- Disabilities & the Disabled
Hearing loss and life
The letters H and I are generally used together as a form of greeting but they could also signify and describe a condition that many thousands of people live with on a daily basis--that is Hearing Impairment. There are many words used by people to describe hearing loss; some of them are--partial deafness, hard of hearing, hearing impaired and many others .Living with hearing loss creates many personal,social and employment effects that could be annoying to the normal hearing person but are routine to the hearing impaired individual.The person with hearing loss may find it hard to function in a loud environment, have difficulty understanding people who speak too fast or with a foreign accent and there could be other unseen and unexpected issues with communication. Some of these effects can negatively affect the way a hearing impaired person is perceived by others because they do not understand the differences between the hearing world and the hearing impaired world.The hearing impaired person may need ocassional reliance on others to help hear and understand sounds and speech.This sometimes can lead to an awkward and uncomfortable encounter with strangers and coworkers. The affected person is sometimes assisted by hearing aids which can present other hearing issues such as muffled hearing and difficulty in understanding when there is more than one source of sound or a type of sound coming from another direction. Hearing impaired persons live in a world of distorted sounds which can be scary, confusing, very frustrating and at times isolating.
On a personal level not everyone with a hearing loss or impairment will admit that it exists; friends and family members will notice that the television, radio, or other audio device will become progressively louder and at times proceed to a level that is annoying to other people. While loudness is an issue in homes and workplaces--the individual with the hearing loss usually can no longer tell how loud a noise is or the direction of the sound or sounds around them. Increasing the volume level on the television or radio is not meant to annoy people with natural hearing but is an attempt to understand the words or music. This is a way to feel "connected" to the outside world, know what is happening in the world and to stay informed. Eventually the hearing impaired person gives up and turns the volume down because it can only be so loud and then it really becomes too loud and cumbersome to hear and understand. Constantly trying to understand speech and other sounds through muffled ears is tiring and difficult. Sometimes people will attempt to understand that they are dealing with a hearing impaired person and attempt to communicate effectively; at other times, other individuals, however, will not and give up or become frustrated because the hearing impaired person does not always understand what is said the first time. Verbal communication can resemble a battle between comprehension and understanding the issues and how effective the information is being conveyed it is not about how loud someone speaks to you.
Since life is made of continual sounds and noises of varying kinds the inability to recognize and orient to everyday sounds can be annoying and sometimes intimidating to the person who has a hearing impairment. One of the biggest frustrations within the hearing impaired world is conversation. Hearing impaired people are more than capable of having a conversation in normal voice tones and without exaggeration of voices.Hearing impaired persons do have a tendency to raise their voice levels because of their hearing loss and not as a means to annoy or embarrass people. People will yell at you or emphasize what is being spoken or speak in tones that are so soft and distant that understanding becomes even more difficult .People will also "forget" you have a hearing impairment or just don't want to remember that it exists. I have had family, friends and coworkers all respond to my hearing impairment in different ways; some are empathetic and helpful, others seem to ridicule the problem by mimicking "sign" language or saying the word "What" over and over again. Some people think it is funny to mock a hearing impaired person because it some how seems funny to them. Unfortunately being hearing impaired is anything but funny--it is a constant struggle to function in the hearing world and it can be physically tiring because there is so much effort put into trying to understand speech, music, movies, television or any kind of sound. People complain about the loudness of the TV "Can you turn that thing down?" is a phrase that comes to mind -yes it can be turned down and then the closed captioning comes on and of course that takes up space on the screen so you give up part of the picture and so it goes. Subtle sounds in the home can be quite difficult to discern because you can't always hear them--the refrigerator, the heater/air conditioner motors, clocks ticking and other sounds of everyday household living. Being outside of the home is not a better situation, in fact it may be worse--you can feel the wind but not hear it; you can see the lightening and maybe hear some really loud claps of thunder but for the most part the storms pass and you don't hear them until someone mentions that they occurred. The wind if you can hear it sounds like someone crinkling paper next to your ear and can be very annoying.. I personally do not like the wind because of the way I hear the wind. At times I feel more vulnerable when I'm outside because I cannot hear the world with my natural hearing and I usually do errands and doctors appointments by myself and I have been known to mistake whether my name has been called or not; luckily, I have a sense of humor and have "rescued" myself from embarrassment by using it. These environments while not dangerous can be overwhelming to the hearing impared person and cause more stress, frustration and insecurity.
Driving a personal vehicle requires the hearing impaired person to become even more vigilant about their surroundings. You may not hear the horn of another car or truck. Sirens from approaching fire trucks and ambulances may not be recognized until those vehicles are quite close to you and your vehicle. Once that happens you have to try to not go into panic mode when you move your car to the shoulder and let the emergency vehicle go by. A hearing impaired person may not hear the unhealthy sound of a motor that's beginning to breakdown or the brakes that are grinding when you go to stop the car. An approaching police officer who may stop you for a driving violation cannot possibly tell that you are hearing impaired until he approaches your vehicle and then you can explain that you are a hearing impaired driver. It is also not noted on your drivers license either, usually there is a line that states that you must wear corrective lenses while driving but nothing to indicate that you are a hearing impaired driver. Some states have a hearing impaired designation on the drivers licesnse but it is not in every state. Some people and lawmakers could question whether an individual with hearing loss should be allowed to drive and they are probably right to do so. I am not advocating the loss of driving privileges because of hearing impairments; most hearing impaired persons wear hearing aids or other assistive devices and can function in the hearing world with minimal difficulty. However, as an EMT I can also see safety issues with hearing impaired drivers--my question is at what level of hearing loss would a person become ineligible to be a licensed driver?. Also would hearing tests become mandatory as part of the renewal process ? Since there are many levels of hearing loss and different kinds of hearing loss the issue would have to be broadly defined so as to be fair to hearing impaired persons who are aided with assistive devices and those who are profoundly impaired or deaf because of potential safety concerns for the individual and other drivers. Any potential course of action would have a significant impact on hearing impaired drivers and the issue of driver safety. Those drivers who are or become hearing impaired and rely on a driving job as a source of income could be devastatingly impacted by any course of action that would limit their ability to be employed I worked as an EMT for over twenty years and drove ambulances and never had an incident that could be related to my hearing loss. I believe that those persons who are profoundly hearing impaired or deaf are ineligible to obtain driver licenses because of the degree of hearing deficit they have however, I have not seen anything in writing that would prove or disprove that belief.
People with hearing loss are employed in every facet of the working world and we should be working as productive individuals with jobs and careers and it shouldn't be a problem. We are hearing impaired which does not equate into unemployable. People with hearing loss or impairments are covered by the ADA and that affords us some extra protection against using our hearing issues against us--it tries to limit discrimination as long as the criteria placed in the ADA are met. Employers are required to provide reasonable accomodation to employees who request it as long as it does not impose an undue hardship on the employer and if it is requested. However, once again the individual would have to admit that the impairment does exist and could possibly run the risk of having undue and unkind gossip and rumors spread about why that person is covered by the ADA and whether some people think it is appropriate. It is a matter of choosing to admit that a problem exists and taking some type of corrective action to minimize the effects of the problem.
Other workplace issues that are faced by hearing impaired persons is that not all coworkers want to understand that you are hearing impaired nor do they care about it. A "not my problem" attitude can take over and affect work place relationships and perceptions of the affected person. Hearing loss is not something that goes on a checklist and gets selected and then becomes chosen as a desired state of living; but it does exist and is a fact of life for persons of all ages and walks of life. There are people who have heard sound and speech and there are those that never will; some of these are infants and children and others are teens, adults and the elderly. Most will find a way to function in the hearing world; others will never have that opportunity and that is a shame. Hearing loss and its implications are something like a "silent" illness; it exists but no one recognizes it until it affects someone in the family or a close friend and then it is a different story. There have been workplace studies reflecting on the hearing loss of employees and the noises that they are subjected to while on the job. Ear plugs are made available in warehouses and other loud environments in an attempt to alleviate the long term negative effects on the hearing of employees. Listening to loud music through head phones or ear buds has been shown to contribute to hearing loss and is now something that should be avoided. Listening to music in a public area such as a waiting room can be a problem for the hearing impaired individual who wears hearing aids because if you don't wear headphones you can't listen to your iPod or other device because you won't be able to use the ear buds because of the hearing aids. Newer in the ear hearing aids will allow the wearer to listen to the iPod because of the advances in hearing aid technology. Those of us who wear the molded shell style may not use ear buds because we wear hearing aids.
For years visually impaired and blind persons have used dogs to assist with activities of daily living such as opening doors and refrigerators and indicating when the phone is ringing or someone is at the door to the residence. Dogs help disabled students get around school campuses and become "helpers" in many ways; they help break down social barriers when in groups or at other types of events. Dogs that have been trained to be used by hearing impaired individuals have proven time and time again to be beneficial in daily activities and are a source of support and companionship. It has been demonstrated that pets have a very strong positive effect on the psychological well-being of the owner of the animal and that having a "helper" makes them feel more independent and confident. They have someone who may not be able to speak but can listen and let the owner "vent " what ever feelings of sadness, loneliness or level of frustration they are feeling. As they say dogs are mans' best friends. These dogs usually wear a vest that says "Service Dog" and people are informed by the master that the dog is working and is not a pet at that time. There are times when the master of the dog will allow the dog to be petted by admirers and dog lovers .People are usually quite impressed with these animals and ask questions of the owner about the dogs' abilities and lifestyle. Most owners are happy to answer the questions and provide some important public relations for the programs that are available to assist the hearing and visually impaired person.
People with hearing impairment cross paths with the hearing world on a daily basis. The hearing impaired individual may be someone in your family, a friend or a neighbor. The implications of hearing loss are far reaching and affect all aspects of the persons' life. Is there a discrimination towards hearing impaired persons? Probably in some cases but mostly hearing loss and hearing impairment are seen as an annoying problem of not listening or not understanding; some people are ignorant to the fact that this is an issue that will not go away and may not be alleviated by the use of hearing aids or other assistive devices. While being hearing impaired is not the end of the world it is life changing and life challenging for the people affected by it. One of the biggest adjustments to being hearing impaired is getting acclimated to wearing hearing aids. Natural hearing occurs every minute of every hour of every day even while sleeping we can "hear" unusual sounds or the cry of a child and wake up. Hearing impaired persons lose that ability unless they wear their hearing aids twenty-four hours a day. The practice of wearing hearing aids for extended periods of time is not recommended because of the potential for ear infections and other comfort issues. Most hearing aids are made of hard plastic and lying on either side of your head causes a degree of discomfort when trying to sleep. Older models of hearing aids may emit a high pitched squeal when the aid is covered that can occasionally be heard by persons with normal hearing. I have become accustomed to wearing my hearing aids for twenty-four hours on occasion, but there are times when I do not wear them because I need to give them a rest. My natural hearing is diminshed so I use close captioning on the television and read the speech of the shows that are enabled with closed captioning. Reading closed captioning can be challenging because depending on the quality of the translation and transcription of the words the captions and the spoken word are quite far apart. I have seen or "read" many programs in closed captioning and I find the spelling, grammar and clarity of the captioning to be questionable and sometimes downright misunderstanding and, at times, humorous. I do not know if the closed captioning services have proof readers but they certainly could use them.
Through the wonders of modern technology, the advances in hearing aid technology will allow the hearing impaired person to wear a hearing aid for extended periods of time and enjoy swimming and other activities that must be curtailed by wearers of the older style of hearing aid .When wearing the older style hearing aid the device cannot get wet because then the circuitry will be ruined and since most repair costs must be covered out of pocket and not by insurance it can be expensive to repair or replace the aid. These new hearing aids can be worn for up to six months and are inserted into the ear canal. To me this is as close as we will ever get to having our natural hearing. I do not wear that type of aid, however, if I am ever afforded the opportunity to do so I will. When you are fitted for a hearing aid the dispenser may use a putty type material and inject it into the ear canal. This substance will harden after a few minutes and the end of the mold will become the shell of the hearing aid. The hearing aids will then be sent to the manufacturer for the circuitry. When you first start using them they will make you crazy because you may hear sounds that you have not heard in a while and those sounds will seem very loud .Every time you change hearing aids, which is not like changing your socks, your brain has to become acclimated and relearn the many sounds we hear on a daily basis. In the summer your ears will sweat and that becomes a problem because most hearing aids cannot be dried out internally where all the wires and circuitry are located. I have days when the ear canal itches and I take my aids out and then let them dry and I clean my ears. Keeping your ears clean and free of the naturally occurring ear wax is a necessary task when you wear hearing aids. Ear infections can and do happen and having to apply ear drops to an ear with a hearing aid in it doesn't work--not to mention the cotton ball that is usually inserted into the ear because of the ear drops prevents the use of the hearing aid.
Hearing aids are color coded so that the user recognizes which aid goes into which ear. My hearing aids have a red dot on the right ear and a blue dot for the left ear. This is simple information but it is helpful to users and non-users alike because people with natural hearing do not have first hand knowledge of hearing aid use. It is important to clean the shell of the aid to lessen the chance of getting an infection. I have had ear infections since I became a wearer in 1987 and I have learned that cleaning my aids with a soft cloth or tissue has greatly reduced a repeat infection. The obvious fact is that hearing aids and ear infections are just not compatible and needs to be avoided..
One of my favorite phrases about dealing with hearing loss, hearing aids and daily living is "I function in the hearing world you don't function in the hearing impaired world" I say this not to get attention because of my hearing loss but to bring awareness to the hearing world that there are people who function everyday in a world that is neither hearing nor deaf. At times I've wanted my hearing loss to become deafness because then I'll know which world I function in. I have made my family, friends, coworkers and numerous other persons aware that I am hearing impaired and doing that can be quite repetiitous and tiring and sometimes in the long run does not make a difference to anyone but me. I still go to work and I am still hearing impaired that is my life on a daily basis. It is said that people suffer from hearing loss while there is no real tangible feeling of pain in my mind it is a misconception that we "suffer" from a hearing impairment or deafness. When I am not wearing my hearing aids I feel a sense of muffled sound or a pressure like feeling similar to when you have a cold or sinus infection. I have had ear infections that have caused real pain and the prescribed ear drops usually clears it up;of course, at those times I cannot wear my hearing aids and that increases my discomfort with functioning in the hearing world and not being able to hear adequately.
Every day of life we are involved with the weather in some way; we love the heat, hate the cold, tolerate rain, wind, snow and other weather events. The person wearing a hearing aid will absolutely dread rainy, windy days and want to stay inside and away from the weather. Rain is a huge problem because if your hearing aids get wet you don't hear and if you remove them from your ears you don't hear. There is no compromise when it comes to wearing a hearing aid and dealing with the weather. I hate rainy days because I know if my aids get wet I am in serious trouble when it comes to dealing with the hearing world and the sounds that are around me. I try to" duck" my head towards the side but then you have one wet ear and one dry one, I mean your natural ears, not the prosthetic ones. a drop of rain can cause momentary loss of sound. Even if you choose to wear a hat depending on the type of hat, the length of your hair and the density of the rain your ears will get wet and so will your hearing aids. I have compared the back of my ears to being rain gutters because rain water will stream behind my natural ears in go into the ear canal; this scares me more than anything I have to face on a daily basis. Hearing aids can be insured against damage but if they are not insured then any repair costs will be paid by the wearer--you. It can be costly to repair an aid that has been damaged--possibly hundreds of dollars. Protecting your hearing aids from damage requires some common sense and ingenuity. I work in all kinds of weather as an EMT and I try the head tilt method most of the time, once in awhile I take them out of the ear and put them in a pocket which is neither advised nor encouraged but does protect the aid from getting wet and possibly becoming permanently destroyed. Replacement costs can be prohibitive to some people who do not have hundreds or thousands of dollars to invest in replacement aids. Hearing aids are considered prosthetic devices and may not be covered by insurance plans; getting them wet is not desirable nor practical. Living with hearing aids and changing weather conditions is not a match made in heaven but rather a union of technology and Mother Nature.
One of the aspects of being hearing impaired and functioning in the hearing world that needs to be addressed are social situations--not the kind found on the computer but those found in everyday family life. I have found that going to church, attending a class, wedding or other type of event can be quite stressful and unnerving. There is no way to tell a hearing impared person from a hearing one at first glance. Many of us wear hearing aids but there is never a sign attached or other way of indicating that we are hearing aid users .I have had occasions where someone has noticed my hearing aids and it will lead to a discussion about my hearing loss. I have found that most of these encounters are with children. One of the biggest fears in social situations and functions is not understanding what is being said and the possible embarrassment that could result. If you are with friends or family members they will usually help you by becoming your "ears" for the duration of the event. However, if that is not an option you are on your own and have to do the best you can to adapt to the environment. You may choose to sit closer to the front and hope that the issue is minimized. If your only choice is to sit farther away from the speaker or instructor then you can try to discreetly "cup" your hand behind your ear to increase your level of comprehension. When none of these work you need to be honest about your hearing impairment and ask the speaking person to talk so you can understand. There is no harm or shame in admitting that you have a hearing loss and when I have had to admit the existence of my hearing loss most speakers are more than understanding and will try to modulate their speaking voice so I can understand. You may not be the only one in the room with a hearing issue; you may be the one to admit it exists. All social situations present different conflicts with noise; soft background music, loud band music, multple speaking voices with differing levels of rate, rhythm and tones of voice and other sounds that occur.
There are times when you will hear one persons' voice clearer than you will the voice of another person. Male voices are sometimes easier to understand than female voices which tend to be softer. Childrens' voices can be either understood with little difficulty or with major confusion, fortunately children are patient most of the time and will repeat what they said without getting impatient. I have found that when I have to ask someone to repeat what they have said it is usually accepted but there is always the one or two people who do not like being asked to repeat what was just said. They look at you like you are from outer space and you can sense the displeasure they feel by the way they sound when they respond to your request which is quite often sarcastically. There are many people who do not understand the world as we know it and it is a sad fact that they show little or no compassion or empathy for hearing loss and its implications. It is my hope that this article will help you help someone who is or may be hearing impaired and those who are not hearing impaired will have a better tolerance of the issue.
I spoke earlier about wearing hearing aids when there is rain or snow and how you need to be creative when it comes to wearing them and keeping them dry. Now I want to address the effect of summer weather and hearing aid use. This has been one of the hottest summers I have had since wearing my aids and it has made me occasionally wish I did not have to rely on them to facilitate communication with the hearing world. To put it simply your ears sweat, just like the perspiration on your skin, the ear canals become wet and wearing a hearing aid causes increased discomfort because perspiration is water and water is not good for hearing aids. I find myself twirling a tissue into a wick and inserting it into the ear canal to wick the moisture out and then reinsert the hearing aid. It may not be the perfect solution to the problem but it works. I also keep my hearing aids dry and clean to lessen the chance for an ear infection to start brewing. The other heat related issue is wearing hard shell hearing aids and itchy ears. My hearing aids have caused me to have quite a few episodes of my inner ear itching while I am wearing the aids and I can't make the itch stop. I have not found a remedy for this problem. When I am home I often times will not wear my hearing aids because of the perspiration and itch issues. This does make hearing every day sounds much more labor intensive but it enables my hearing aids to dry out and allows my ear canals to do the same. When I resume wearing the aids all of the same issues begin all over again--the alternative is to decide that wearing hearing aids is too much trouble and I'm not going to do it. That would be counter productive and i would still be hearing impaired and unable to hear common everyday sounds and is not a choice i want to make or advise. Since I live alone in an apartment I need to wear my hearing aids and deal with these issues as they happen.
Recently, I experienced an incident that created a laceration to my inner ear while wearing my hearing aids. I was visiting my family and while there one of my granddaughters went running by me. I made a movement to grab her in order to give her a hug, unfortunately for me she brought her head back and hit my ear while the hearing aid was in place and I felt instant discomfort and a wet sensation in my ear. I hugged my granddaughter and put her down to the floor and went in search of a tissue to make a "wick" for my ear. It was bleeding and now I have a problem because I cannot wear that hearing aid. I came home and the ear continue to bleed for several more hours. Over the next few hours the ear canal also became swollen and painful when I attempted to wear the aid. I cleaned the affected ear with peroxide and basically wore one hearing aid. The lesson to be learned is to be careful of moving objects and how close they are to your ears/aids or be prepared for the possible consequences . I am also more careful when I playfully "grab" one of my granddaughters and hug them. The hearing aid itself was not damaged and that was a good thing.
Another situation I have experienced during the past few months is a distaste for loudness of any kind and from any source.I have recently begun to watch my television with the sound completely muted. Listening to commercials, infomercials and talk shows when people start shouting and talking at the same time seems to have put my hearing limits and tolerance level off the charts and I would prefer to read the poorly spelled and slow to respond closed captioning. I am not sure if that is an indication that my natural hearing has changed for the worse or I just really don't care to listen to people thru my muffled, prosthetic ears. I guess the answer to this situation will be determined in the future.
I have recently realized that it has been a very long time since I've had a hearing test or evaluation for new hearing aids. I probably need both of them. Now for my rant most insurance plans do not allow for hearing exams or hearing aid evaluations which I find to be absurd and ridiculous. Health insurance will cover vision, dental and other preventive health care programs and services but evaluating and protecting one of our most necessary senses is not covered. Protecting our hearing health should be as important as getting dental care or routine physicals.
We can obtain help for smoking cessation and weight control but not for hearing loss. There are programs available that offer discounts on hearing services and I know very little about what they offer and how they work. I do know that hearing aids are expensive and paid by the consumer--you--they also use button batteries and that is another expense. Some employers offer a flexible spending account that allows an employee to save towards the cost of the hearing aids through a payroll deduction. My question is what if I can't afford to have another dime deducted from my paycheck even if would be for my benefit? I have no understanding of why a hearing aid is considered a prosthetic device and therefore ineligible for coverage be insurance companies. Maybe I will ask an insurance company for an answer and use it in my next update
I recently had a hearing test and my hearing loss has not significantly changed which is good. However the hearing and word recognition tests were administered while I was sitting in a soundproof booth I do not live in a soundproof booth. I still find following sounds in the real world to be as challenging as it has been for the past 27 years. I believe these tests should be administered in a more realistic setting and have real life background noises incorporated into them. I also received new hearing aids and while they are the in the canal style they have a really cool feature that enables me to adjust the volume with the press of a button. I press the left or right aid and it adjusts the volume level of both aids. The battery life of the new aids is a lot longer than the older aids and that means less button batteries
I have recently started to not wear my hearing aids at night because trying to sleep with these hard plastic hearing devices is uncomfortable. One I remove the aids I have no concept of sound or noise of any kind, I turn the television to its lowest possible volume and try to use closed captioning but captioning does not always follow the words as they are being spoken and when the captions can't follow the rate and clarity of speech they usually freeze and a lot of information is lost. My television serves as my "white noise" I fall asleep to it and can usually tell time by what show is on I realize this is probably not a good thing to do especially since I'm not hearing the dialogue. In fact now that I reread that last section I realize it accomplishes nothing and seems contradictory to living with and coping with hearing loss.
I have been unemployed for approxiamately nine months and this situation has nothing to do with my hearing loss, it has been a catalyst to getting me to think about whether my hearing loss has become a disability. I need a doctors note saying that I cannot function without these prosthetic ears and I know first-hand that without them I do not hear sound. Living alone also makes me aware that I cannot follow noises I hear and where they may be coming from. I am trying not to sound like I am whining but I seriously do not know how to proceed.