Hearing loss is a relatively common experience. An estimated 48 million Americans suffer from some form of hearing loss. The phenomenon is so widespread that it affects more people than diabetes or cancer.
Between work-related causes and the omnipresence of headphones, it's no wonder hearing loss is so common. But at what stage does it become a real problem, and what is its impact on our quality of life?
Depending on the severity of the hearing loss, the quality of life can be seriously affected.
Situations as ordinary as dinner at a restaurant can become very burdensome and depressing for people with hearing loss, as speech becomes impossible to distinguish from the ambient hubbub of a crowded room.
For the affected person, following a conversation is a challenge. The situation becomes uncomfortable, as it is difficult to follow and participate in exchanges, which generates a feeling of isolation and a lack of social connection.
Before examining how hearing loss influences our lives, it is essential to understand the different types of hearing loss and the solutions available for each of them.
The main types of hearing loss
There are three main types of hearing loss, divided into four main degrees of hearing impairment.
However, before discussing the types and levels of hearing loss, we must look at the basic structure of the ear and how we hear.
The ear consists of three parts: the outer ear, the middle ear, and the inner ear. The outer ear, called the pinna, is the visible part.
The outer ear
The outer ear consists of the lobe, the ear canal, and the eardrum, which transmit sound to the middle ear. The eardrum is located between the outer ear and the middle ear and separates the two cavities.
The middle ear
The middle ear includes the eardrum and the ossicles, three small bones that help transmit sound through the ear. Better known as the hammer, anvil, and stirrup, the ossicles vibrate at varying speeds, as needed, to transmit sound from the ear canal to the inner ear.
Hearing obstructions usually occur in one of these two parts of the ear. If blocked, sounds can become muffled, and a feeling of pressure may appear. In more severe forms of hearing loss, one may lose the ability to hear both the softest and loudest sounds.
We hear in stereo: both ears work together to perceive a sound simultaneously, identify the direction from which it comes, and improve its clarity. When one ear is damaged, it becomes difficult to assess the volume, direction, and distance of the sound, which can pose real safety problems in certain environments.
When one of the two ears has an obstruction or another cause of hearing loss, the overall perceived volume is affected, as is the ability to determine the direction and distance of the emitted sound.
The inner ear
The inner ear is composed of the snail-shaped cochlea and small semi-circular canals that participate in hearing and contribute to overall balance.
A key component of the inner ear consists of tiny hair cells connected to nerves, which send signals to the brain that are then interpreted as sounds. Damage to the inner ear is usually irreversible: at this stage, the damage is permanent, although some solutions remain possible for milder cases.
The 3 types of hearing loss
There are three types of hearing loss. The causes can be natural, such as a buildup of earwax that blocks fluid flow in the ear, but also injuries due to trauma, congenital malformations, inner ear damage, and many others.
Conductive hearing loss
The first type of hearing loss is also the most common. Conductive hearing loss is usually caused by an obstruction of the outer or middle ear. Also referred to as "temporary" or "transient" hearing loss, it is by far the easiest to treat. The damage is often not permanent, hence its designation as temporary.
Sensorineural hearing loss
The second type is sensorineural hearing loss. More serious, it is permanent. Indeed, it corresponds to damage to the inner ear and the ear canal. Whether it is damage to the cochlea, the auditory nerve, or the hair cells that transmit sound, no intervention can repair this type of damage.
Mixed hearing loss
The last type is mixed hearing loss. Mixed hearing loss occurs when conductive hearing loss is combined with sensorineural hearing loss. As mixed loss includes inner ear damage specific to sensorineural loss, the damage is permanent. However, solutions exist to alleviate the less severe part of the impairment.
Symptoms of hearing loss
Hearing loss diminishes sounds, making them muffled and indistinct, makes speech unintelligible, and many simultaneous sounds, such as in a crowded room, can be perceived as a wall of sound rather than distinct sounds.
In some people, hearing loss is also accompanied by a continuous ringing in the ear, called tinnitus: this is the perception of a noise, and not a disease in itself. Perceiving a ringing, buzzing, or roaring in the ear is the most frequent symptom; the causes can be age, prolonged exposure to loud noises, or, in some cases, circulatory disorders.
Common symptoms of hearing loss range from a slight pressure in the ear to muffled sounds and confused speech, including but not limited to:
Feeling of blocked ear or pressure difficult to relieve
Muffled sounds
Confused speech and difficulty understanding what was said
Pain in or around the ear
Consonants, especially soft ones like the letter "s", can be difficult to hear.
Inability to follow conversations or understand what was said, especially in crowded places
Difficulty perceiving high-pitched noises and sounds
Withdrawal from conversations
Avoidance of social situations, especially in noisy places
The consequences of hearing loss are not limited to hearing. They can also have a profound impact on the quality of life.
The four levels of hearing loss
There are four levels of hearing loss, and the impact on quality of life depends on the extent of the damage and the available solutions.
Mild hearing loss
The most common form of hearing loss is considered "mild" and is generally well treated. It can be due to a moderate obstruction of the outer ear, for example when earwax accumulates and causes a blockage or traps fluid. The perception of soft speech may be affected, but it is most often a temporary condition.
Moderate hearing loss
After mild hearing loss comes the "moderate" level. With moderate hearing loss, certain sounds like consonants become difficult to perceive without sound amplification, for example without a hearing aid.
Severe hearing loss
Severe hearing loss corresponds to a level of impairment such that daily conversations become unintelligible. Communicating, especially in crowded places where ambient noise dominates, can become almost impossible, even with hearing aids. This stage of hearing loss is generally permanent but remains manageable through a combination of hearing aids and alternative communication methods.
Profound hearing loss
The most severe level of hearing loss is called "profound." With profound hearing loss, normal hearing is impossible, even with hearing aids. At this stage, other means of communication must be explored, both for the affected person and for those seeking to interact with them.
The effects of hearing loss on quality of life
Regardless of its type, hearing loss affects daily quality of life. As soon as it appears, it becomes a nuisance when the person tries to hold a conversation at normal volume.
Other activities are affected: ambient noise can become indistinguishable from speech, television may seem muted, and phone calls difficult to follow.
These experiences can change our interactions with others, make us miss essential information, both at work and in life, and make daily activities a little less enjoyable.
A dwindling social life
As hearing declines, normal volume conversations become very difficult to understand, especially in a crowded room like a busy restaurant, making these moments less pleasant. Becoming less enjoyable, these situations push people with hearing loss to withdraw from social life, knowing that communication is more complicated, which can harm their mental health, self-esteem, and well-being.
Another problem: soft sounds become almost impossible to hear, especially the voices of young children and high-pitched sounds. This hearing impairment can complicate interactions with young children and grandchildren, and spoil shared moments with them.
Impact on mental health
Whether it's difficult to hear what your children and grandchildren are trying to tell you or to perceive their little cries of joy, you miss out on a part of quality of life and all the joys of childhood that you share with them. These factors can affect the mental health of the person concerned. Relatives must remain attentive to the psychological state of the person suffering from hearing loss.
Possible relationship difficulties
Another significant effect on the quality of life of people facing hearing loss concerns the damage caused to relationships. Over time, the difficulties associated with more severe hearing loss can strain relationships and generate a feeling of isolation and marginalization, as human relationships become less pleasant.
When communication deteriorates due to hearing problems, the trust necessary for a healthy relationship is weakened, which can create fractures that further deteriorate the relationship.
If you or a loved one suffers from some form of hearing loss, know that solutions exist. Some treatments are medicinal or surgical. Others rely on hearing assistance, such as a hearing aid or a cochlear implant. Consulting a specialist to learn about available treatment options is the first step, and it is also essential to consult a mental health professional specialized in supporting people with disabilities.
Whether the hearing impairment is mild or more severe, the person concerned must be aware that their experience is shared by many and that they are not alone in learning to live with their hearing loss.
In cases of more severe hearing loss, it is essential for loved ones to understand how to support the person through the changes they are experiencing.
Areas of life affected by hearing loss
Professional prospects and career opportunities: employment opportunities and career advancement can be hampered by the consequences of more severe hearing loss
Academic journey: depending on the severity of hearing loss, the ability to communicate is affected, as are learning opportunities.
Mental health and emotional balance: faced with a major change in our body, the acceptance process can undermine our mental health and overall emotional balance
Social withdrawal: due to the psychological and emotional burden of hearing loss, there is a tendency towards social withdrawal, and self-esteem can suffer
Interpersonal relationships: any significant change in our health can alter our self-image and how we relate to others
Quality of life: cinema, theatre, music, and communication can be altered by hearing loss, and these negative experiences can reduce overall quality of life.
The most important thing for a person with hearing loss to keep in mind is that they can communicate and that their self-image is constantly evolving. It is essential to learn how to help them adapt, which involves adopting new, more effective ways of communicating.
How to communicate with a loved one with hearing loss
The key point to consider with a loved one with hearing loss is that many physical and psychological changes can make them feel marginalized. You must be supportive and patient while they learn to adapt to their new situation. Learning how to communicate with your loved one is essential to adapting to their particular situation.
Get their attention visually or physically before speaking
Face your loved one, speak more slowly, and articulate clearly
Learn to speak louder without shouting
Use expressive body language, use your hands and face to emphasize important points.
Have concrete tools available such as a pen and paper, a phone, or a tablet
How to communicate with others if you have hearing loss
Tell people you have some form of hearing loss.
Ask them to speak slowly and clearly.
Encourage face-to-face exchanges, without visual obstacles: hands in front of the face, napkin in front of the mouth. Any obstruction makes understanding more difficult.
Ask questions whenever you need clarification.
Ask for key sentences to be repeated if you are unsure of what you heard.
Letting people know you have hearing loss and clearly expressing the need to apply the above tips will allow you to speak and interact more effectively with others. Communicating with a hearing impairment works both ways: it requires both the sender and the receiver to cooperate for the exchange to be effective.
In addition to interpersonal communication, hearing loss affects the quality of life in other ways. For example, it can make comforting activities such as listening to music or enjoying the joyful laughter of young children less pleasurable. Other forms of entertainment, such as a TV series or movie, become too quiet to follow. This difficulty in hearing makes our daily hobbies and distractions less enjoyable.
Safety issues related to hearing loss
Safety is another major concern for people with hearing loss. A person with hearing loss will have difficulty perceiving the very quiet sound of many electric vehicles, which are simply inaudible to them. Another safety issue: the beep of a truck backing up on a construction site, or even the ability to hear the whistle of a kettle, all situations that pose significant health risks.
The consequences of hearing loss do not only affect the person concerned. They impact each of their loved ones. Between daily communication, self-esteem, and the psychological difficulties that can result from this decrease in quality of life, patience and understanding are needed for relationships to continue to flourish.
If you or a loved one has some form of hearing loss, talking to a general practitioner or an audiologist is a crucial first step to assess the level of loss and learn about available solutions.
