Tuesday, November 02, 1999
Cost of hearing loss
Experts, patients urge people to deal with problem before emotional turmoil sets in
BY SUE MacDONALD
The Cincinnati Enquirer
Jean Rothenberg, 91, has lived with hearing loss since the 1930s.
(Craig Ruttle photo)
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Hearing loss is often called an invisible handicap.
Jean Rothenberg doesn't believe it for a minute.
For more than 60 years, her deteriorating ability to hear has created very tangible effects in her life and the lives of those close to her — family members, friends, co-workers, her late husband.
“People don't think of hearing as a handicap,” says the spunky 91-year-old Walnut Hills woman. “But not hearing keeps you away from people. It's a rotten handicap.”
A recent national survey confirmed her assessment: people with untreated hearing loss have higher levels of depression, anxiety, anger, isolation, loneliness and fatigue than people who use hearing aids.
John Clark, a Cincinnati audiologist with HearCare in Western Hills and Springdale, sees the emotional and mental effects of hearing loss frequently, especially in older people who claim they hear fine when it's obvious they do not.
“Most of them look to me like people who are still in fairly good health and still want to be active,” he says. “But as you talk with them, you can help them recognize that they are withdrawing from their families and friends a little bit — that they aren't doing some of the activities they enjoyed.”
The flip side is that hearing aid users say their relationships, mental health, stamina and happiness have improved because of their hearing aids.
She doesn't hide it
The barely noticeable hearing aids Mrs. Rothenberg wears proudly are only a tiny part of her experience with hearing loss.
When she started losing her hearing in the 1930s, she sensed what sounded like sand on water. On a Michigan vacation, she watched her children romping and screaming outdoors and realized she didn't hear them. For a time, she feared she was losing her mind.
“I was so relieved to find out I was only hard of hearing,” she says, noting that most doctors at the time offered little hope or help.
For a time, she and her husband quit talking to each other because communication was so difficult — she couldn't understand what he said clearly and usually ended up crying, while he withdrew. Even though they had a close relationship, she considered divorcing him at one point.
Finally, a specialist told her bluntly: “You're hard of hearing and you're going to become quite deaf. My advice to you is to get off your tail and do something about it.”
So she did. She began wearing hearing aids in 1937, even when they were bulky with heavy battery packs and thick, black wires. She became a trained hearing specialist, and her zeal led to the founding of the Cincinnati Speech & Hearing Center in 1950.
Today, she uses lip reading, voice placement and other skills to communicate and stay active in many social, volunteer and community affairs. She does not hide her hearing loss from anyone.
Negative effects
Many people do, however, and researchers are finding that untreated hearing loss can have lasting negative effects, according to the survey by the National Council on Aging.
It found “significantly” higher levels of depression, anger, frustration, isolation, withdrawal from friends/family, anxiety and other negative emotions among people with untreated hearing problems compared with people who use hearing aids.
In addition, people who refuse to use hearing aids report higher levels of fatigue and insomnia than those who wear them, according to NCOA. Funded by the Hearing Industries Association and conducted by Senior Research Group, the survey involved 2,304 people 50 and older who were hearing-impaired and 2,090 significant others (spouses, family members, children).
Subtle loss
Often, hearing loss is subtle, developing so slowly over time that people whose hearing is failing don't even notice, Mr. Clark points out. Usually, spouses or family members notice obvious signs first — TV and radio volumes cranked up, people asking “What did you say?” more frequently, even irritability and frustration by the person who can't follow the topic or pattern of a conversation.
“When I first got hearing aids, I was less tired because I had been straining so hard to hear,” says Sue Ransohoff of Clifton, a retired social worker who began wearing hearing aids about nine years ago. “When you can't hear well, you're always working at it, always straining, always struggling to hear, always deciding whether to ask, "Please repeat that? Please turn your face toward me when you speak? Please remove your hand from your mouth?' I didn't realize I was getting tired until I got the hearing aids and had all this extra energy.”
She understands how easily people can slowly pull back from the world as too confusing, too frustrating, too judgmental or too much trouble if they don't understand what's going on or being said.
“It's very, very easy to get impatient and say, "Oh, I can get along without hearing aids,' but you don't know what you're losing because you're tuning out,” she says. “If you can't talk to people, it's awfully lonely.”
Mrs. Ransohoff got hearing aids fairly quickly once she realized her hearing was fading. It's not always so, says Mr. Clark.
“The average adult will wait about seven years from the time they first notice they're having a hearing loss until the time they seek assistance,” he says. “That in itself speaks pretty highly of the denial that exists about hearing loss.”
Seniors hit harder
Nationwide, about 29 million people have a hearing problem; only about 20 percent seek help from doctor, audiologist or hearing professional.
The negative effects of hearing loss are usually worse in older people than in younger adults, Mr. Clark says. Older people tend to fear technology and devices like hearing aids, and some remain in denial about hearing loss because hearing aids are yet another admission — a fairly visible one — of getting older.
Many people think that the admitting to a hearing loss also means they become totally responsible for the communication problems that result, he says. They fear being rejected if they tell others they have a hearing loss.
Neither is true, he says, because cooperation, environmental factors, listening devices and helpful friends and family all play a role in helping someone deal with an inability to hear clearly.
Those who have gotten help say they'd rather deal with the less-than-perfect hearing and annoyance of a hearing aid than be left out of conversations altogether or thought of as ignorant, silly or old because they can't follow a train of thought or conversation.
Working through problems
Ivone Halsted, 84, of College Hill, says the gentle support of her husband, retired minister Winton Halsted, made her realize the extent of her hearing loss.
“It was very gradual, and all of a sudden I realized i was not hearing well,” she says. “My husband realized it first because i could not hear what he said to me.”
She gave up on a first pair of hearing aids as too annoying. But about a year ago, with a different audiologist, she was willing to try hearing aids again “because I was going around saying, "What did you say? Excuse me? I didn't hear you.'
“I've always had a sight problem and I've worn glasses since I was 7, and I accepted that completely, but it seemed to be different with the hearing,” she says. “I think I was angry, more than anything, to think I had one more sign of old age.”
But Mrs. Halsted also remembered clearly what happened to her father, who grappled with and ignored his own hearing loss as he aged.
“I watched him grow from a very jovial, happy and conversational person to a very quiet, withdrawn person who sat back in the corner while the conversation went on around him,” she says. “I did not have that same feeling of isolation, but I tasted enough of it that I could realize how easily people could withdraw. I could be involved in a conversation and not feel part of it at all.”
Mrs. Rothenberg urges people with hearing problems to work through the accompanying emotional problems — shame, fear, self-doubt, low esteem, worry — and confront the issue early so that coping skills and lifestyle adaptations are learned early. Counseling and professional training might be necessary.
Adds Mrs. Ransohoff: “Getting a hearing aid is a very nice thing you can do for your spouse, your children, your friends, because they can stay in your life, and you can stay in theirs.”
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