How Well Do People with Early Onset Hearing Loss Age?
Kathy Pichora-Fuller's column “What’s new about getting older?” delves into all aspects of ageing and hearing ranging from health policy developments to neurophysical research on the aging auditory brain.
Recently, I had the opportunity to sit down for a conversation with a late middle-aged neighbour who has lived with hearing loss since childhood. The conversation gave me some new insights into the differences between how aging adults adjust to late-onset hearing loss and how adults with early-onset hearing loss adjust to aging. This conversation occurred around the same time my colleagues and I were writing a paper (Wittich et al., 2024) in response to a call for submissions from The Gerontologist for a special issue on “Bridging Aging and Disability Research.” The special issue is motivated by the recognition that much is known about the onset of disabilities as people age, but that much less is known about aging in people with lifelong disabilities. Notably, most population health studies that have revealed associations between hearing loss and cognitive decline (or other health declines) usually do not have data on etiology or duration of hearing loss. These studies cannot answer whether the associations differ between people with early- or late-onset hearing loss. It is possible that aging has earlier and more negative effects on people with lifelong disabilities, with complex intersections between aging, disability, and social determinants (e.g., those with early onset disabilities may have lower education and socio-economic position). Conversely, those with lifelong disabilities may have an adaptive advantage in aging because they have already adjusted to and become experts in how to function and live well with their impairments. Studies about aging in people with lifelong disability could help to disentangle the effects of aging and disability. In this column I touch on two lessons learned from my neighbour.
Stigma
One of the experiences my neighbour shared with me was about how becoming the owner of a hearing service dog during COVID had helped reduce stigma. The popularity of the dog as a sort of celebrity in the community seemed to put a positive light on social interactions that previously might have been darkened by the shadow of hearing loss stigma. Stigma is recognized as one of the most significant challenges facing people who are hard of hearing as they begin help-seeking for age-related hearing loss. Hearing aids are avoided because they signal disability. The lesson from my neighbour was that stigma also challenges those who have lived with hearing loss for decades. However, their experiences may reveal new ways of overcoming stigma. The service dog signaled disability, but it was a catalyst for breaking down the barriers of stigma. Rather than triggering the negative response that people fear will be triggered by a hearing aid, the puppy triggered a positive response. The dog created an opportunity to contextualize hearing disability, encouraging awareness, understanding, and acceptance in social interactions.
Peer Support
Another experience described by my neighbour was that a growing number of older people in the community had sought advice about hearing loss because they were beginning to experience hearing problems. They recognized my neighbour as an expert who held valuable wisdom as a person living well with hearing loss. This new role as a model to be emulated conferred a sense of pride and joy in being able to help others. Papers on social support abound in the audiology literature and peer-support is a cornerstone of organizations for people who are hard of hearing. Nevertheless, there seems to be much more to learn about the potential power of holding, giving, and receiving ‘wisdom’ about living with hearing loss as people age. It may be of great mutual benefit to foster interactions between older adults with lifelong hearing loss and older adults encountering hearing loss for the first time.
Conclusion
We can look forward to the papers on aging with disability that will appear in the special issue of The Gerontologist. In the meantime, I encourage readers of the Canadian Audiologist to have conversations with people with lifelong hearing loss to learn more about how their experiences increase both the negative and positive sides of aging well.
Reference
- Wittich, W., Granberg, S., Jamieson, J., Martiniello, N., Mick, P., Savundranayagam, M., Simcock, P., Wahl, H.-W., Watharow, A., & Pichora-Fuller, M. K. (submitted July 2024). Aging with a Vision and/or Hearing Disability. The Gerontologist.