I recently presented a mini module at the American Academy of Audiology’s annual convention in Nashville. My talk was well attended and I received numerous comments and questions from the audience after the presentation. I am excited and grateful to have had the opportunity to share the patient’s perspective with such an impressive group of audiologists and related hearing professionals. Below I share my remarks from the meeting. I hope to have the opportunity to speak on this topic again soon.
Good morning everyone! My name is Shari Eberts. I am a hearing health advocate, writer, and the founder of LivingWithHearingLoss.com, an online community for people living with hearing loss and tinnitus. I sit on the national board of Hearing Loss Association of America (HLAA) and assuming most of you in the room are audiologists, I am also one of your patients.
My Hearing Loss Story
My hearing loss journey began in my mid-20s when I was a graduate student. Fairly quickly into the first semester, I began to miss things in class — a comment that was made under one’s breath or as an aside. Sometimes the class would erupt in laughter and I would be left looking around the room trying to figure out what had been said.
I knew what the problem was. I was losing my hearing. My father developed hearing loss as a young adult, as did his mother. I was entering a path from which there is no escape. I was devastated.
The stigma surrounding hearing loss was strong in my home growing up, such that my father eventually became isolated and withdrawn as he tried to hide it from everyone. I remember him sitting alone at parties and just assumed he was shy. But now that I have hearing loss, I know the truth. He probably couldn’t hear and was just too embarrassed or exhausted to try.
For many years, I hid my hearing loss too, using my hearing aids only when absolutely necessary, avoiding friends I couldn’t hear and isolating myself more and more. I was following my father’s example.
But then I had children of my own. Since my hearing loss is genetic I worry that I might have passed it onto them. I didn’t want them to see me hiding my hearing loss and being embarrassed by it. I needed to accept my hearing loss. So I did. And now I am an advocate for people like me.
The Audiologist Role is Key
For most people, an audiologist is the first hearing care provider they see. This was the case for me. The tone and outcome of that first visit is critical in setting the individual down his or her hearing loss path. Your role is paramount in helping the patient overcome stigma, learn how to utilize their new devices, and embrace this new phase of life. Please take your responsibility seriously.
How can you help your patients hear their best? Here are my suggestions.
Partner With Your Patient
1. Focus on hearing solutions specific to the patient. Be sure to ask about your patient’s priorities for hearing better. Do they work and need a captioned phone? Do they have trouble hearing in meetings or one on one at home? Attend the theater often? Dine out frequently? The more you know, the more appropriate solutions you can offer. Most often the best solution will be a combination of hearing aids and other things.
2. Set realistic expectations. Everyone wants hearing aids to work like glasses — you put them on and suddenly your hearing is back to normal. But we all know it doesn’t work that way. Explain the work and time that will be required by both the audiologist and by the hearing aid wearer to get things working smoothly.
3. Include the family. Hearing loss impacts the entire family so include them whenever possible in these discussions. Family involvement increases the likelihood of compliance and success.
4. Provide hearing accommodations at your office. Remember your patients are there because they can’t hear well! Make them feel welcome by insisting your receptionist is easy to understand, even over the phone. Invest in a portable hearing loop, a simple pocket-talker-like device or other assistive listening technologies for your office to aid in communication.
Embrace Innovation
1. Incorporate hearing assistive technology or HAT. The most effective hearing solutions combine hearing aids with other technologies. Stay current on new devices and apps that are developed to help people with hearing loss watch TV, enjoy dining out, attend a lecture or live performance so you can integrate them into your patient’s hearing loss tool kit. HAT can be confusing. Train your receptionist to work these devices so they can help your patients learn the ropes.
2. Recommend T-coils. While T-coils have been around for a long time, many audiologists do not make patients aware of them. Please do, since T-coils can be life changing when attending the theater, riding in a taxicab and at lectures and museums. As more venues install loops, T-coils will only become more useful.
3. Try the devices yourself. Try out the hearing aids and other assistive listening technology in various listening situations (at very low volumes of course). Use captions readers at the movies or a Roger pen at your next family dinner. Real life experience with the products will help you better understand the fit and programming issues your patients are facing.
See Beyond The Technology
1. Share communication tricks and tips. While things like getting the attention of the person first, and making sure the speaker’s mouth is visible are obvious to you, they may not be to someone new to hearing loss or to his family and friends.
2. Teach self-advocacy skills. Many people with hearing loss are shy about asking for the accommodations they need. Encourage them to ask for captioned phones at work and to use caption readers at the movies. Explain the options they have open to them through the ADA. Asking for what we need is difficult at first, but it gets easier every time we do it.
3. Join the hearing loss community. Attend meetings of the local HLAA chapter or similar group and recommend that your patients get involved too. Meeting other people with hearing loss made a big difference for me. Finally, I had people who understood my frustrations and from whom I could learn useful tips to help me hear my best. It is also a good source of referrals.
4. Be a hearing ambassador. Counsel your patients to protect the hearing they still have. Be an ambassador for hearing health wherever you go — loud restaurants, concerts, etc. You can make a huge difference for others who may not know how important it is to protect their hearing.
Want More Patient Perspective?
For more on the patient perspective, visit my website LivingWithHearingLoss.com. You can also find me on LinkedIn, Twitter, and Facebook.
Readers, what would you add to my talk?
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Excellent!
Thank you!
This is all great!
I would like to add that it is helpful if audiologist’s offices (and all providers, actually) allow you to schedule appointments via the internet. If you can’t hear or your hearing aid is broken, trying to make an appointment on the phone is futile. While my audiologist’s office does not have an active website to do that, both the audi and the office receptionist now communicate with me via email to set up or change appointments.
Great suggestion! Thanks for sharing it.
Brilliant, Shari! Really brilliant!
I’m forwarding this to my HOH/deaf friends…as well as family.
You really hit on so many important points.
People visit the audiologist and really don’t know what to ask, or what to say.
Audiologists often “assume” that, if the patient doesn’t ask questions, then why bother talking about technical info, or aural rehab info, etc.?
Well, ask you know, it makes a huge difference. Audiologists SHOULD be our partner, in learning how to live in the world, with hearing aids, as a HOH person.
Both the patient and the audiologist need to work together, as a team, for the best outcome.
As a speech pathologist, who is now having support group meetings, in Israel, I’ve met people who are HOH…even, almost deaf, who really don’t know what to say, or what to ask. They have told me that the audiologist gave them the hearing aid and then sent them on their merry way, instead of providing education about the technology, as well as info about communication strategies that will enable the HOH patient to feel more included in conversations…more able to adjust volume and other control settings. This is not the optimum method of providing service to HOH people.
I wish and hope that more audiologists follow your suggestions, in terms of being a full-service provider/educator/clinician.
Way to go, Shari!
Regards from Ronnie (SLP)
Thank you for helping to spread the word! Your support group meetings sound wonderful!
Thanks so much! I also love the idea of making appointments online. I find so many people speak too quickly and mumble. And I find it irritating that the receptionists in the audiologist ‘s office do not speak up so that I may hear them. So weird that I have to remind them that I’m hearing impaired!!!
So true! Thanks for sharing your thoughts.
Ask them to train their office staff so they know they are speaking to the deaf and hard of hearing. Inevitably when I get a phone message I am unable to decipher what is being said since the speaker is talking fast, and softly.
Absolutely! Thanks for sharing your suggestion.
I am so glad you wrote this. I have been trying to get people to understand the “Human Factor”. But that’s hard to do here in the Seattle area, with Microsoft and Boeing. People seem to think all you need is technology. But captioning and loops do little good at casual picnics when hearing people are stuffing their face with food. Many don’t understand. BUT, some do and more are learning.
The good news is that things are moving in the right direction, albeit slowly. Thanks for sharing your thoughts.
Your perspective and common sense advice is absolutely perfect!! If for some strange reason we are all forced to use only TWITTER to communicate with each other, try this:
“Audiologists: Please take your responsibility seriously. Join/participate in HLAA. Help patients build a hearing tool kit that will work in ALL settings and teach them how to successfully advocate for themselves.”
Thank you for all that you share!
Very succinct! Thank you for sharing!
Love it,love it, love it. Unfortunately, my experience with audiologists were not very positive which is probably why I do not use assistive devices today. You give me hope that experiences I’ve had will change for the better. Keep up the great work , and thank you from the bottom of my heart!
It might be time for you to try again with a different audiologist. Thank you for sharing your experiences.
Just excellent, Shari! Yesterday, someone contacted me who has decided she should see an audiologist and asked for recommendations for an audiologist. Amongst other things, I’ll be sending her your blog!
Thank you for sharing the information Barbara!
Just excellent. Your presentation is so straightforward while comprehensive. It is a snapshot of a full aural rehab package in audiology. I hope that you’ll “take this on the road.”
One thing you might add for future presentations is auditory training opportunities for patients. Audiologists can subscribe to versions of online A.T. programs, e.g. clEAR and LACE, that allow the practitioner to follow, moniter, and coach the person with hearing loss as he/she works on listening and sustaining attention.
Your voice is so important, Shari. I hope you’ll be writing for hearing loss patients and their audiologists for a long time to come. I continue to benefit greatly from your work.
Thank you for this great suggestion and your kind words.
I really appreciate reading your blog. I’m also a Bikram yoga enthusiast and I think just one of the reasons that I like that practice is that the sequence of the postures doesn’t vary. That way I don’t have to strain to hear instructions.
Recently I had an ear infection in one of my ears. When I saw a Dr. and told him that I had worn hearing aids for five years, he said that infections like mine were common with hearing aid users. I wish I had been warned when I got them because I think I would have been more careful about putting them around anywhere or in my pocket, etc. The Dr. said that going five years without an infection was actually quite good. Do you know of any kind of storage for hearing aids that would be very sanitary?
I think that is part of why I like Bikram yoga too! That is interesting about ear infections. I have not experienced that. Would keeping them in the case when not in use be sanitary enough? Thanks for your question.
I’ve never had an ear infection from wearing a hearing aid and have been wearing them a very long time . And I just leave it out on the dresser at night with battery case closed so it gets fresh air, lol . Not sure what type of aid Itha wears . I do however get a lot more wax build up lately from wearing the ear mold which could trap water and bacteria if not removed . Maybe as we age, the body doesn’t fight trapped bacteria as well as when younger . You may want to keep the mold clean , with a tissue or gentle cleaner for ear molds , but I’ve been pretty fortunate and never had ear infection from my HA (knocking on wood)!
Hi Itha. I’m a frequent visitor to this blog and have been wearing HAs for over 20years. The ear canal can be quite moist. It’s important to be able to dry out the HAs overnight. There are a couple of things you can do to assure your HAs are clean an sanitary. There is the Dry N Store, Zephyr and probably other brands. It’s a box that has a UV light in it and a heater with a fan that circulates warm dry air for an overnight “treatment” for your HAs. These devices use a desiccant cake that absorbs moisture and must be replaced every couple of months. Your audiologist can supply these accessories or you can order them from providers like Amazon. You can also use an alcohol swab to clean the ear-mold. Your HA should go in such a device every night. I have learned the hard way that cleanliness for a HA is as critical as a fresh battery. Good luck. Jerry
Your presentation was wonderful Shari, hit on all the necessary points that I sometimes think audiologists miss or don’t always know how to deal with . I can imagine it’s very difficult to fit hearing aids on elderly people with hearing loss due to aging , especially if their mental is starting to decline . I’ve been fortunate to have started wearing hearing aids at a very young age so was able to adapt easier to tolerating amplified sounds , but I notice as I’m getting older , my tolerance is becoming less and less .
Thank you for sharing your thoughts.
You do a tremendous service to so many people by providing this platform. Thank you!!!
I have shared this with dozens of people yesterday and today, and wish I could share with more of the 48 million with hearing loss and all of their families, friends, co-workers, neighbors, etc. Figure another 100 million who need to be better informed!! 🙂
Thank you so much for helping to spread the word!
Shari, it’s exciting to know you have such access to audiologists, specially those who are seeking input that will enhance their practices. It’s imperative that audiologists move beyond providing HAs. Hearing rehab, assistive listening devices and as you have mentioned, being aware of just how a patient lives her life is important in managing hearing loss and using expensive HAs. An audiologist has the best opportunity to provide information and encouragement that will increase one’s quality of life. Thanks again.
I agree! Thanks for sharing your thoughts Jerry.