But people think they do, don’t they? They think you put them in your ears and, lo and behold, you can hear again. But it’s not like that. It’s become a bit of a cliché amongst people with hearing loss that hearing aids are not like spectacles, but it’s true. I’m short-sighted but when I put my glasses on I can see almost perfectly. Hearing aids??? No, no…..not like that at all.
Well, let me have a caveat here. They don’t work like glasses unless your hearing loss is really fairly mild. I meet people and I read about people who do, in fact, put their hearing aids in and experience a huge and immediate benefit. I’m sure when I got my first one, about twenty five years ago, it made a big difference. When there is just a relatively small amount of hearing loss to be tweaked amplifying the “hearing loss bits” works. It’s when the “hearing loss bits” get more substantial that the problems really kick in.
A quick look at three of the problems……..
One. Hearing aids amplify the sounds you are not so good at hearing, but they can’t amplify a sound if you are profoundly deaf for that particular frequency. If there’s no hearing left for, say, very high pitched sounds (some consonants for example, or the sound of birds singing) no amount of amplification will make any difference.
Two. Hearing aids amplify everything at the affected frequency, not just the bits you want to hear. The healthy human ear is very good at differentiating between speech and background noise, for example. So far, no hearing aid comes close to being able to do that anywhere near as well. Many claim to have “noise reduction” settings but my deaf friends and I have often bemoaned the effectiveness of them. They can be quite good, in our opinion, for reducing the sound of the vacuum cleaner or the passing lorry. What they are not very good at is helping you to hear the one voice you are trying to hear amongst a hubbub of other chattering people.
Three. Wearing hearing aids requires the brain to make a big adjustment. Particularly difficult, in my case, was going from one hearing aid to two. It was awful. My whole head felt blocked up. My voice sounded really strange and other people’s voices even worse. I was working then and I remember one day trying to run a team meeting, really struggling to hear people, trying and trying again and then……..yes……..ripping the new aid out and carrying on with only one hearing aid, heaving a huge sigh of relief.
In the end, I got used to wearing two of them. Clearly, there was a lot of what I would now call brain-training going on, as the brain struggled to adapt to a completely different experience. Eventually, Brain worked it out, and I happily wore aids in both ears for many years – but I can see why people give up.
Lots of problems, then, but in my experience very little forewarning of them.
I’m writing this from a new perspective. I still wear a high powered hearing aid in my left ear but, as all readers of this blog know, the right one now has a cochlear implant. That means that I’ve lived through an admirably thorough process of preparation and follow up, designed to give cochlear implant recipients the best possible start with their new device.
The Cochlear Implant Centre in Bradford first of all manages expectations. You are still going to be deaf. Things will get better but perhaps only somewhat; don’t expect miracles. You are going to have to work hard at adjusting to the new experience; it won’t happen automatically. You will get tired and may want to take the speech processor off; please try not to.
Crucially, the centre goes out of its way to involve families or friends too, so that they too have their expectations managed and have a good idea what their loved one or friend is letting themselves in for. Nigel came with me to a fantastic orientation session before the operation, where he could ask his own questions and talk with someone who’d already had an implant. He also had to complete his own expectations questionnaire. Yes, he realised I was still going to be deaf. He knew there were months of practice ahead. He knew that outcomes varied. Staff told us that they sometimes had to spend a lot of time managing relatives’ expectations downwards, because they could be quite unrealistic.
But when you get given a hearing aid (or two) what do you get?? Very little, usually.
I can’t remember any expectation managing. Nigel was never invited along or told what to expect. I wasn’t told how hard the adjustment would be and I wasn’t offered much follow-up. They would see me if I got in touch with a problem but there was no proactive programme of support. There are no Hearing Therapists employed at our local hospital. I accept that many people’s hearing loss is within the mild to moderate range and perhaps intensive follow-up and support is not appropriate but to have experienced almost NOTHING at any stage of my hearing aid story is, I think, indicative of a problem.
At the very least, surely, there should be easily available literature, explaining the problems. Literature for relatives and friends should not just set out “ten ways to communicate with someone with hearing loss” but explain the limitations of hearing aids, and how hard they can be to wear, so that people don’t think their deaf relative or friend is just “not trying hard enough”. Relatives and friends need their expectations managed.
Actually sometimes I think audiologists need their expectations managed. In my experience they often seemed to really believe that “X” hearing aid feature would be hugely beneficial, which made it all the more disappointing when I found it didn’t help very much at all.
Certainly, some hearing aid manufacturers could do with a huge dose of expectation management. “Perfect clarity!” they say. “Better than you’ve ever heard before!!”
No no……..it’s not like that. Not like that at all.
PS. Number one of “things people don’t understand”, back in October, was about noise. You can read it here.
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