn’t hear.
• Avoid pretending to understand when you don’t.

For communication partners, she recommends:

• Get the listener’s attention before speaking to them.
• Ensure your face can be seen in a well-lit area.
• Avoid blocking your mouth.
• Aim to communicate within 3 to 6 feet from the listener.
• If the listener needs you to repeat yourself, use different verbiage and shorten your sentences.
• Try speaking a little more slowly.
• Don’t give up by saying, “Never mind.” Keep trying to be understood.

There are myriad assistive options for people with hearing loss. Whether a person uses a landline phone with a captioning feature or a cell phone with a captioning app, Merkison says these technologies can be helpful ensuring the entire conversation is understood.

Regarding hearing aids, she says over-the-counter devices can be beneficial for people who have mild to moderate hearing loss and want to address it independently. Prescription hearing aids are devices fitted by an audiologist and can be adjusted to meet individual hearing needs. Regardless of the chosen method of assistance, it is important to keep in mind that when "learning how to use something that you've never done before, it is OK to struggle in the beginning. Give yourself grace. Be patient with yourself. The more you use the technology, the better it will get."

Jaffe emphasizes the importance of using hearing aids consistently: "They are something that takes training. It takes time for your brain to adapt to wearing them. The more you wear them, the more you'll get used to the way that they sound."

Whether joking with a store clerk, hearing a grandchild's laughter or sharing a deep, meaningful conversation with a loved one, the ability to hear enriches peoples' lives. Once a hearing loss is identified, further evaluation can help pinpoint specific hearing needs and guide decisions about how to address it. The right resources and tools can empower people with hearing loss to fully participate in conversations and nurture meaningful social connections.    

Claire B. Crompton is a freelance health writer and registered nurse. She is passionate about applying her nursing knowledge to write educational, inspirational and reassuring health information for readers. Learn more at clarityhealthwriting.com. Read More