Conversation Starters

Hearing loss shows itself in the way that the hearing-impaired person acts in various social situations and the way he/she interacts with others. Usually it is a spouse, relative, friend or business associate who notices the problem first. Initially, those who interact with the hearing-impaired person often remark, "he doesn’t pay attention", or "he ignores me." As time progresses, it is not uncommon for interpersonal relationships to become strained and for family members and friends to become frustrated, and even angry with the hearing-impaired individual.

The hearing-impaired person, being the focus of this frustration and anger, is in the process of undergoing emotional changes, which usually occur in stages. Being aware of these emotional stages, and the behaviors associated with them, will help you to better grasp how the hearing-impaired person is dealing with their hearing loss and at what stage they are in relative to seeking help. This is important if you are to assist them successfully in making the transition toward hearing help.

Stages of Hearing Loss

The first stage is denial. Denial usually takes the form of two characteristics: (1) The person does not believe he/she has a hearing problem; and/or (2) The person cannot talk about the hearing problem. It is characterized by placing blame or responsibility on others. "I don’t have a problem, they mumble, they don’t speak clearly, they talk too fast" are common comments during this stage. Denial is usually a temporary response. It is important during this stage to acknowledge the fears and uncertainties of the individual. Providing reassurance and support in seeking information can help them to move forward towards treatment.

A behavior that often occurs next is withdrawal. The hearing-impaired person deals with the psychological hurt of hearing loss, by not exposing himself/herself to the situations in which he/she is vulnerable. The best way to avoid embarrassment is to avoid potentially embarrassing situations. Additionally, activities that were once enjoyable to the hearing-impaired individual may not be enjoyable anymore because of the hearing loss. Their attitude becomes one of, why go somewhere or do something that is no longer fun!

Anger is the next stage. You may notice that the hearing-impaired person is "grouchy" or "has become difficult to live with". Considering the circumstances, it is reasonable to expect hostility to develop. The hearing-impaired person becomes less tolerant of others because of the comments, frustration, jokes and anger that has been focused on him/her. He/she is angry at what they have lost, what you may still retain and how they are treated when they respond incorrectly or inappropriately when communicating with others. The strike first reaction offers protection for them. You need to respond to them with understanding and not anger.

Bargaining for just one more day of hearing, one more day of not having to deal with their problem, is the most private stage of the process. Often, it will not be visible to others, including family members. It may stem from guilt that the loss could have been prevented, or from the failure to be able to do things now that they were able to do in the past. Many hearing-impaired persons, at this stage, come to expect that all their daily interactions with others be arranged around their hearing loss. At this stage, they are not ready to accept help for their hearing loss.

Loss of self esteem, difficulty in doing today what was easy yesterday, suspicion of others, social isolation and loneliness are all part of the next stage, depression. Making sure the hearing- impaired individual is included in conversations, activities and decisions can help to prevent or lessen the stage of depression.

"I have hearing loss and I am ready to do something about it" is the last stage – acceptance. Acceptance is required for making the transition to seek treatment for hearing loss, including hearing instruments, aural rehabilitation and auditory training.

Talking about hearing loss

How do you help your loved one move through the stages of grieving for hearing loss? How do you begin a conversation with them about their hearing loss? First and foremost, it is important not to place blame. Hearing loss is an invisible disability that they have no control over. They can only control their response to it. Beginning a conversation in a quiet, safe environment is the first step.

• Talk about what you perceive and ask them what they perceive (in a non-prosecutorial) manner. "When we were at dinner last night, could you understand the waitress?"
• Talk about situations where you both may have problems and situations where one of you seems to do better.
• If they have changed their activities, stopped going to club meetings for example, use this as an opportunity to talk about how hearing can impact their ability to feel connected and belonging in these types of situations.
• Use the common signs and symptoms of hearing loss to talk about what you have observed. Take the quiz together and see how you both do.
• Go with them to their hearing test so that you can talk about your perspective as well