About 15 years ago, I was working at a seaside town when a wealthy American yacht owner came into the clinic, dragged in by his attractive partner who was less than half his age. He’d lost around half of his hearing and, much to his partner’s frustration, had refused any kind of assessment or treatment. “She can just speak up!” he insisted.
The couple were planning a trip to Polynesia however a few months later, the gentleman came back into the clinic. The trip never happened. The young lady had left him and he was finally motivated to address one of the root causes of his relationship breakdown… his hearing loss.
For me, one of the most frustrating things about working in hearing health care is the depth of avoidance and denial people face when dealing with the challenges of their hearing loss for the first time. A big part of the problem is that the profession has failed to shift the outdated stereotype of the ‘big beige banana’ hearing aids. In Audiology, we see one of the lowest treatment rates I can find of any medical profession. If only more people knew that today’s devices are smaller and smarter than ever before. If only more people knew that the benefits of treating hearing loss are relatively immediate, often profound and may reduce the risk of cognitive decline in later life.
What makes hearing loss uniquely different to just about every other health condition is the impact it has on other people. When you have hearing loss, it doesn’t just affect you; it affects anyone wanting to have a conversation with you and in particular, your closest loved ones.
In 2012, researchers at The University of Queensland investigated the extent to which spouses of people affected by hearing loss acquired a ‘third party disability’ as a result of their partner’s hearing impairment. Third party disability is defined as the disability and functioning of family members as a result of the health condition of their significant other. The study included 100 couples and the criteria for taking part was that one spouse had hearing impairment and the other had normal hearing. What emerged was that 98% of the normal-hearing spouses were found to have at least some degree of third party disability as a result of their partner’s hearing loss. In severe cases, this commonly resulted in lower relationship satisfaction as reported by the spouse. I find that the results of this study are echoed in my audiology practice. Spouses are often the much more motivated individual to have their partner’s hearing loss treated.
When conversation becomes challenging and it becomes necessary to repeat ourselves often, the tendency is to just stick to the basics. Nuances and subtleties are often diminished; we do away with verbal affection and we avoid talking because it’s difficult and tiresome. We don’t bother telling little jokes or funny stories anymore because timing and suspense are so important to the effect. The richness of communication disappears and we end up sticking with the mundane. Inevitably, this leads to a weakening of the human connection and there is a real danger of isolation setting in, even within a long-term relationship such as a decades-long marriage.
The impact of untreated hearing loss on cognitive health has gained significant research attention in recent years. If you’ve read my book, you’ll know that the globally-recognised Lancet Journal cited hearing loss as the number one risk factor for the development of dementia. It also revealed that hearing loss is associated with a 30-40% acceleration in cognitive decline. The good news is, studies have shown that treating hearing loss increases cognitive function. After just two weeks, there are significant increases in selective attention, memory recall and processing speed. I can only speculate as to how much harmony these kinds of improvements would restore in a relationship dealing with hearing loss in one of the partners.
The graph below illustrates ten areas of life improvement that are experienced by wearers of hearing devices and their family members, when hearing loss is treated. Almost all the factors show that family members are more satisfied than the person receiving the treatment!
For many, the idea of treating hearing loss can feel daunting. If you suffer from hearing loss, I’d encourage you to consider the wider implications of letting it go untreated. But if you do seek treatment, and wear your devices which I promise, are not the ugly old hearing aids of days gone by, you will experience a fuller participation in life. Plus, you’ll be enabling those around you to better share it with you.
#Audiologist#Audiologist #HearingLoss#HearingLoss #HearingAid#HearingAid #NeuAudio#NeuAudio
For most, the prospect of taking the first step to treat hearing loss is daunting. Unlike a trip to the doctor or dentist, it’s hard to know what to expect. I believe it is important to give you some insight into what we’ll cover and to address common factors and concerns that tend to hold people back. Often there are questions, many of which go unspoken, I like to call these the ‘Eight Elephants in the Room’. Let’s bring them out and address them shall we?
Elephant # 1 “I already know what the diagnosis will be.” If you’ve put off having a hearing assessment because you’re reasonably sure of the likely outcome, you’re not alone. On average it has taken seven years of struggle for a patient to get to the point of making an appointment, we now know that’s seven years too late. In my 18 years of experience I’ve learned rarely are there any surprises as, more often than not, hearing loss has been around for some time. At your appointment you’ll get the full picture on your hearing health including your ability to hear in background noise relative to your age. You’ll also learn how simple treatment can be.
Elephant # 2 “Hearing Aids look like Big, Ugly, Beige Bananas.” That’s exactly what the first behind the ear hearing aids looked like! Fortunately, much has changed. The last time I fitted a big beige banana was around 18 years ago and I still feel a bit embarrassed, alas, it was what we had to work with at the time. Today’s devices are modern, discreet and look nothing like the traditional devices of yesteryear. Most enable additional, seamless interactivity with your smartphone and TV. Almost always there are completely invisible options too, which may involve a trade off in functionality. If hearing devices are needed, let’s discuss the right option for you, you have my word, it WON’T be a big beige banana!
Elephant # 3 “I don’t want to draw attention to my hearing loss.” Whilst hearing loss itself is invisible, rarely are the symptoms. Leaning in to hear conversation and asking for repetition are common outward signs. My patients often confess to pretending to hear in social situations and dread the times they were caught out. Skilled lipreaders can often conceal their hearing loss by putting the visual pieces of the puzzle together, however hearing from another room or at other times when you can’t see the speaker’s face is likely to be an ongoing challenge. TV at normal volume is difficult for most people with hearing loss as quite often you can’t see the speaker’s face. The magnitude of the required TV volume is often the tipping point that brings people into my practice. Know there are always discreet options and the sooner you act, the better the outcome.
Elephant # 4 “Don’t hearing aids just end up in the top drawer?” Unfortunately, there is some truth to that statement. In Australia, studies have shown that around 1/3 of hearing aids almost never leave the top drawer, but not on my watch. At your appointment, we’ll discuss why this occurs and how to avoid such waste. 93% of my patients wear their devices at least 12 hours per day, which is necessary to receive the full benefit and value. I’ll make comfort a priority to enable full time ease of use.
Elephant # 5 “Don’t hearing aids just make everything louder?” Essentially true of traditional devices and untrue of premium technology. You’ll learn the difference.
Elephant # 6 “I don’t want to be sold something.” No one likes that feeling and that is not what you can expect when you come to my practice. We have a strong focus on patient education and uniquely independent advice. As a referrals-based practice, we depend very much on the word of mouth satisfaction of our patient base which only come as a result of appropriately meeting our patient’s needs. These referrals help us expand our reach of quality hearing services and support the less fortunate in Cambodia. The only regret we commonly hear from our patients is that they didn’t take action sooner. You won’t get pressure from us. You will get unbiased, professional advice and a full picture of your hearing health. Regarding the cost there’s a range of options, none of which equate to more than $50 per week over a three-year period.
Elephant # 7 “I/my friend/my family member didn’t have a great experience at another practice, how are you different?” Perhaps the staff at the other practice lacked confidence and experience or is simply not at liberty to use their clinical judgement by virtue of their employment situation. The hearing industry in Australia is arguably the most corporatised in the world, meaning that most clinicians are required to answer to a frequently non-clinical boss. As the owner of NeuAudio, I only answer to my patients. Most practices in Australia are owned by manufacturers which means that the range of solutions they can offer you is exceptionally limited. It has been my experience that no one manufacturer has the ideal solution for all patients and their research and development cycles differ, meaning the best solution today may be superseded tomorrow by another brand that’s ahead of the curve. As an independent practice, we’re in the unique position of having access to the full range of solutions so we can recommend what is best for you.
Elephant # 8 “Is this going to be a long drawn out process?” Not at all. Most people walk out of their first appointment able to hear better straight away. It is important to note that adjusting to your new world of sound is an adaptive process, we’ll let you know what to expect and make the experience as comfortable as we can.
Today’s premium devices require only the simple act of putting them in first thing in the morning, taking them off at night, and nothing in-between! Most are rechargeable without the hassle of batteries and automatically adapt to changing environments without you lifting a finger. A common inconvenience for hearing impaired people is mishearing in social settings to the point they start to avoid them. Our job is to help avoid that situation and simply enable a fuller participation in life.
Hopefully this addresses some of the questions or concerns you may have had ahead of your appointment. A gentle reminder to bring someone you care about that has a familiar voice as they may be needed in part of the assessment.
Best Regards
Andrew
#Audiologist#Audiologist #HearingLoss#HearingLoss #HearingAid#HearingAid #AllEarsCambodia#AllEarsCambodia #NeuAudio#NeuAudio
Do you ever feel like you’re not quite receiving all the messages you should be? People are talking to you but you’re not hearing them? Or maybe you’re watching TV and zoning out and then, when the programme is finished, you have no idea what you just watched? Similarly, you may have noticed that other people frequently comment that you don’t pay attention when they talk.
Mild hearing loss is something that often goes unnoticed – or at least unacknowledged – for a long time before a person takes action. It’s often such a gradual decline that it’s only after a couple of years that you might take stock of your situation and think: “Geez, maybe I’m not hearing properly.”
It reminds me of the old fable, The Emperor’s New Clothes. The jolly old Emperor is spun a fib, that the clothes the two weavers have made for him are made from the world’s finest fabric ever to grace the form of an important dignitary, but that only those of equal status are able to see them. The weavers, great scam artists of their day, simply made no clothes at all but employed theatrics to dress the Emperor with great assurance, pretending to fasten his invisible buttons, straighten his glorious invisible coat and correct his invisible lapels.
In reality, the weavers were out to make a grand fool of the Emperor and sent him out to greet his public in nothing but his undergarments. The Emperor, blissfully unaware, feels immensely proud of his spectacular outfit. He walks through the streets completely oblivious to the titters and sniggers of the crowd. All his loyal subjects know he is parading close to naked, but no one is brave enough to tell him. Some simply don’t want to offend him, others are fearful of what might happen to them if they do and still others think the whole affair is nothing more than a huge laugh.
What if you’re travelling through life in blissful ignorance? What if you don’t really know the extent of your hearing loss? Being such a gradual decline, it can be an issue that doesn’t bother you on a daily basis. And you don’t meet the same people every day either. One day, you might engage with the checkout operator and she has to repeat herself a couple of times. Later that same day, you might bump into an old friend who tells you what’s going on in his life but in the evening, when you go home and tell your spouse, you can barely remember what he said. A few days later, you’re having a meeting with a client in a noisy café and you notice that you’re reading his lips instead of listening to what he’s saying. “Hmm,” you think, and the penny starts to drop. You make a mental note: “We should meet in a quieter environment next time.” Meanwhile, the client has gone away wondering if you’re entirely interested in doing business with him. Of course, he doesn’t say anything to you and you’re none the wiser that he’s considering choosing someone else.
No one wants to appear rude and tell you: “Hey, I think you’re hard of hearing.” Certainly, it would be confronting if someone who is not close to you told you so. Even if a family member tries to gently let you know that they’ve noticed you zoning out instead of listening, it can be a difficult thing to process.
One of my patients is a 51-year-old businesswoman who noticed she was lip-reading instead of properly listening. At client meetings, she would watch the other person’s mouth instead of maintaining eye contact. “I found myself doing it more and more and it was embarrassing after a while,” she says. “Eye contact is so important in communication yet there I was, looking as though I wasn’t listening, and the truth was, I was listening extra hard!”
After being treating her hearing loss, my patient has discovered that communication is now easier and she can now even take notes while listening, and not have to keep her vision fixed on the person’s face. “I knew I’d been having problems hearing but I didn’t equate it to ‘hearing loss’ as such,” she explains. “I thought I was too young for hearing loss and certainly too young for hearing aids! But now that I have them and looking back, I feel as though I was really not a part of the same world everyone else was in.”
The Emperor in the fable fell victim to the invisible clothes scam because he was incredibly vain and was susceptible to his scammers’ ploys. In someone who is suffering from hearing loss, vanity is often not the issue, sometimes it’s purely a lack of awareness. It’s not your fault that you’re not aware of your hearing loss. The wonderful thing is that hearing loss can be treated; you can shake off those ‘invisible clothes’ and get back in the world and hear what everyone else is hearing.
#HearingAid #Audiologist #HearingTest #Tinnitus #CognitiveDecline #Dementia #Alzheimers
#AuditoryDeprivation #SocialIsolation #Loneliness
Hands down, the best piece of advice I can give any hearing aid owner is that their devices need to be worn full time, meaning at least 12-16 hours per day or all waking hours.
Ask anyone that has had their hearing treated at my practice and they’ll tell you that I’m fanatical (in the nicest possible way) about full time hearing aid use, it’s really, really important! Apart from bathing, swimming and sleeping, the more your devices are in, the more beneficial they’ll be in the immediate and long term. Yet, a surprisingly high number of Australians that own hearing aids don’t wear them adequately. We’ll discuss why this occurs, what can be done about it and the benefits of full-time use.
In a major study on 13,591 Australian hearing aid owners published in 2015, Dr. Anthony Hogan found that approximately one third of hearing aid users don’t wear their devices at all or less than two hours a day, one third wears them only 2-12 hours per day and only one third wears them 12+ hours a day, the necessary timeframe for the benefits you’ll soon read about. I’m not advocating that this lack of device use is in any way acceptable or advisable, the fact is, under use is a real thing. But it doesn’t have to be this way.
Hearing Aid owners simply weren’t told. Perhaps the Audiologist that fitted the devices, was short on time, has a company restricted schedule or wasn’t across the benefits of full-time use? Not a week goes by that I explain the benefits of full time use to someone that has purchased them elsewhere and it’s as if the first time they’d heard it. It takes time, effort and persistence to encourage full time use and frequent checking of the inbuilt databases that all todays devices have. In my opinion, advising and checking on full time use it is the most important thing your Audiologist can do.
The initial acclimatization period was not fully completed. On average, it takes 7 years of struggle for Australians to address a hearing problem (we now know that’s seven years too late, but that’s another story). Whether its 3 years or 30 years delay, hearing loss has generally been around for a long time before it is dealt with. When we do address it and finally fit hearing aids, there’s much to get used to and it’s an adaptive process. Like a muscle that hasn’t been exercised, the neural pathways take time to strengthen. The brain also needs to ‘relearn’ to filter which sounds are useful and which are not, this resetting of the filters simply takes time. For most people, 7-10 days of 12-16 hours of use at conservative settings does the trick, sometimes adjustment is needed. It’s a personalized process depending on the degree of loss, how long hearing loss has been around for, personal preference and loudness tolerance. The early stages are the most challenging, but they are a crucial aspect of success, everything tends to get better from there.
The devices are not comfortable enough for full time use. If they’re not comfortable, they simply won’t be worn sufficiently. Normally the physical fit can be improved substantially in experienced hands. Loudness and noise reduction settings can also be made to be more comfortable in most cases, provided the technology level of the hearing devices allows it. Sometimes the look of the devices makes the wearer uncomfortable wearing them in all situations, a matter that can often be addressed with more cosmetically acceptable devices.
In the absence of encouragement for full time use, insufficient acclimatisation or if the devices are uncomfortable; too often hearing aids are left in the top drawer or treated like ‘reading glasses’ and put on only for conversation. Our sense of hearing is completely different to vision, the full benefits and value can only be experienced with full time use. For instance, reading glasses can assist with short sightedness which is an inability to appropriately focus at the eye level. The ability to focus on what you want to hear occurs at the level of the brain, not at the ear. Wearing hearing devices on a part time basis creates confusion because it is challenging for the brain to learn to focus at varying volume levels.
Another benefit of full time use that is attracting recent research attention is the reduced risk of falls that occurs when hearing loss is treated. Untreated hearing loss has been shown to result in a 300% increased risk of falls for 40-69 year olds, even at mild levels. Researchers have cited two main reasons for this, the first being environmental awareness. With untreated hearing loss, you’re less likely to hear that thing you’re about to trip on, that step you may miss or that bike or scooter whizzing past when you’re out for a walk. The second reason they cite is the sheer mental resources taken to compensate for hearing loss leaves less attention for steadiness and balance. Falls account for 25% of all hospital admissions, and 40% of all nursing home admissions 40% of those admitted do not return to independent living; 25% pass away within a year. As alarming as these statics are, they are an underestimate as many falls go unreported. Separate to this, a major cause of falls in the elderly is when they get up to answer the phone. Some of the latest hearing aids integrate to cell phones and are handsfree which could help prevent that happening. Falls can happen at any time; full time hearing aid use essentially nullifies the increased risk that comes with hearing loss.
When you think about it, you can’t turn your natural hearing levels on and or up and down. If you, or someone you care about owns hearing devices, know that 12-16 hours per day is critical to success and to maximise the value of these modern marvels. If comfort is an issue, let your Audiologist know. Indeed, we’d love to help you get back on track. click here
#hearingaid #tinnitus #hearingloss #WixBlog
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