Whose problem is the hearing loss? People with hearing impairment sometimes forget that their hearing loss affects everyone around them. In some cases, there are a lot of compensatory tasks taken on by “significant others” who assume the role of translator when communicating with family members, healthcare providers, accountants, mechanics, and countless others.
Richard E. Carmen, AuD, has been a practicing audiologist for a half-century, and he has seen virtually every compensatory behavior in the human arsenal. “Clinicians know all too well that an entire family can develop compensatory tasks and behaviors to accommodate a loved one’s unwillingness to seek help for hearing loss,” says Dr Carmen, who now heads the hearing industry book publishing company, Auricle Ink, in Sedona, Ariz. Dr Carmen, who has written and published several books and articles on this topic,* recently outlined what he sees as the Top-5 compensatory behaviors:
1) Speaking Louder: Practitioners know that louder isn’t always clearer, nor does it always solve hearing challenges. Even with hearing aids, louder can pose its challenges. However, the poor choice of no hearing aids at all can prove to be a lack of judgment that no family and friends want for their loved ones.
2) Becoming the Messenger: Out of love, compassion, and instinct to help anyone in need, family members often repeat and interpret what their loved ones miss. While in the early stages of hearing loss, this is common and helpful. In later untreated cases, this can eventually become a daunting task and can lead to co-dependence in family dynamics. It can also lead to many ill-gotten emotions, feelings, and actions by everyone—such as anger, anxiety, avoidance, defensiveness, depression, discouragement, fatigue, frustration, guilt, hopelessness, impatience, irritability, loneliness, nervousness, paranoia, resentment, resignation, shame, stress—to name more than a few.
3) Preventing Isolation: Family members often try to help in vain. Data show that the mere process of aging can often result in social isolation, so add hearing loss to the mix (often combined with other health issues) and those with untreated hearing loss pose higher risks for eventually finding themselves in a dark corner. They may feel abandoned by the family, ignored by friends, and excluded from social engagements, all because they cannot hear well enough in social situations to interact. The compensatory behavior is isolation, and it comes as a result of not wanting to embarrass oneself—“preferring to stay home, watch TV, or read.” The more isolated we become, the greater the likelihood of declining overall health. The simple choice to seek help for hearing loss can create profound improved changes, yet coaxing one out of isolation to seek help can take years.
4) Overcoming Resistance: There comes a point when untreated hearing loss usually reaches a tipping point. In a true co-dependent relationship where a husband refuses help and the wife actually enjoys being his “ears,” we know she is actually doing him a disservice. If her compensatory behavior persists, he will progressively lose his independence and grow to depend on her even more. Change happens when the wife finally asks: “Wait! Whose problem is this anyway?” She must become confident enough and the husband must grow strong enough that they look each other in the eye and admit it’s time for change. If price comes into play, that can be surmounted through low- or no-interest hearing aid financing solutions.
5) Seeking Inspiration – Begging for Treatment: Who is it that’s pleading? Loved ones always remain hopeful, and hope is perhaps the greatest compensatory behavior. We practitioners know that it often takes years of coaxing and nagging for one spouse to convince the other to get help. An unmotivated patient (pushed by the spouse, preferring to look at the walls rather than at you) will undoubtedly be your first challenge. I’ve seen it go two ways. The more you talk, the higher the walls of resistance. However, letting the patient talk is key. Before we can be the audiologist, we must be the “counselor” — helping shift the patient from negative feelings to positive experiences. Our compassion and understanding is vital. We must find out what he/she really wants by framing the initial interview on favorable options and positive outcomes.
Once patients and significant others are in the building for an evaluation, the spouse may well become a positive force when she sees the benefits. That’s because both people have a hearing problem. “If and when that happens, the spouse can become a real advocate for buying these hearing aids,” adds Von Hansen, a long-time audiology consultant based in Lebanon, Ore. “They are going to make a $3,000 to $7,000 decision, and they need to make that decision as financially comfortable for themselves as possible. If the provider can offer financing options, it makes the decision to gain help far easier.”
*Related to this article’s topic and written for consumers, Dr Carmen is author of How Hearing Loss Impacts Relationships: Motivating Your Loved One (Auricle Ink, 2005) and The Consumer Handbook on Hearing Loss & Hearing Aids: A Bridge to Healing (Auricle Ink, 2014).
About the author: Greg Thompson is a freelance writer and a former editor of Physical Therapy Products and other publications. He is based in Loveland, Colo.