The other day, I asked a group of my retired friends whether they ever get irritated with their spouse as a result of a hearing problem. They mentioned blaring televisions, partners who seem to mumble more, and difficulty understanding cellphone conversations. Several rolled their eyes knowingly or pointed at their spouses. For older couples, bickering and hearing loss aren’t inevitable, but they frequently go together.
Case in point: I have a mild hearing impairment, and like millions of others who are over 65, I wear hearing aids. I know I say “what?” a lot, but I didn’t realize how much my hearing loss was affecting my marriage until the morning of our 50th wedding anniversary.
A spat got in the way of our special day. My wife, Kay, was talking on the phone with one of our sons. We were both outside and I was coiling a gardenhose, about 20 feet from her. Kay said something to me, and as frequently happens outdoors, her words were lost in the wind. I didn’t respond because I didn’t feel like going through the rigmarole of shouting for her to repeat herself. Sometimes I get sick of asking her (and others) to repeat themselves. Next thing I knew, she was irritated at me for apparently ignoring her. I was irritated at her for being irritated at me. Voices were raised; feeling were hurt. Goodbye, celebratory mood.
There is nothing unusual about my hearing loss, its progression and its interference in my ability to communicate with my spouse. Hearing problems are actually the norm for older adults. A recent nationwide survey found that about two-thirds of people 71 and older have some hearing loss, and that by age 85, nearly everyone is having some trouble hearing. That can translate into a lot of bickering going on among couples where one person has trouble hearing and the other being heard. Or worse, when both are a bit hard of hearing.
“It can become a frustration on both sides, especially when it’s happening day in and day out to retired couples who are around each other a lot more than they used to be,” says Dusty Jessen, a Littleton, Colo., audiologist. Jessen has seen so many patients struggle with the effects of mild hearing loss that she created the Five Keys to Communications Success program that helps her clients improve their communications skills.
Audiologists, such as Jessen, appreciate but don’t hype the benefits of hearing aids. Those benefits are real and contribute to a better life for those needing them. But hearing aids only amplify sound and may help eliminate background noise. Alone, they don’t solve communication problems. “A lot of times, communications breakdown because of outside factors, such as someone talking from the other side of the house or responding with their head in the refrigerator. Hearing aids aren’t a magic bullet when communication partners are not doing their part,” Jessen says.
Does it really matter? Occasionally getting annoyed with a spouse or not catching every word someone says isn’t that bad, is it? Research and clinical experience say otherwise. People who have trouble hearing tend to withdraw from frustrating situations, such as group conversations. They may miss out on social events, avoiding the stress of trying to converse in noisy restaurants or with more than one person at a time. This can lead to isolation, which can lead to depression and increase the risk of dementia. Hearing impairment is now recognized as one of the leading modifiable midlife risk factors for later development of the disease. “Modifiable” is the key word, one that can lead to a healthy, rewarding future instead of difficult years spent coping with cognitive problems.
Successful communications between partners are important for hearing impaired adults as well as those who have no hearing impairment. “Good communication is such a big part of a healthy relationship that we don’t want that communication breaking down for any reason,” says Bria Collins of the American Speech-Language-Hearing Association. She recommends that couples go together when one of them is having their hearing tested or being fitted for a hearing aid. That way they both talk to the audiologist, ensuring that they both understand the extent of the hearing problem and how to reduce its impact on their lives.
This shared understanding is critical to avoiding future problems. “One person may think he or she is being ignored or that their partner may not care about what she said – without realizing that their partner can’t hear them,” says Collins.
Neither dementia nor relationship problems are inevitable for people with hearing loss. All it takes is an intentional strategy and a lot of practice to create workarounds that reduce misunderstandings between spouses or friends of people with hearing loss.
Audiologists and speech language pathologists teach those workarounds routinely to hearing impaired couples. Based on working with hundreds of hearing-impaired individuals, Jessen has grouped her suggestions for better communications into five main areas. These are: technology, speaker responsibilities, listener activities, environmental changes and practice. By building a communications strategy grounded in these areas, people with hearing loss and their partners can reduce the irritation and problems that too frequently interfere with their understanding of each other.
Jessen starts with the fact that a hearing aid should be a given for people with hearing loss. Although it’s common for older adults to deny their hearing problems or back away from the idea and expense of wearing hearing aids, the tiny, barely visible devices are a necessity for someone with mild to moderate hearing loss. And, the earlier someone’s hearing is improved, the better it is for their health and happiness. Then comes the need for teamwork — speakers and listeners have to work together, both making the effort to communicate clearly with each other. This can mean never shouting from one room to another, or getting someone’s attention before addressing them.
Or it can be as simple as selecting a quiet, well-lit booth in a restaurant and speaking face to face, making sure the menu is held near the table where it doesn’t hide either of their mouths and muffle their words. It can also mean that when the speaker hears his partner say “What?” he takes the trouble of finding different words instead of repeating the same words. “The most common sounds that people with hearing loss miss are the consonant sounds — like the s, t and k. When a person with a hearing loss says ‘what?’ to their partner, the partner typically raises their voice, repeating the very words that can’t be heard. There’s no way to make those soft consonants sound louder. Their voice gets louder and to their partner it just sounds like they’re angry. Finding different words to express the same thoughts can solve this problem,” Jessen says.
Jessen points out that the environment can almost always be altered. Dishwashers can be turned off; TVs can be turned down; water running into a sink can be shut off. Finally, communications take practice. Jessen notes that by the time an older person starts using hearing aids, he or she has had years of poor communications habits behind them and that it takes time and practice to change those habits. One of those habits is especially harmful. Instead of acknowledging their difficulty understanding a speaker, hearing-impaired listeners may resort to “faking it,” by smiling and appearing to follow a conversation, when, in fact, they are struggling, trying to fill in the gaps of sounds and words they don’t hear. Good communication requires honesty, even if it means asking someone to speak louder, more clearly or to help by substituting different words.
All these techniques are part of what audiologists refer to as “aural rehabilitation.” For many people, lip reading is also a part of their rehabilitation. “Almost everybody can benefit from some degree of lip reading,” says Tessa Nguyen, audiologist at MU Health. “Even people with normal hearing watch others’ lips move as they make speech sounds,” she says. Some audiologists can help train people to master this skill; other times it requires the expertise of a speech-language pathologist.
But none of these strategies can impact individuals and couples until a person’s hearing loss is recognized as a problem. That’s not as easy as it sounds. “Hearing loss comes on gradually as we age,” says Nguyen. She recommends that older adults get their hearing screened each year as part of their annual checkup or if they notice any hearing problems. If the screening shows some loss, then a full evaluation with an audiologist or hearing aid specialist is in order. If there are other symptoms, such as drainage or ear pain, those professionals will refer their clients to an Ear Nose and Throat specialist.
In the past, hearing aids were bulky and obvious. But since the Food and Drug Administration lifted the prohibition on over-the-counter hearing aids, the number and types of new hearing aids has exploded. New technology is also giving consumers more choices and features, with prices ranging from $100 to $7,000 for a pair of hearing aids. The more expensive models usually come with Bluetooth so they can be controlled by smart phones with a variety of adjustable settings, programmed to minimize car noises, the clatter of restaurants or the echo of large rooms. Some are beginning to have AI built in so that they learn to adapt by themselves to different hearing environments. Nguyen points out that although OTC models may be good for some people with mild hearing problems, that the hearing aids prescribed by audiologists and hearing instrument specialists are more sophisticated and are programmed specifically to an individual’s hearing profile.
Regardless of the amount of technology people put in their ears, it’s the strategic approach to communication in their brains that is essential if they want to understand others and to be heard – as well as avoid sound arguments.
Learn More About Hearing and Better Communications
Books
Five Keys to Communications Success by Dusty Jessen, Au.D
Hear and Beyond: Live Skillfully with Hearing Loss by Shari Eberts and Gael Hannan
Websites
American Speech-Language-Hearing Association
www.asha.org
Hearing Loss Association of America
www.hearingloss.org
Podcasts
“The Hearing Matters” by Blaise Delfino and Douglas Beck
“Hearing Wellness Journey” by Dawn Heiman and Lindsey Dohgerty
