Limiting Factors to Hearing Aid Benefits
by Garth Brears, M.S., Aud(C) Clinical Audiologist
When I first started fitting hearing aids I had all the answers before I even asked the questions. And generally speaking, I only asked lousy questions. I did not see different people as being different, I saw everybody as having the same problem.
I neglected to ask questions such as:
- If the hearing loss even bothered them and to what extent.
- I forgot to ask what they were looking for.
- I forgot to ask what they would consider to be a successful outcome.
- I forgot to ask how much work they were willing to put in.
- I forgot to tell them that they needed to put in some work.
- I forgot to tell them what kind of work they needed to put in.
In other words, I was a limiting factor to their hearing aid benefit.
Today, I feel I have become more in-tune with my patients and their needs, but I still have to believe I miss important information. I fit people I should not, I neglect to say everything I should have, I talk too fast, I talk when I should be listening and I simply do not listen carefully enough to each unique story. The bottom line: there is no substitute for experience and good listening skills on the part of the professional you are dealing with.
Another intangible is the lifestyle of the hearing aid wearer. Many people who get hearing aids live quiet lifestyles. As a result, they do not have the opportunity to practice aural rehabilitation, since after all, they are not communicating much and when they are, it is generally only in quiet. This unfortunately is not going to help them much when they meet in a noisy restaurant for that one hour per week.
Compare that lifestyle to the young professional who interacts with others all day, everyday, often in noisy places. Without knowing it, this person is practicing aural rehabilitation all day long. Therefore, lifestyle does have a significant impact on your outcome with hearing aids.
Good focus leads to good understanding, as I have said many times in previous articles. The problem is, focus is disrupted by many things. The most obvious distractor is noise, but there are many not so obvious “focus busters”. And yes, they will all affect understanding while wearing hearing aids. My elderly patients often come in with eyesight problems, emotional and physical ailments, as well as chronic pain of all sorts and memory problems. Unfortunately the list is extensive. Consider a gentleman with chronic back pain, who also presents with short term memory deficits. How successful will his hearing aid fitting be? As you might appreciate, his other difficulties may interfere with his ability to focus to the necessary level for understanding speech in a room full of noise.
Lastly, I have avoided until this point to mention that the worse the individual’s hearing impairment, the less they will derive from hearing aids despite doing everything else they could possibly do. I have left this to last because I want to make the point that everybody will benefit from hearing aids, if properly motivated, if properly counseled, and with reasonable expectations. For those who find absolutely no benefit – and these people do exist – cochlear implants may be a better alternative, but they are another topic entirely.