Help for You

Risk Factors Associated with Hearing Loss

The relationship between hearing loss and dementia has probably received the most attention in the press of all the risk factors reviewed here. However, just a few of the other numerous risk factors are mentioned below.

“Brain scans show us that hearing loss may contribute to a faster rate of atrophy in the brain,”
- Frank Lin, M.D., Ph.D, Johns Hopkins

As you walk, your ears pick up subtle cues that help with balance. Hearing loss mutes these important signals, Lin notes. “It also makes your brain work harder just to process sound. This subconscious multitasking may interfere with some of the mental processing needed to walk safely.” Falls are the leading cause of fatal and non-fatal injuries among the elderly

Two studies have shown a link between hearing loss and loneliness. In Great Britain loneliness is a national epidemic in elderly males. We don’t have that distinction in sunny California, Yet!
Nancy Donovan and colleagues, Sung and colleagues at Johns Hopkins and the University of Oklahoma.

Hearing Loss has been independently associated with depression.
Mener et al, NHANES study
The relationship between hearing loss and dementia has probably received the most attention in the press of all the risk factors reviewed here.

Contrary to what many in the healthcare community assume, age-related hearing loss (ARHL) is not a benign consequence of aging. ARHL is associated with a number of psychosocial and physiological conditions.

Listening Styles / How to Hear Better

People with hearing loss may fall into one of three listening styles.

Many people with hearing loss are passive communicators, especially when they have just begun experiencing communication difficulties due to a hearing problem. Passive communicators withdraw from conversations and pretend they understand out of a fear of saying the wrong thing or looking “stupid.” For some people, it seems easier to be passive, but this communication style can leave one feeling isolated and depressed because their needs are not being met. With certain communication partners, passive communication might be ideal, but it can grow quite frustrating.

Communication Strategies Here are some things you can do to be a better listener

Basic Strategies

There are some basic things to remember to maintain strong communication in spite of hearing loss, no matter what environment you’re in.
Here are some tips:

  • Let others know that you have hearing loss upfront.
  • Be mindful that not everyone knows how to talk with someone with hearing loss, so give your partner tips right off the bat.
  • Say things like: “Because I have hearing loss, I use lip reading to help me understand a conversation. Would you mind speaking a bit slowly and moving your hand away from your mouth? I’ll have an easier time understanding that way.”
  • Don’t be afraid or embarrassed to ask for what you need.
  • Keep background noise low. Turn down the TV or radio and turn off fans and running water so you can hear more easily.
  • If you are unsure you understood, summarize what you think was said so the speaker can confirm or explain again.
  • Face the person you’re speaking with. Some people don’t even realize they use lip reading, but you might notice that things are easier when you’re facing your partner.
  • Try to keep a sense of humor. You aren’t the only one that mishears things and communicating with hearing loss requires a lot of brain power, concentration and patience.
  • You may get tired after communicating in very difficult listening environments like a noisy party. Don’t be too hard on yourself and give yourself a break in a quiet area to recharge.
  • Remember that hearing and communicating might be affected by feeling anxious or tired. If you’re too tired or distracted for a conversation, postpone.

Set the scene

The things to do before starting or joining a conversation depend on what environment you are in. Here are some tips to make communication effective and meaningful:

  • Do your best to have a conversation in a place with good lighting so you are able to see the speaker’s face, gestures and body language.
  • If you’re heading to a restaurant try to arrange a time that is not during peak dining hours. Also, pick a restaurant that you know has minimum noise and ample lighting.
  • When you’re with a group of people, try to position yourself in the middle of the room so you have visual access to most people’s faces.
  • If you’re joining a conversation with a group, ask for the conversation topic so you have contextual cues.

Advanced Strategies

Repair communication
Sometimes, problems will occur in a conversation. You may not have understood what the other person said, or that person seems confused by your response. Here are some communication repair strategies to help get you back on track:

Even before repair strategies are needed, you can anticipate what you might need to know. For example, obtain and read an agenda before an important meeting, and review the names of party guests before you arrive at an event.

Hearing Health Care Professionals

There are three types of hearing health providers

  • Hearing Aid Dispensers/Hearing Instrument Specialist
    In California an HIS or dispenser must have the minimum of a high school diploma and successfully prepared and passed a state licenser examination. Dispensers are licensed to administer a hearing test for the purposes of fitting hearing aids on adult patients. Typically dispensers spend a minimum of one year preparing to pass their licensing examination. Additionally, dispensers are required to take 12 hours of continuing education every year to maintain their license.
  • Audiologists
    have at least a master’s degree in Audiology. Most audiologists also have Doctorates in their respective field. An audiologist is licensed to test and treat newborns through adults and people with special needs. They are trained for diagnostic medical evaluation of the patient’s auditory and vestibular system.
  • ENT Surgeons
    ENT stands for ear, nose, and throat. An ENT is a physician who specializes is conditions involving these three areas. The technical name is an otolaryngologist. Otolaryngologist treat diseases of the ear, nose, throat, base of the skull, and for the surgical management of cancers and benign tumors of the head and neck. ENT doctors generally do not treat hearing loss.

Places to get Hearing Aids

  • Hearing Clinics
    Are usually run by audiologists or hearing aid dispensers. Patients either self-refer, hear about the clinic through the community or are refereed by their primary care or ENT physician. These clinics typically dispense everything from basic over the counter devices for mild or slight hearing loss to power devices for profound losses. Typically they are usually one stop locations, meaning they can provide hearing aids, streaming devices, custom earmolds and all the other components of hearing aids and hearing tech in one location.
  • TPA’s or Third parties
    are middle wo/men that often consolidate hearing aid purchasing for insurance companies. They may market directly to the end consumer. Some health insurance companies have purchased larger TPA’s. Those insurance companies now provide a “Hearing Aid Benefit” to their member, yet, the member still has to pay a substantial fee back to the insurance company to obtain the hearing aids. Some TPA’s offer a wide array of hearing devices, others offer a limited selection. TPA devices do not include all the service you typically need for a hearing system.
  • VA
    The VA provides excellent hearing aids to our veterans. If you are already in the VA system and seeing any medical providers through the VA you can obtain a hearing aid for no cost in less than one year. If you are not already participating in the VA, you most likely need to register with the VA, see a primary care physician and then get referred to audiology for testing and fitting of the appropriate devices. This process can take over a year.
  • Big Box Retailers
    have gotten into the hearing aid industry over the past decade. The big box retailers go after the “low hanging fruit” Patients with mild hearing loss can be served at the big box retailers. However, once someone has a moderate or greater hearing loss, the device and fitting has been deemed overwhelming inappropriate by the professional writing this description. Additionally, the professional writing in third person is very interested to see how the propagation of OTC devices in the next few years is going to affect the big box retailers. The OTC market is exactly where Big Box Retailers dominate today.
  • Online Advertisements
    for online hearing aid sales or direct mail to consumer devices are numerous. Obviously, someone is buying these devices or the advertisements would not persist. Often these devices are relatively inexpensive. If they do not work they are not returned. These devices are usually targeted to two types of patients. Those with mild hearing loss or those who want an invisible solution that is maintenance free. While invisible solutions are appropriate for many patients, all options and the features one gives up for an invisible device should be discussed with the patient before any devices are ordered.