This article appeared in the November/December 2001 issue of Hearing Loss: The Journal of Self Help for Hard of Hearing People.

Why Don’t People Who Need Hearing Aids Get Them?

Our Readers Write

By Samuel Trychin

This s a follow-up on Sam Trychin’s article in the May/June 2001 issue of Hearing Loss. Our readers’ response to that article provide their personal insight into the question raised by Dr. Trychin. Read on.

In response to my article in the May/June issue about why people don’t acquire or wear hearing aids, our readers responded with realistic comments and suggestions. All were important and are reprinted below.

S.S. Writes…

S.S. writes that she has been wearing hearing aids since age six and is “lost, helpless, and isolated without them.” An effective method she uses for getting someone to try wearing a hearing aid is to share her own story about the difference it has made in her life.

She also states that hearing aid dispensers did not prepare her for the “break-in phase” each time a new hearing aid was acquired. Nor was she ever informed that adjustments requiring many visits back to the hearing aid dispenser are often needed to get the best results from a hearing aid. Not knowing this, the person who bought the hearing aid becomes frustrated and disappointed because it doesn’t work.

She also suggests that support groups might also be helpful, but, “I’ve never run across a hearing aid dispenser office that offered this service or indicated how the person might locate this type of service.”

Ms. S.S. goes on to make a very important observation. “The hearing person who nags his family member about his hearing loss only makes the person with the hearing loss feel inadequate and alone.” She suggests that the hearing family member be supportive and encouraging in order for the person with the hearing loss to seek further assistance by having his or her hearing tested and following up with other solutions.

A.M. Writes…

In a response related to family members’ roles in regard to hearing loss, A.M. writes that she is one of those who are unable to benefit from hearing aids due to the nature of her hearing loss. She states, “Actually, if I could find an aid that would help, I’d wear it on top of my head with an antenna attached.”

Family members, especially those who are benefiting from hearing aids, and who do not understand that some types of hearing loss are not suitable for hearing aids, may mistakenly believe that the person is denying the hearing loss, malingering, or using some other excuse for not using hearing aids. This type of reaction increases emotional distress and adversely affects the individual’s psychological health.

K.J. Writes

K.J. writes that, “ I would LOVE to have a hearing aid, but I have been told by my otolaryngologist that because of my hearing loss I cannot wear a hearing aid.”

She has a unilateral hearing loss with normal hearing in one ear and a profound sensorineural hearing loss in the other. She goes on to say, “It is so frustrating when I’m doing everything I can and still can’t hear.”

J.A. Writes

J.A. is another individual who uses “encouragement by example.” He states that, “The simple act of exposing a needy person with a hearing loss, in a non-threatening way, to an example of someone with aids who is positive, active, involved, “normal,” informed, successful, etc., has convinced more people to pursue hearing aids than any other method we’ve tried.”

His wife wears “decorated visible aids” and has many “converts” among the people she’s met due to her general enthusiasm.

D.S. Writes

D.S. states that a number of his friends in the 60s age group acknowledge their hearing loss, but procrastinate in doing anything to accommodate it. His advice to them is, “Look, you and I are not getting any younger; our hearing loss is not getting better; while you can still learn how to use it and have the dexterity to manipulate this little device, now is the time to learn how.”

Recognize that your hearing ability to learn, manual dexterity, and stubbornness are not going to improve with age. Procrastination will only make it more difficult for you later. Besides, you do not want to wait until someone has to do it for you.”

D.M. Writes…

D.M. makes the important observation that, “The difficulty of detecting your own hearing loss is like the difficulty of noticing slight deterioration in visual acuity.”

Failing to see what others see and failing to hear what others hear can drive home the point that one needs a vision or hearing assessment.

He states, “As part of their marketing strategy, hearing aid companies insist on involving the spouse. Spouses are more aware of what’s missed…”

D.M. has this advice for family members and friends, “Speak the truth in love -- combine reason with emotion.” Examples are, “I love you John. But I am tired of hearing the radio and television blare…so would you puhhl-le-ease, as a gift to both of us, just get a hearing test.”

D.M. makes the following specific suggestions:

“Use the foot-in-the-door technique based on the idea that people who agree with a small request often later become more willing to comply with a bigger request. First, “Would you think about doing…” Later, “Would you seriously consider doing…” Then, “I’d be glad to help make an appointment for a free hearing test and go with you, or would you rather make it?”

To gain a concession, take advantage of the door-in-the-face technique. Someone who has just turned down a large request (who has just slammed the door in your face) will often concede to a more modest second request, such as, “Let’s call right now.” “No!” “Okay, how about after Christmas, when the kids have left?”

Explore what hearing loss feels like, as in, “How did you feel when you realized that you had interrupted Mary?” If the person shows interest in the hearing loss, provide him with information from SHHH and other sources. If the person does not show interest, try more indirect cues or attractive comparisons, such as, “President Clinton got hearing aids…”

An Audiologist Writes…

In this regard, B.G., an audiologist writes, “After I complete a hearing evaluation…and they do not decide to purchase needed hearing aids, I follow up with a letter reminding them that they need to take action soon. I also include printed materials from SHHH and ASHA and articles that I have written myself to encourage them.”

Other Comments

Finally, several people cited the cost of hearing aids and the fact that most insurance policies do not cover them as the major reason they do not have the hearing aids that they need and would willingly wear if they had them.

The wife in the B. family, an educator, states, “Affordability is a big issue; I believe that this area makes a difference in who can have access to the latest development -- whether it is due to wealth or having access to economic aids… I recently attempted to gain the services of VR (vocational rehabilitation) to assist in the financial aspect of new aids, complete with FM system and a directional microphone which would aid me in classroom situations, professional meetings, and public and personal involvement. I was very surprised to hear the counselors use these disparaging, comparative statements, such as, “Getting these top-of-the-line hearing aids is like getting a Cadillac; it would have more unnecessary features than a Volkswagen.”

Other writers, in even more unfortunate economic circumstances, expressed frustration and anger about their inability to afford hearing aids and other audiological services that they need in order to function on a day-to-day basis and have a decent life.

Recap

As we review these comments, I am sure other readers will find themselves agreeing with them, and what’s more important, adding their own personal experiences to the ones we have cited. Please continue to give us your personal views and input on this subject.

Samuel Trychin, Ph.D., is the former director of training at the Mental Health Research and Training Center for Hard of Hearing and Late-Deafened Adults, California School of Professional Psychology, San Diego, California (1995-1997). Previous to that, he was professor of psychology and director of the Living With Hearing Loss Program, Gallaudet University, Washington, D.C. (1981-1995).

Dr. Trychin currently conducts training programs, classes, and workshops for people who are hard of hearing, their families, and professionals who provide services to them. His specialty is the application of psychological concepts, principles, and procedures to problems and issues related to hearing loss.

Dr. Trychin has written 15 books, authored numerous professional books chapters and journal articles, and produced a variety of videotapes related to coping with hearing loss. He has conducted hundreds of workshops and training programs across the United States and in Canada including ones at SHHH Conventions.

Dr. Trychin is a member of the American Psychological Association, is listed in the National Register of Health Service Providers in Psychology, and is a licensed psychologist in the District of Columbia and in Maryland. He is also the mental health and rehabilitation advisor to SHHH. Dr. Trychin is hard of hearing himself and has been wearing hearing aids since 1953. He and his wife, Janet, an audiologist who frequently conducts workshops with him, live in Erie, Pennsylvania.

This Just In…

Dear Sam Trychin:

I have made numerous copies of your article “Why Don’t People Who Need Hearing Aids Gets Them?”

My group of approximately 20-25 women (average age 74) have only two people who wear hearing aids, and about 10 others that badly need them! When my friend or I say, “This is a book discussion and you can’t hear,” they will make all kinds of excuses as pointed out in your article.

One item you neglected to mention: hearing aids are not paid for by Medicare and most insurances. My friend and I have paid $4,000 and $5,000 out-of-pocket for our hearing aids. Money is a big factor to get an aid that will really be of help in many situations so they can be worn constantly.

My reply to cost is always: “If you needed a new heart, if you need an artificial limb, etc., wouldn’t you see about getting it?” But, then, everything else I know about is paid for by insurance. This financial problem needs to be addressed.

Sincerely,

Edith S. Speert

San Antonio, Texas