reluctant to repeat what he has just said, to look a parent in the eye, or to use a strong, clear voice. Adult children may have different concerns. They may worry about the safety of a parent who’s unable to hear the doorbell, the telephone, the smoke alarm, or an intruder. They may feel disappointed that phone calls, once pleasant times for sharing and catching up, have become times for shouting and repeating bits and pieces of information. Communicating with grandchildren can be especially challenging. Small children have high-pitched voices, making it particularly difficult for most adults with hearing loss to hear them. Their speech is also immature, and they can be shy. A grandparent’s inability to communicate with his grandchildren can cause disappointment for all three generations.

How to Help Your Partner with Hearing Loss

Encourage her to accept hearing loss as a fact of life—let her know that the problem affects both of you and that together you’ll find solutions.

Learn how to improve communication between the two of you (see Chapter 10).

Don’t let him give up or withdraw.

Encourage your partner to have a hearing evaluation (see Chapter 4) and go with her to all audiology appointments (another pair of eyes and ears can be very helpful).

Encourage him to follow the audiologist’s recommendations for treatment.

If the recommendations include a trial with hearing aids (see Chapter 7), listen carefully to the audiologist’s advice about realistic expectations and adjustment to hearing aids. Use this information to encourage your partner to give hearing aids a fair chance during the trial period.

Learn about hearing assistance technology (see Chapter 9) and hearing rehabilitation (see Chapter 10).

To the extent possible, accept your partner’s emotional responses to hearing loss and hearing aids. Understand the challenges and fatigue that she is likely to experience. Like anything else, using hearing aids becomes easier with practice.

Read on for much more advice.

STAYING IN THE GAME

If you want to live life to the fullest, you’re going to have to find ways to live with your hearing loss. This book tells you how to do that.

Some of the information in this book can’t be explained without discussing auditory structures and their functions; therefore, the next chapter provides very basic information about auditory anatomy and physiology.

Reading it makes the chapters that follow easier to understand. However, if that prospect strikes you as painful, you can always refer to the Subject Index to locate the information you need in Chapter 3.

The first step toward addressing your hearing loss is to have a qualified audiologist thoroughly evaluate your hearing. You should choose an audiologist as carefully as you would choose a physician. You need an audiologist you can trust, in whom you have confidence, and with whom you feel comfortable communicating. Information about what to look for in an audiologist is included in Chapters 4 and 7.

After your hearing evaluation, the audiologist will explain your test results and make recommendations. It’s possible that the explanation will be too fast, too technical, or just too much at one time, making you feel a little overwhelmed. If you can, read the information in Chapter 4 before your hearing test. Doing so will make it easier to understand the results and ask good questions. During your appointment, ask if you can take a copy of the test results with you. After the hearing evaluation, use the information in Chapter 4 to review the results at your own pace. If new questions arise, you can always follow up with your audiologist at that time. If you’ve already had a hearing evaluation, contact your audiologist now and ask for a copy of the report. Use the report and the information in Chapter 4 to gain a better understanding of your hearing loss.

Your audiologist will tell you if it’s necessary or advisable to see a physician about your hearing loss. Five to ten percent of all hearing losses are caused by medical conditions that can be diagnosed and treated by a physician (for example, an ear infection). When no medical condition exists, your audiologist can explain the probable cause of your hearing loss based on your test results and the history you provide (for example, hearing loss due to aging or noise exposure). If you’re like most people, you’ll want to learn more about the condition(s) responsible for your hearing problem. Chapter 5 provides information about common causes of hearing loss in adults.

Many people with hearing loss (and some without it) are plagued by noises in their ears (often described as high-pitched ringing). Such noise is called tinnitus. Everyone experiences tinnitus on occasion, but for some people it’s constant and nearly unbearable. Chapter 6 contains information about tinnitus and the techniques being used to manage it.

Based on the results of your hearing test and the information that you share with your audiologist, he will make recommendations about the steps that should be taken next. These recommendations may or may not include a trial with hearing aids (see Chapter 7). The audiologist’s recommendations are based on the nature of your hearing loss, the demands that your lifestyle places on your hearing, your feelings about wearing hearing aids, and other factors. When talking with your audiologist, it’s important to be honest about your motivation, preferences, and expectations. Not everyone is driven to hear.

What Are Your Listening Needs?12

At home . . .

What is your current living situation? Dormitory? Apartment? House? Retirement community? Assisted-living facility? Nursing home?

Do you live alone? With another person? With children? With grandchildren?

Is there a need to communicate from upstairs to downstairs, or across several rooms?

Do you watch television?

Do you spend a lot of time on the telephone?

Are there people in your life who are more difficult to hear than others?

Do you have difficulty hearing the doorbell? The telephone? The smoke alarm?

What is your most challenging hearing problem at home?

At work . . .

What is your work environment like? Noisy? Quiet? Large office? Small office? Vehicle? Outside?

How much interaction with people does your job require?

How much telephone use does your job require? Which type of telephone do you use? Landline? Speakerphone? Cell phone?

Do you handle voice messages?

Do you take dictation from a phone or recorder?

Do you attend meetings? Lectures? Seminars?

Do you give presentations?

Do you run meetings?

Do you work with small children?

Is it necessary for you to hear noises and signals produced by machinery?

Are there situations (or people) in your work environment that make communication especially difficult?

Is your employer aware that reasonable accommodations are required by the Americans with Disabilities Act (for example, telephone amplifiers or assistive listening devices for meetings)?

What is your most challenging hearing problem at work?

During social and recreational activities . . .

Do more of your social activities involve one-to-one interactions or interactions with larger groups?

Do you attend movies, lectures, concerts, or plays?

Have you ever used an assistive listening system in a public place?

Do you go to dinner parties? Restaurants?

Do your recreational activities involve sporting events? Listening to music? Bird-watching?

Are there activities that you avoid because you can’t hear well?

What is your most challenging hearing problem in social or recreational situations?

You’ll be relieved to know that today’s hearing aids are not your father’s hearing aids. No longer do they simply make all sounds louder. Instead, state-of-the-art hearing aids use digital technology to process sounds in ways that could be only imagined a few short years ago. For example, most hearing aids include circuits that make soft sounds audible but keep louder sounds from becoming uncomfortable. Many include multiple microphones and other programmable features that enable them to automatically adapt to the listening environment. For instance, a microphone that picks up sounds coming from all directions might work best in a quiet setting, but a directional microphone that picks up sounds coming only from the front might work better in a noisy setting. Contemporary hearing aids are smart enough to understand the environment and choose the best combination of features. Today’s hearing aids are even smart enough to nearly eliminate the whistling (acoustic feedback) that’s always plagued hearing aid users. All this is accomplished by an extremely tiny computer housed within the hearing aid. Believe it or not, the processing power of a desktop computer is now contained inside an instrument no bigger than the top of a pinky finger (along with its own energy source in the form of a tiny battery).

Digital technology is indeed state of the art, enabling the audiologist to customize a hearing aid to fit your particular hearing loss and to reprogram the aid should your hearing change in the future. Digital technology also offers sophisticated technical features and signal processing strategies. Whether you actually need those features and processing strategies depends on the nature of your hearing loss and the demands on your hearing. “Entry-level” digital hearing aids—and even nondigital hearing aids—are perfectly suitable for some hearing losses and lifestyles, and they can be much less expensive. Your audiologist can guide you through those decisions.

Hearing aids come in a variety of styles, some of which are virtually invisible. Among those that are visible, some are now small, sleek, and fashionably high-tech looking. Hearing aid features and styles are described in Chapter 7. Also included in that chapter is nuts-and-bolts information about the cost of hearing aids, where to buy them (and where not to buy them), trial periods, service fees, insurance coverage, warranties, batteries, and other useful information. Chapter 7 also explains why two hearing aids really are better than one (in almost all cases).

If your hearing loss is quite severe, the help that hearing aids can provide may not be enough. You may be a candidate for a cochlear implant, a

surgically implanted device that bypasses damaged parts of the ear and stimulates hearing nerves with electrical current. Training is often required to teach the brain to interpret this new type of stimulation as “sound.” People of all ages, including many who lost their hearing as adults, have had great success with implants. Implant technology and candidacy requirements are explained in Chapter 8.

Hearing aids and cochlear implants, although very helpful, have limitations, particularly across distance and in poor listening conditions. The use of hearing assistance technology (HAT) can improve speech understanding in many of these situations. Some of these devices rely on remote microphone technology to improve the signal-to-noise relationship (SNR). With remote microphone technology, a microphone is placed near the desired sound source (for example, a television, a teacher, the stage, a passenger in a car), and sound is transmitted directly to a receiver worn by the listener— without wires or cords. This reduces the effect of speaker–listener distance and makes the desired sound louder than the background noise (improving the SNR and speech understanding). Hearing aids alone cannot accomplish this.

HAT includes systems that are used in public places like auditoriums, theatres, and places of worship, but it also includes personal devices that go practically anywhere. This technology can make it easier to converse in a restaurant, hear at meetings, talk on the telephone, communicate in the car, and watch television without driving everyone else in the house crazy. Assistive listening technology helps people participate more fully in all aspects of their lives and should be considered by every listener with hearing loss. Chapter 9 covers various aspects of hearing assistance technology.

If your hearing loss is quite severe, you may have difficulty hearing things like an alarm clock, the doorbell, a smoke alarm, the telephone, or a child crying in another room. Alerting devices are available to solve many of these problems. Most use flashing lights or vibration to make a listener aware of sound in the environment. Information about these devices is also included in Chapter 9.

Despite the remarkable technological advances of the past decade, there’s still nothing that you can buy that’s as good as the human auditory system—and that’s unlikely to change in the foreseeable future. Fortunately, there are skills and strategies that—when combined with technology—can help to minimize the negative impact of hearing loss. Some of these are things that you can do; others are things that your significant other(s) can do. Teaching these skills and strategies is called hearing rehabilitation. Chapter 10 describes the full array of hearing rehabilitation services. Some services help listeners take full advantage of their hearing aids (adjusting to new hearing aids, learning to operate and care for them, etc.). Others involve instruction on important topics related to hearing and hearing loss (how hearing loss affects communication, the benefits and limitations of hearing aids, etc.). Still others involve practicing new skills

(combining speechreading with aided hearing, “stage managing” your surroundings to improve communication, etc.). Additional components may include personal adjustment counseling or family instruction and support.

Most people take their hearing for granted—at least until something goes wrong with it. The information in Chapter 11 can help you protect the precious hearing you have left and enable you to educate friends and family members about the importance of life-long hearing conservation. After all, who’s in a better position to educate others about the value of protecting their hearing than someone who’s already lost some of hers? Chapter 11 discusses the causes of hearing loss that are preventable— primarily exposure to occupational and nonoccupational noise (including iPods and other personal music players) and ototoxic medications. The chapter also covers information about various types of wearable hearing protectors (earplugs and earmuffs), actions that you can take to combat noise, and future trends in hearing restoration and hearing loss prevention.

Finally, a section at the end of the book provides resource information for a variety of hearing-related topics. The Resources section is followed by a Subject Index.

My Dad

Sometimes after my family has been discussing something for several minutes, my dad will bring up the very thing we’ve been talking

about—unaware that it’s not new to the conversation. It isn’t until then that I realize how much he’s missing, sometimes even with his hearing aids.