Hearing Aid/Hearing Assistive
Technologies Acceptance
The most common type of hearing loss among adults can only be remediated through
amplification and due rehabilitation services that accompany the fitting. Yet, just as many can be reluctant to admit to die true existence and impact of hearing impairment, many do not accept hearing aids in spite of our endorsement of potential benefit. Even when adults have reconciled thememselves with the emotional aspects of hearing loss acceptance, they must confront and accept the residual limitations of less than perfect instrumentation, the necessity to deal with an unwanted prosthetic device, and personal vanity issues that remain with many of us throughout our lives. As Garstecki(1994) has stated, audiologists must ease this transition through an amplification system fit within "a program of client-centered professional care emphasizing individualized attention, careful instruction, an 'empathic ear,' and steadfast encouragement to succeed in what some perceive to be a near-Herculean task" (p. 211).
Acceptance of corrective amplification and personal assistive listening devices is predicated on self-perceived improvement in daily communication and social functioning. This acceptance is further enhanced when comfort is ensured and utilization remains simple. Toward this end, the abilities of elderly adults to manipulate prescribed instrumentation successfully must be carefully assessed. This is ability will direcdy impact our recommendations for adjunctive technologies for further hearing enhancement and signal alerting and warning.
In spite of the successful use of hearing aids by two recent United States presients, and the ongoing technological advancements in signal processing and instrument selection and fitting protocols, the acceptance of hearing aids by the adult public is extremely low. On the average there is a seven-year hiatus between the time an adult recognizes the presence of hearing difficulties and the eventual pursuit of corrective measures to address the disorder. We need not look beyond this statistic to recognize that there is a substantial degree of denial among adult hearing loss sufferers. Adult grieving for the loss of hearing is common and denial is a normal aspect of this grieving process. Discussion of this denial and means of addressing it are covered in Chapter 4.
Hearing-Aid Orientation
Full discussion of the care and use of hearing instrumentation is outside of the intended scope of this text. However, beyond the necessary information transfer/content counseling requisite to hearing-aid orientation, audiologists need to bear in mind that there is a strong relationship between memory and language in old age(Light, 1988).
The content counseling inherent within hearing aid orientation will benefit from the use of more slowly delivered concrete instructions boiled down to the most salient points when we are working with the elderly. While human learning is largely through audition throughout our lives, visual supplementation is always a strong reinforcement the leaking process. This is even more true when function of the auditory system is compromised. As visual acuity may also be diminished among the elderly, lighting should always be adequate during orientation supplemented wide liberal use of magnification as needed.