The world of hearing loss can be a dismal place. Confusing, frustrating, embarrassing – and frightening.
Bottom line: "It's a pain in the butt," says Catherine O'Connor, a hearing-care specialist with the Canadian Hearing Society (CHS) and herself hard of hearing.
This is especially true for those who have had a lifetime of hearing and are suddenly faced with the loss.
"All sorts of things set in," says Gael Hannan, president of the Ontario chapter of the Canadian Hard of Hearing Association (CHHA), a national consumer association providing support and information. "There's fear. And panic. And denial. You go through all the stages of grief because things that were wonderful before become very difficult."
At family dinners the former easy camaraderie becomes a mesh of garbled voices. Spending time with grandchildren is frustrating since their high voices are often impossible to understand. Movies and the theatre become too incomprehensible to seem worthwhile.
Yet these are changes that are affecting an enormous number of people as they age. Hearing loss, says O'Connor, is the third-most-frequently-reported health problem in the elderly population, after arthritis and high blood pressure. Fifty per cent of people between the ages of 60 and 70 have some degree of impairment and many don't realize it.
It's an isolating experience when the world of sound recedes. And to exacerbate that isolation, relationships undergo fundamental changes.
Communication is the cornerstone of relationships, particularly intimate ones, says Hannan. "Hearing loss introduces new dynamics and I would say it's most pronounced in a spousal relationship."
Having grown up with hearing loss, she says part of her criteria in choosing a mate was an understanding and comfort level between them. This is a luxury not available to those who started out with equal abilities.
"They have to work out a communication strategy. The hard-of-hearing person must learn to be assertive and open, in a non-threatening way, about what they need." And, it's equally frustrating for the hearing partner.
"When you've lived with someone for 40 years, even though you love each other, when something else is introduced, like hearing loss, it can really cause a strain," she says. "When the relationship isn't good to begin with, it gets really tense."
The truth of that was evident last fall, when Hannan, in co-operation with CHS, initiated a panel discussion on "Hearing in Marriage," moderated by renowned American psychologists and educators Mimi and Ed Clifford. Married for 51 years, the Cliffords both have hearing loss. They and the panel of three other couples, including Hannan and her husband, Doug, found that despite a high level of support in their relationships, new concerns surfaced during the discussions.
"While hearing loss is a complex issue, certain communication problems stem from the 'man-woman' thing," she says. "There are hearing problems and listening problems. Hearing loss is a defining characteristic of how spouses interact, but the success of their marriages also depends on general compatibility and willingness to find solutions."
Part of the problem is that it's an "invisible disability" and even those living with it tend to forget sometimes. As well, it's difficult for a hearing person to understand the physical effort expended in trying to understand with limited hearing.
"It takes a lot more physical energy than people realize," says Hannan. "You have to concentrate. You can't be doing one thing and listening to a conversation. You have to be watching whoever is speaking."
The problems play out in other ways in different relationships.
Adult children may eventually become frustrated enough that they encourage their parents to consider moving into an institutional setting earlier than necessary, O'Connor says.
"The adult children may feel stressed because mom can't hear the phone. They imagine all sorts of awful things happening to mom, who is in fact enjoying a cup of tea on the front porch and not hearing the phone." However, there are less extreme solutions than moving to a nursing home, including louder phones, flashing lights and strategic placement of ringers or simply a hearing aid.
And there are problems with professionals. Isolation and depression can be misdiagnosed as cognitive failure, sometimes leading to a move to nursing home or seniors residence.
There can also be problems understanding doctors' directions and, O'Connor notes, medical professionals sometimes prefer to talk about the hard of hearing patient to someone with better hearing, rather than to the person. She cites the case of her mother who was hospitalized for cancer prior to her death. "The doctors and nurses found it easier to talk about her, over her head, but it was her situation. She had a right to hear what was going on so that she could make intelligent decisions."
There are answers for those experiencing these problems, Hannan says. The first step to admitting the hearing loss and getting a professional diagnosis and a hearing aid.
"A hearing aid is a first step and the most important step," she says. "Then what's important is to learn a new way of communicating, learn how important it is to control your environment, get good aural rehabilitation, learn a bit about speech reading, about the best way to communicate."
After that, there are a multitude of resources available through both CHS and CHHA. CHS branch offices offer a variety of services, often including hearing-help classes that teach many of these communication techniques.
For information contact the CHS head office at 416-964-9595 or via its website at chs.ca or CHHA at 800-263-8068 or on the Internet at Chha.ca.
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Couple - While hearing loss is a complex issue, certain communication problems stem from the 'man-woman' thing, says one expert.

child - Spending time with grandchildren is frustrating since their high voices are often impossible to understand. One hearing-aid manufacturer, Beltone, recognizes this problem and features this intergenerational pairing on the cover of one of its brochure.

hearing aid - Obtaining a hearing aid should be the first step, say counsellors, and then it’s important to re-learn how to communicate.