What I Wish Audiologists Understood© February 2002 by Neil Bauman, Ph.D.
Question: A lot of people are not completely happy with their audiologists. Obviously, audiologists are missing the boat somewhere. I am an audiologist just starting my own audiological practice. What is it that hard of hearing people really want from their audiologist? I want to meet their real needs and have satisfied clients.—M
Answer: Excellent question!. Excellent attitude too! I wish you every success! Here is what I wish audiologists would understand—and practice.
I wish audiologists understood hard of hearing people! From what I have observed, audiologists seem to think their "job" is to fit/sell hearing aids as the solution to the hearing loss problems of the hard of hearing people that come to them. I wish audiologists understood that their real job is to us help hard of hearing people cope with our hearing losses.
One way they can begin to do that is by fitting us with appropriate hearing aids. The trouble is, they stop there. They think their job is now done. The truth is, at this point, their job has barely begun.
With a little training, anyone can learn to dispense hearing aids. They don’t need a Doctor of Audiology for that! Learning about hard of hearing people and the many effective coping skills they need to live successful lives—now that is worthy of an audiological degree!
There are three main coping strategies we hard of hearing people need to learn—amplification, speechreading and coping skills.
AmplificationAmplification includes hearing aids and other assistive listening devices (which audiologists know little about and push even less). Many times hearing aids are what we need, but very often we need more than that. We need attachments to our hearing aids—things like microphones that plug into DAI (direct audio input) boots. We need hearing aids with t-coils so we can effectively use the phone and listen using loop systems. Few audiologists seem to know t-coils exist. If they really understood our problems and truly cared about us, they would never sell us hearing aids that are not equipped with good pre-amplified t-coils. I wish audiologists realized just how vitally important such things can be to our hearing health.
I wish audiologists would teach us how to become friends with our hearing aids. We need training and coaching and support as we start life with these strange uncomfortable things stuck in our ears. We need to learn to cope with sound all over again. We need their help to do this. I wish audiologists would not sell us hearing aids and then dump us out on the street. That is one reason why so many hearing aids languish on bed tables and in dresser drawers instead of doing their job of helping us hear. Many of us never learn how to cope with hearing aids.
SpeechreadingSpeechreading (the old term is lipreading) is very important to us. Unfortunately, in my experience, most audiologists downplay the value of speechreading. I've actually had audiologists pooh-pooh speechreading to my face. Obviously, they don’t have a clue just how necessary speechreading is to people like me. People who lose their hearing need help, training and encouragement in learning speechreading—not derision and scorn. Speechreading is every bit as important as being fitted with hearing aids! I wish audiologists could realize this.
Coping SkillsThere are numerous coping skills we hard of people need to learn. I wish audiologists would realize this and teach us what we need to know—even though we don’t know we need to know it. We need to learn how to talk to hard of hearing people—whether we wear hearing aids or not. We also need to know the rules so we can teach our families and friends how to communicate effectively with us (My book, "Talking With Hard of Hearing People—Here's How to do it Right," gives many tips on how to do this.) We need to learn about the various alerting devices available so we can be alerted even when we are not wearing hearing aids (like at night). We need to learn how to re-arrange the furniture in our homes so we can hear/understand better. We need to learn how light affects our ability to "hear." We need to learn how to cope in noisy restaurants—e.g. how to pick the best place (hearing-wise) in any given restaurant by taking into consideration the available light, sources of noise, etc. We need to learn to use our eyes in place of our ears for warning signals. (For example, watching for flashing lights instead of listening for sirens. By the time we can hear a siren, it is already to late.) This list goes on and on and on. There are just so many things we need to learn. I wish audiologists would teach me these things I need to know.
We also need audiologists to warn us about things like noise and how it can damage our ears—especially now that we already have hearing losses. We need to know how to preserve the little precious hearing we still have. Furthermore, we need to know about the many drugs that can damage our ears. We need to be warned that we are now even more at risk from the effects of ototoxic drugs than the general population. We need to know how noise and certain drugs can team up to smash our remaining hearing.
Hard of hearing people feel alone and cut off. I wish audiologists realized just how cut off we can be and put us in touch with support groups (like SHHH and ALDA) so we do not feel so alone any more. Because we so often shrink inside, we need help in learning how to be assertive in asking that our needs be met.
If we have not been through the grieving process, we need help grieving for our hearing losses. We need someone to guide us though the process and not make us feel stupid or foolish for grieving. I wish my audiologist understood how important it is to help my hearing spouse grieve for the loss of the easy communication they once enjoyed. We need to know that failure to grieve leads to both physical and emotional problems down the road.
Hearing loss affects our whole family. Therefore, all of us need joint help and counseling. I wish my audiologist would teach all of us the coping strategies we need to live successful lives together.
I wish audiologists would realize that hearing aids are just a small part of the solution, not the total solution. I wish audiologists understood just how vitally important speechreading and coping skills are to us. I want audiologists to be aware that if I had to make a choice between hearing aids or speechreading and coping skills, I'd dump my hearing aids in a heartbeat—not the other way around. (If we all did that, they’d be out of a job.) That’s how important these things are to me. These are the things I wish audiologists would understand.