Sit Up And Listen

10th April 2015

Hearing loss is distressing, and all too easy to overlook, discovers Heather Harris

Medically, presbyacusis (also called presbycusis) is about as common as the cold – my mother has it, and so do at least half of her friends aged over 60 – so why, I wondered, had I never heard of it before? Ironically, the answer lies in the question.

Presbyacusis (and you’d be forgiven for saying ‘pardon?’) is the medical term for the hearing loss that occurs in people as they age and the nerve cells in the inner ear that convert sound into nervous impulses to send to the brain, become damaged.

Ten million people in the UK suffer from some form of deafness but it remains one of the most misunderstood afflictions.

“If people wear glasses it’s just an accepted fact that our eyesight changes as we get older. We even make a joke about holding a menu at arm’s length or borrowing our partner’s specs in a restaurant, but no-one laughs when you have to ask the waiter to repeat himself five times and still then make a guess as to what he’s saying,” my 75 year-old mother told me when I casually dismissed her news that her hearing was going.

Her distress at the doctor’s diagnosis that she needed a hearing aid was something that I just wasn’t prepared for. After all, I thought – just pop in one of those contraptions behind your ear and you’re cured. Simple.

Except it’s not – as I learned from the various hearing loss specialists to whom I spoke.

“There is still a massive stigma attached to hearing loss,” Melanie Pickard, from the Hatch End branch of Hidden Hearing, pointed out. This nationwide company is aiming to change this lack of knowledge by making hearing problems as much an everyday talking point as failing eyesight, “We want to have more of a High Street presence, so are actually opening up inside opticians and also holding exhibitions where people can talk about their concerns.”

They are also offering new ‘on the spot’ hearing screening which takes just a few minutes, as opposed to the longer standard hearing test which many elderly people find daunting – and thus continually defer.

“I knew that in a group I was beginning to lose lots of the conversations unless the person talking was right next to me, but I didn’t want to admit I needed help, as I saw this as a real sign of old age,” a fit and sprightly Dorothy, 72, told me from behind the counter at the local charity shop where she works.

And she’s not alone. Incredibly, figures from the charity Action on Hearing Loss (previously the Royal National Institute for the Deaf) reveals, “One in ten adults in the UK would benefit from wearing hearing aids – that’s four million people – yet only one person in 30 does.”

The fact is that presbyacusis comes on gradually, often over several years, so sufferers don’t always notice at first, or can easily dismiss it. Eventually, of course, they are forced to confront their limitations.

As Dorothy admitted, “It wasn’t until I realised it was affecting my voluntary work here that I forced myself to go to the doctor who told me I needed a hearing aid.”

And, ironically, this is where the problems can start. Both my mother and Dorothy suffer from arthritis, so trying to handle the tiny pieces of technology that fit behind their ears – let alone change the minuscule batteries – has proved a challenge. Thankfully, all the specialists I consulted did stress that help is available at any time in their branches.

“It’s a really tricky situation. People want the aids to be as discreet as possible, but then have problems handling them, particularly if they are elderly, so we do encourage them to come in, and it is amazing how quickly they can learn with our encouragement,” Sarah Slade from Hearing Help in Pinner explained.

She has been working with customers for over ten years and admits there is still a huge range in responses. “Some people burst into tears when they come to choose a hearing aid, whilst others are so happy because it means they can finally communicate. The problem is the first time they wear it they can hear everything amplified – just as the first time you put on a pair of glasses it feels odd. The answer is to persevere.”

And that’s something that my mum is struggling with. As she admitted, “At my age, patience is not my strong point, and because the hearing aid is so different from what I am used to, I end up taking it out!”

Leon Cox, Director of Chalfont Hearing, who has a masters degree in Audiological Science, explained that it takes on average 45 days of constant wearing to get used to a new aid. “We do recognise this and offer a full rehabilitation programme. This involves teaching the customer how to change the way they listen. We help them manage their integration into the world of sound using their new piece of technology.” The benefits are incalculable.

The hearing aids themselves all work on the same principle, as explained by Action on Hearing Loss. “They have a built-in microphone that picks up sound, which is processed electronically in the hearing aid. The resulting 'signals' are then passed on to a receiver – like a tiny loudspeaker – where they are converted back into louder sounds that you can hear.”

The NHS tend to supply BTE (behind the ear) aids, whereas private companies can offer a wider range of choice, depending on the severity of the hearing loss. They also have more time to adjust the device to suit individual needs, which is often not feasible in the NHS, given time constraints.

As Melanie explained, “The technological advances are huge both in terms of clarity of sound and ease of use. They no longer just amplify sound but can be designed to cope with an individual problem and also have accessories which link in wirelessly with a person’s television, telephone and even the Bluetooth on their mobile phone when they’re driving.”

But such technology comes at a cost. Privately sold hearing aids range in price from £299 to £3,000 and require changing on average every four years. The premium product can, however, include such features as the ability to connect to an iPad, thus allowing the elderly to Skype relatives abroad and perhaps hear grandchildren speaking for the first time.

The hearing aids experience of many wearers is something to give my mum hope. Retired teacher Kathleen was fitted with two NHS aids eight years ago and it transformed her life. “No longer do I need the subtitles when watching television. Shopping is much less stressful – especially in shops that have working induction loop systems [hearing aids have a setting which allow these loops to make sounds clearer]. Now I can enjoy conversations with family members, friends and acquaintances without repeatedly having to ask for repetition and suffering the ensuing embarrassment of still not having heard properly.”

She also made a point about safety – again something I’d not considered in relation to my mother. “As a walker, driver and cyclist I rely on my hearing aids to help alert me to potential hazards. Also doorbells, timers and alarms would be inaudible without my hearing aid, adding to the frustration and feeling of vulnerability.”

And as the charity is keen to point out, hearing aids are not the only solution. Many sufferers combine the use of this technology with lip reading, as Sylvia, 61, tells me. She admits that her loss of hearing caused tension at home: “my family and two children didn’t know how to deal with it, often leaving me angry at the lack of their understanding.”

What helped overcome some of these issues was the understanding and practical help of a local lip-reading class. “The class is truly excellent and a wonderful support network. People of all ages coming together with disability in common… it’s the kind of support that is so very much needed.”

Hearing her use the term ‘disability’ brought the message home. The desire of the older generation to have the television on full blast and their often comical misunderstanding of conversations is not something to be dismissed.

We wouldn’t ignore other disabilities or treat them so lightly. Let’s hope that with the advancement of technology, more High Street specialists and continued NHS funding into hearing loss, presbyacusis will be a term which will make us all sit up and listen.

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