Hearing Loss Can Be Hard to Manage

Photo by Eknath Gomphotherium

On Thursday, I went to visit one of my friends who lives in a skilled nursing center.  She has a number of chronic diseases that she's managing with help from the staff, so I usually feel as though her situation is somewhat under control. This week, however, I watched her struggle to manage her latest challenge.

About a month ago, she suffered hearing loss that appeared at the same time that she fell and hit her head.  I am not a doctor, and I am not a member of her family, so I don't have access to her medical records. And she has cognition problems that prevent her from reporting what her doctor and her adult children tell her about her own health.

Consequently, I don't know for sure why she can't hear or whether she will ever fully regain her hearing. But I did observe these new communication challenges that have emerged:

• She has trouble reading hand-written messages because of vision and cognition problems.
• She has a sound amplifier (apx $40) that is of lower quality than a customized hearing aid, which on average runs $1,500 per ear. 
• She has problems with cognition, vision and fine motor skills that make managing the sound amplifier difficult. For example, when I arrived, she told me it was broken, but the problem was that one of the batteries was in backwards.  

I spend 10 minutes trying to teach her how to properly install the batteries, but she never understood what I was saying.  It didn't help that the sound disappeared from her amplifier each time I removed a battery to show her the diagram beneath, a diagram she couldn't even see.  I tried a combination of talking, writing instructions, and demonstrating proper use--but this only confused her more.

The harder I tried to teach her to manage her own listening device, the more frustrated she became.  After failing to explain how to install the batteries correctly, I didn't bother with trying to show her the on/off button (which was tiny and marked with 6 pt font).  In order to hear properly, she would need a staff member or a family member to frequently manage the location and use of  hearing amplifier--probably hourly.  That's not feasible.

For now, she tries to communicate by these methods: reading lips, reading written notes, interpreting body language/pantomime, and using her amplifier.  She's overwhelmed and frustrated by these alternative acts of communication.

Instead of staying focused on any one new path of communication, she gives up and expresses in a very loud voice her frustrations.  "I can't hear. I don't know what you are saying. I am so frustrated. I don't know why I can't hear.  I don't know what is going on.  I don't know when I will hear again."  She is very social, so the isolation is particularly upsetting.  

She even recognized that throwing money at the problem won't necessarily fix her hearing loss. After explaining the cost of her personal amplifier, she tells me, "I have a friend from where I used to live who spent hundreds of dollars on a really good hearing aid, and then she lost it the first week. They are so small and fragile. I don't know what I am going to do." 

She talked to me--really just talking at me--about her ultimate response. "I guess I will just have to find a way through this."   The challenges of aging invite people to draw on emotional and spiritual reserves that make me feel weak willed in her presence. 

I usually pride myself in being a problem solver, in being a person who seeks out pertinent information that will fix things right up.  This time, I am stymied.  Her hearing problem more complex than I initially imagined, and I feel powerless to address it.

Before studying gerontology, I just assumed that a hearing aid would quickly address every older adult's hearing issues. But the cost and management of a hearing aid can be very challenging for many older adults.  I'm going to talk with a fellow grad student in audiology to see what she knows about existing options, and I can mine the internet a bit more, now that I see how many hits "hearing loss in older adults" garnishes. 

And to add insult to injury, Medicare does not cover the cost of hearing aids--probably for the very reason my friend cites: they are expensive, fragile and tiny (easy to lose, expensive to replace). 

In the meantime, I can increase the number of visits to my friend and offer compassionate body language--a smile, a hug, a pat on the arm.  Maybe if I sit there and just let her talk it out, she can find her own path. And maybe she can teach this chatty gal how to be a compassionate listener.