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The psychology of aging and hearing loss

What you need to know to help a loved one make the journey back and re-engage with life.

Hearing loss robs us of the richness of sounds that add texture to daily life. It drives us away from the warmth of the social circle and the bridge of conversation. And it can have profound effects on the psyche, working cruelly against the will to get help.

As a caregiver, your goal is to help your loved one get back what hearing loss takes away. The good news is that help is available in the form of today’s advanced hearing instruments. And this help can make a profound improvement in the quality of life.

Ironically, many hearing loss sufferers reject this help, despite your willingness to support them through it. The reasons for this paradox are bound up in the complex psychology of hearing loss. As a condition that directly affects the brain, hearing is intimately involved with our identity, our sense of wholeness and our ability to connect with the world around us. By understanding some of the emotional and mental conditions that people encounter as their hearing declines, you can be better prepared to help a loved one make the journey back to a happier, healthier life.

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With loss comes grief.

There are as many psychological profiles as there are hearing loss sufferers. Adults vary in their response according to age, the timing in their lives, their emotional makeup and the cumulative effect of life experiences. Common to the experience of most sufferers, and strongly bound up in denial and resistance, is the understanding that hearing loss is indeed a loss, and it causes grief.

For most adult sufferers, hearing problems are often seen as another sign of aging, coming, as it often does, when other physical powers are failing. The remedy for this — hearing instruments — is seen not as a sign of independence, but as a sign of weakness and disability that compounds the sense of lost youth and power. This is one of the reasons it’s so common for people to resist getting hearing instruments.


Going through stages.

Another important challenge is the psychology of grief over lost capability and lost youth. Hearing therapists often observe the classic stages of grief first described by psychologist Elizabeth Kübler-Ross: denial, anger, bargaining, depression and finally acceptance. Denial can be triggered by the fact that, compared to other losses that come with aging, hearing loss is invisible.

It can’t be seen in a mirror, like a receding hairline or new wrinkles, which makes it easy to ignore at first. Once the problem can no longer be denied, you may see anger: at hearing care professionals, at hearing devices themselves and at you, the caregiver. Take heart, though: anger is actually a sign of progress. Bargaining, the third stage, is a form of conditional acceptance that you may see in the form of conscious postponement of such committal steps as getting a hearing evaluation. The fourth stage, depression, comes with a complete realization of the condition, and it can be manifest as hopelessness and withdrawal. This is the time when a caregiver’s support is most important, and it is a sign that the final and most productive stage — acceptance — is coming.

Understanding the grief process can help caregivers see when the time is right to seek help in the form of a hearing evaluation and hearing instruments. A person who is still grieving over lost abilities is less likely to be ready to do something about it than a person who has accepted reality.


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When a hearing crisis becomes an identity crisis.

A second important timing factor is time of life, as it affects an individual’s sense of self and identity. While most adults losing their hearing tend to go through some form of grief, they approach acceptance differently, depending on age.

Younger adults are more likely to be able to incorporate their condition into their personalities than those who experience it later in life. They’re more likely to be able to say, “OK, I have a hearing problem. That’s part of who I am.” Once they accept it, people with this self-image find it easier to get help for their problem and adjust to life.

By contrast, later in life, when someone has already developed a self-image as a person who is fully able to hear, he or she may have a harder time accepting the loss. Their internal (or external) dialog is: “This is not who I am, not by a long shot!” They often describe it as robbing them of their identity. It may trigger an identity crisis, and the anxiety and depression that can go along with it.


The effect of hearing loss on the mind.

While hearing loss can rob one’s sense of youth and sense of self, it’s different from other losses we encounter and grieve in our lives. It creates its own psychological challenges.

Helen Keller is credited with noting that while blindness cuts us off from things, deafness cuts us off from people. Conversation and social interaction become harder to follow. Sufferers increasingly choose the vacuum of isolation over struggling and failing to keep up.

Therapists compare the long-term effects of untreated hearing loss on the mind to those caused by situations like solitary confinement: anxiety, depression and dementia. In other words, the longer it goes untreated, the harder it is to marshal the mental and emotional strength to seek help and put it to use.

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The psychology of getting better.

As a caregiver observing someone going through denial, grief, depression and resistance to help, you will feel frustrated at times, to say the least. Your job will be to provide as much help as you can, to avoid enabling denial, to show them what other strengths they have and to be supportive until the time is right to seek help.

When is that time? Look for resilience. Look for the moment when your loved one is able to accept the situation and make a commitment to take action. The decision for hearing instruments needs to be an active decision, based on your loved one’s desire to achieve real goals. And it needs to be their decision, not yours.

Everyone’s timing is different. When the time is right, a hearing care professional can lay out the options, explain the clear consequences and help your loved one understand how each option relates to personal goals. If there’s a true commitment to get help, the journey through grief and denial will be over.

And the new journey to a better life has begun.

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