If we really want to understand hearing loss, we need to understand both the physical side, which makes hearing progressively difficult, and the psychological side, which includes the lesser-known emotional reactions to the loss of hearing. In conjunction, the two sides of hearing loss can wreak havoc on a person’s total well being, as the physical reality brings about the loss and the psychological reality prevents people from dealing with it.
The statistics tell the story. Although nearly all cases of hearing loss are physically treatable, only around 20% of people who would benefit from hearing aids make use of them. And even among those who do seek help, it takes an average of 5 to 7 years before they arrange for a hearing test.
How can we explain the massive discrepancy between the possibility for better hearing and the commonplace unwillingness to attain it? The first step is to acknowledge that hearing loss is in fact a “loss,” in the sense that something valuable has been taken away and is apparently lost forever. The second step is to figure out how individuals generally react to losing something invaluable, which, owing to the scholarship of the Swiss-American psychiatrist Elisabeth Kübler-Ross, we now understand very well.
Elizabeth Kübler-Ross’ 5 stages of grief
Kübler-Ross defined 5 stages of grief that everyone dealing with loss seems to go through (in remarkably consistent ways), although not everyone does so in the same order or in the same timeframe.
Here are the stages:
- Denial – the individual buffers the emotional shock by denying the loss and contemplating a false, preferred reality.
- Anger – the individual recognizes the loss but becomes angry that it has happened to them.
- Bargaining – the individual reacts to the feeling of helplessness by trying to take back control through bargaining.
- Depression – comprehending the significance of the loss, the individual becomes saddened at the hopelessness of the situation.
- Acceptance – in the last stage, the individual accepts the predicament and presents a more stable set of emotions. The rationality associated with this stage leads to productive problem solving and the recovering of control over emotions and actions.
People with hearing loss progress through the stages at different rates, with some never reaching the last stage of acceptance — hence the gap between the opportunity for better hearing and the low numbers of people who actually seek help, or that otherwise hold off many years before doing so.
Progressing through the stages of hearing loss
The first stage of grief is the most challenging to escape for those with loss of hearing. Because hearing loss advances gradually through the years, it can be very difficult to recognize. People also tend to make up for hearing loss by cranking up the TV volume, for example, or by forcing people to repeat themselves. Those with hearing loss can stay in the denial stage for years, saying things like “I can hear just fine” or “I hear what I want to.”
The next stage, the anger stage, can reveal itself as a form of projection. You might hear those with hearing loss claim that everyone else mumbles, as if the problem is with everyone else rather than with them. People remain in the anger stage until they recognize that the issue is in fact with them, and not with others, at which point they may move on to the bargaining stage.
Bargaining is a form of intellectualization that can take different forms. For instance, people with hearing loss might compare their condition to others by thinking, “My hearing has gotten a lot worse, but at least my health is good. I really shouldn’t complain, other people my age are dealing with genuine problems.” You might also come across those with hearing loss devaluing their problem by thinking, “So I can’t hear as well as I used to. It’s just part of getting older, no big deal.”
After passing through these first three stages of denial, anger, and bargaining, those with hearing loss may go through a stage of depression — under the false presumption that there is no hope for treatment. They may remain in the depression stage for a period of time until they recognize that hearing loss can be treated, at which point they can enter the last stage: the acceptance stage.
The acceptance stage for hearing loss is surprisingly evasive. If only 20% of those who can benefit from hearing aids actually use them, that means 80% of those with hearing loss never get to the final stage of acceptance (or they’ve arrived at the acceptance stage but for other reasons choose not to act). In the acceptance stage, people recognize their hearing loss but take action to restore it, to the best of their ability.
This is the one positive side to hearing loss: in contrast to other types of loss, hearing loss is partly recoverable, making the acceptance stage easier to reach. Thanks to major advances in digital hearing aid technology, people can in fact enhance their hearing enough to communicate and engage normally in daily activities — without the stress and difficulty of impaired hearing — empowering them to reconnect to the people and activities that give their life the most value.
Which stage are you in?
In the case of hearing loss, following the crowd is going to get you into some trouble. While 80% of those with hearing loss are stuck somewhere along the first four stages of grief — struggling to hear, harming relationships, and making excuses — the other 20% have accepted their hearing loss, taken action to strengthen it, and rediscovered the pleasures of sound.
Which group will you join?
Most people are surprised to learn how young the field of audiology really is, and just how recently its founding father established the profession. To put this in perspective, if you wanted to find the founding father of biology, for example, you’d have to go back in time by 2,300 years and read the The History of Animals, a natural history text written in the 4th century BCE by the Ancient Greek philosopher Aristotle.
In comparison, to find the founding father of audiology, we need go back only 70 years, to 1945 when Raymond Carhart popularized the word. But who was Raymond Carhart, and how did he come to establish a distinctive scientific discipline so recently? The narrative starts with World War II.
World War II and Hearing Loss
One of history’s famous lessons shows us that necessity is the mother of invention, meaning that challenging conditions prompt inventions focused on reducing the difficulty. Such was the story for audiology, as hearing loss was growing to be a bigger public health concern both during and after World War II.
Indeed, the primary driving force behind the advancement of audiology was World War II, which resulted in military personnel returning from combat with significant hearing damage due to direct exposure to loud sounds. While several speech pathologists had been calling for better hearing evaluation and treatment all along, the amount of people dealing with hearing loss from World War II made the request impossible to dismiss.
Among those calling for a new profession, Robert West, a well known speech pathologist, called for the development of the speech pathology field to include the correction of hearing in 1936 — the same year that Raymond Carhart would graduate with a Doctor of Philosophy degree in Speech Pathology, Experimental Phonetics and Psychology.
Raymond Carhart Establishes the New Science of Hearing
Raymond Carhart himself began his career in speech pathology. He received his Bachelor of Arts degree in Speech and Psychology from Dakota Wesleyan University in 1932 and his Master of Arts and Doctor of Philosophy degrees in Speech Pathology, Experimental Phonetics and Psychology at Northwestern University in 1934 and 1936. Carhart was in fact one of the department’s first two PhD graduates.
Right after graduation, Carhart became an instructor in Speech Re-education from 1936 to 1940. Then, in 1940 he was promoted to Assistant Professor and in 1943 to Associate Professor. It was what occurred next, however, that may have changed the course of history for audiology.
In 1944, Carhart was commissioned a captain in the Army to head the Deshon General Hospital aural rehabilitation program for war-deafened military personnel in Butler, Pennsylvania. It was here that Carhart, in the setting of helping more than 16,000 hearing-impaired military personnel, popularized the term audiology, designating it as the science of hearing. From that point forward, audiology would split from speech pathology as its own distinctive research specialization.
At the conclusion of the war, Carhart would go back to Northwestern University to develop the country’s first academic program in audiology. As a skillful professor, he guided 45 doctoral students to the completion of their work, students who would themselves become notable professors, scientists, and clinical specialists across the country. And as a researcher, among many contributions, Carhart developed and refined speech audiometry, in particular as it applied to calculating the effectiveness of hearing aid performance. He even identified a distinct pattern on the audiogram that indicates otosclerosis (hardening of the middle ear bones), eponymously named the “Carhart notch.”
Raymond Carhart’s Place in History
Of history’s founding fathers, the name Raymond Carhart may not be as familiar as Aristotle, Isaac Newton, Albert Einstein, or Charles Darwin. But if you wear hearing aids, and you know the degree to which the quality of life is increased as the result, you might place Raymond Carhart on the same level as history’s greats. His students probably would, and if you visit the Frances Searle Building at Northwestern University, you’ll still see a plaque that reads:
“Raymond Carhart, Teacher, Scholar, and Friend. From his students.”
When it’s time to shop for a car, the majority of us know exactly what to do. We do some research, compare options, and compose a list of questions to ask the dealership. We work on this so that by the time we’re ready to stop by the dealership, we have an idea of what we’re looking for and we know which questions to ask.
When it’s time to choose hearing aids, on the other hand, most people don’t know where to get started. Although the process is comparable to buying a car, it’s also in many ways more complicated (and probably not quite as fun). It’s more complicated because each person’s hearing loss is distinct and each pair of hearing aids requires customized programming. If purchasing a car was like this, it would be like you taking it home and having to install the transmission yourself.
Luckily, you don’t need to know how to program your own hearing aids, but you do need to know the questions to ask to make sure that your hearing specialist covers all bases, correctly programming the most suitable hearing aids for your requirements and lifestyle. In this manner, producing a list of questions to talk about with your hearing specialist is the single most important thing you can do prior to your hearing test.
But which questions should you ask? Here are 35 to get you started, separated by category:
Specific kinds of hearing loss require specific types of treatment. The more you know about your own hearing loss, the better you’ll be able to sort through hearing aid options. You want to consider what form of hearing loss you have, if it will get worse, how soon you should treat it, and all of your treatment choices.
Questions to ask:
- What type of hearing loss do I have?
- Do I have unilateral or bilateral hearing loss?
- Can I have a copy of my audiogram?
- Will my hearing loss worsen as time goes by if left untreated?
- Will hearing aids enhance my hearing?
- How much of my hearing will hearing aids restore?
- What are my other choices besides hearing aids?
HEARING AID STYLES AND FEATURES
Hearing aids come in many styles, from multiple producers, loaded with numerous features. You need a organized way to narrow down your choices to ensure that you get the best hearing aid without wasting money on features you don’t need or want.
Questions to ask:
- How many different types of hearing aid styles do you offer?
- Which hearing aid style is most beneficial for my requirements and lifestyle?
- Which digital features would be valuable to me, and which could I do without?
- What are telecoils and directional microphones and do I need them?
- Do I need Bluetooth compatible hearing aids?
- Do my hearing aids need to be professionally programmed?
- Do I need one or two hearing aids, and why?
HEARING AID PRICES, FINANCING, WARRANTIES, AND TRIAL PERIODS
The total price of a pair of hearing aids commonly includes the professional fees associated with custom fitting and programming, along with several other services or accessories. You want to make sure that you fully grasp what you’re getting for the price, if financing is available, if insurance will help, what the warranty protects, the length of the trial period, and if any “restocking fees” apply to the end of the trial period.
Questions to ask:
- What is the total cost of the hearing aids, including professional services?
- Do you provide any financing plans?
- Will my insurance policy help pay for hearing aids?
- How much will my hearing aids cost me each year?
- Do the hearing aids come with warranty coverage?
- How much do hearing aid repairs cost after the warranty has concluded?
- Are repairs performed at the office or somewhere else?
- If my hearing aids have to be mailed out for repairs, are loaner hearing aids provided?
- Is there a trial period and how long is it?
- Is there a restocking fee if I return my hearing aids during or after the trial period?
HEARING AID OPERATION, CARE, AND MAINTENANCE
Your hearing specialist should explain to you how to care for, clean, and operate your hearing aids. To be sure that nothing is forgotten, make sure all of these questions are addressed:
Questions to ask:
- How do I operate my hearing aids?
- How do I use hearing aids with telephones and other electronics?
- Can you show me how to use all of the buttons, features, and settings for my hearing aids?
- What are environmental presets, and how do I access them?
- Do I need a remote control, or can I use my smart phone to operate the hearing aids?
- What batteries do I need, how long will they last, and how do I replace them?
- How should I clean and store my hearing aids?
- Do I need to come back for follow-up appointments?
- How long will my hearing aids keep working?
- Do I need to update the hearing aid software?
- Do I qualify for future hearing aid upgrades?
YOU’RE READY TO SCHEDULE YOUR HEARING TEST
Ok, so buying a pair of hearing aids may not be as enjoyable as picking out a new car. But the quality of life you’ll achieve from better hearing might very well make you happier, as you’ll reconnect with people and take pleasure in the subtleties of sound once again. So go ahead and schedule that hearing test — your new pair of hearing aids are waiting for a test drive.
You’ve without doubt heard that today’s hearing aids are “not your grandfather’s hearing aids,” or that hearing aid technology is light-years ahead of where it used to be, even as recently as 5 to 10 years ago. But what makes today’s technology so much better? And what exactly can modern hearing aids accomplish that couldn’t be achieved in the past?
The abbreviated answer is, like virtually all consumer electronics, hearing aids have benefited considerably from the digital revolution. Hearing aids have emerged as miniaturized computers, with all of the programming adaptability you would anticipate from a modern computer.
But before hearing aids became digital, they were analog. Let’s see if we can understand why the shift from analog to digital was such an enhancement.
Digital vs analog hearing aids
At the most basic level, all hearing aids do the job the same way. Each hearing aid is made up of a microphone, amplifier, speaker, and battery. The microphone detects sound in the environment, the amplifier strengthens the signal, and the speaker supplies the louder sound to your ear.
Fundamentally, it’s not very complicated. Where is does get complex, though, is in the details of how the hearing aids process sound, which digital hearing aids accomplish far differently than their analog counterparts.
Analog hearing aids process sound in a fairly uncomplicated way. In three basic steps, sound is picked up by the microphone, amplified, and sent to the ear through the speaker. That is… ALL sound is made to be louder, including background noise and the sound frequencies you can already hear properly. Put differently, analog hearing aids amplify even the sounds you don’t want to hear — think of the scratching sound you hear from an analog recording on a vinyl record.
Digital hearing aids, alternatively, apply a fourth step to the processing of sound: conversion of sound waves to digital information. Sound by itself is an analog signal, but rather than just making this analog signal louder, digital hearing aids first convert the sound into digital form (saved as 0s and 1s) that can then be changed. Digital hearing aids, therefore, can CHANGE the sound before amplification by modifying the information saved as a series of 0s and 1s.
If this sounds like we’re talking about a computer, we are. Digital hearing aids are in essence miniature computers that run one specific application that manipulates and improves the quality of sound.
Advantages of digital hearing aids
A large number of modern hearing aids are digital, and for good reason. Because analog hearing aids can only amplify incoming sound, and cannot alter it, analog hearing aids very often amplify distracting background noise, making it hard to hear in noisy environments and nearly impossible to talk on the phone.
Digital hearing aids, however, have the versatility to amplify specific sound frequencies. When sound is converted into a digital signal, the computer chip can recognize, label, and store specific frequencies. For instance, the higher frequency speech sounds can be classified and stored separately from the lower frequency background noise. A hearing specialist can then program the computer chip to amplify only the high frequency speech sounds while suppressing the background noise — making it effortless to follow conversations even in noisy settings.
Here are some of the other advantages of digital hearing aids:
- Miniaturized computer technology means smaller sized, more discreet hearing aids, with some models that fit entirely in the ear canal, making them mostly invisible.
- Digital hearing aids tend to have more appealing designs and colors.
- Digital hearing aids can be programmed by a hearing specialist to process sound differently according to the setting. By changing settings, users can achieve ideal hearing for diverse situations, from a silent room to a noisy restaurant to talking on the phone.
- Digital hearing aids can be fine-tuned for each patient. Each person hears different sound frequencies at different decibel levels. Digital hearing aids permit the hearing specialist to adjust amplification for each sound frequency based on the attributes of each person’s unique hearing loss.
Try digital hearing aids out for yourself
Reading about digital hearing aids is one thing, trying them out is another. But bear in mind that, to get the most out of any set of hearing aids, you need both the technology and the programming proficiency from an experienced, licensed hearing specialist.
And that’s where we come in. We’ve programmed and fine-tuned countless hearing aids for individuals with all types of hearing loss, and are more than happy to do the same for you. Give us a call and experience the digital advantage for yourself!
Sometimes, it seems like we enjoy to deceive ourselves. Wikipedia has an entry titled “List of common misconceptions” that consists of hundreds of widely-held but false beliefs. Yes, I know it’s Wikipedia, but take a look at the bottom of the page and you’ll see approximately 385 credible sources cited.
As an example, did you know that Thomas Edison didn’t invent the lightbulb? Or that sugar does not actually make kids hyperactive? There are a multitude of examples of beliefs that we simply assume to be accurate, but from time to time, it’s a good idea to reassess what we think we know.
For some of us, it’s time to reexamine what we think we know about hearing aids. The majority of myths and misconceptions about hearing aids are based on the issues connected with the antiquated analog hearing aid models. But seeing as the majority of hearing aids are now digital, those concerns are a thing of the past.
So how current is your hearing aid knowledge? Read below to see if any of the top 5 myths are preventing you or someone you know from getting a hearing aid.
The Top 5 Myths About Hearing Aids
Myth # 1: Hearing aids are not effective because some people have had bad experiences.
Reality: To start with, hearing aids have been proven to be highly effective. A study reported in the Journal of the American Medical Association comparing the performance of three popular types of hearing aids determined that:
Each [hearing aid] circuit markedly improved speech recognition, with greater improvement observed for soft and conversationally loud speech….All 3 circuits significantly reduced the frequency of problems encountered in verbal communication….Each circuit provided significant benefit in quiet and noisy listening situations.
Additionally, since the publishing of this research, hearing aid technology has continued to get better. So the question is not whether hearing aids work — the question is whether you have the right hearing aid for your hearing loss, professionally programmed based on to your preferences by a qualified professional.
Negative experiences are probably the result of receiving the wrong hearing aid, buying hearing aids online, consulting the wrong individual, or not having the hearing aids customized and professionally programmed.
Myth # 2: Hearing aids are big, cumbersome, and unattractive.
Reality: This one is rather easy to disprove. Simply perform a quick Google image search for “attractive hearing aid designs” and you’ll discover a number of examples of sleek and colorful models from multiple manufacturers.
Also, “completely-in-the-canal” (CIC) hearing aids are available that are virtually or completely unseen when worn. The newer, stylish designs, however, compel some patients to choose the slightly larger hearing aid models to show-off the technology.
Myth # 3: Hearing aids are too expensive.
Reality: Today, some flat screen television sets with ultra-high definition curved glass retail for $8,000 or more. But this doesn’t make us say that “all TVs are too expensive.”
As with television sets, hearing aids range in cost according to functionality and features. While you may not want — or need — the top of the line hearing aids, you can without doubt find a pair that fits your needs, preferences, and finances. Also take into account that, as is the case with all consumer electronics, hearing aids are becoming more affordable every year, and that the value of healthier hearing and a better life is almost always well worth the cost.
Myth # 4: You can save time and money buying hearing aids online.
Reality: Remember myth # 1 that asserted that hearing aids are not effective? Well, it was very likely brought about by by this myth. Like we said before, hearing aids have been proven to be effective, but the one caution to that statement has always been that hearing aids have to be programmed by a professional to assure performance.
You wouldn’t dare purchase a pair of prescription glasses online without contacting your eye doctor because your glasses need to be individualized according to the unique attributes of your vision loss. Buying hearing aids is exactly the same.
Yes, visiting a hearing specialist is more expensive, but consider what you get for the price: you can be certain that you get the right hearing aid with the right fitting and settings, together with follow-up care, adjustments, cleanings, instructions, repair services, and more. It’s well worth it.
Myth # 5: Hearing aids are uncomfortable and confusing to operate.
Reality: If this makes reference to analog hearing aids, then yes, it is largely true. The thing is, almost all hearing aids are now digital.
Digital hearing aids dynamically process sound with a small computer chip so that you don’t have to be concerned about manual adjustments; in addition, some digital hearing aids can even be operated through your smartphone. The bottom line: digital hearing aids are being designed with optimum ease-of-use in mind.
Your hearing specialist can also produce a custom mold for your hearing aids, providing a comfortable and correct fit. While a one-size-fits all hearing aid will likely be uncomfortable, a custom-fit hearing aid conforms to the contours of your ear.