Why Don’t Our Doctors Ask About Our Hearing?
Gael Hannan (The Way I Hear It) is a hard of hearing advocate that understands both sides of the fence between the consumer and the hearing health care professional. Gael’s columns are humorous, sometimes cutting, but always constructive and to the point.
In our healthcare system, who is responsible for flagging hearing problems that could negatively impact a senior’s health and safety? Apparently, it’s the person with the actual hearing loss.
My sister and I worried about our father. He was elderly but still had a razor-sharp mind and a killer sense of humor. He was stubborn and fiercely independent.
He also had hearing loss – about which he planned to do absolutely nothing. “I hear what I want to hear,” he would say, “And what I love to hear is silence.”
He lived alone (our mother had passed several years before). He was constantly refining his home environment to make it safe, both mentally and physically. His house was relatively free of obstacles you might bump into, trip over, or slip on.
But do something about his hearing loss – seriously, are you kidding?!
“Dad, you can’t hear the doorbell and the TV volume is making the windows shudder – you need hearing aids!”
“I have a hearing aid.”
“You got it 20 years ago to mask your tinnitus and you never wore it.”
"But I still have it here," he said. "And I did what you nagged me to do – I mentioned my hearing to my family doctor."
“Great! What did he say?”
“That my hearing is normal for my age. So there!”
“Did he also mention that using hearing aids is also normal for your age?”
“I love you, dear, thanks for dropping by.”
The subject was firmly closed. He wouldn’t listen to me, his daughter, even though he was proud of my success with my hearing challenges. If his doctor had wanted him to be screened, my dad would have done it. I now knew that we couldn’t depend on his doctor to keep tabs on his hearing and that, to me, was outrageous. Hearing health has an enormous impact on overall health and is especially crucial for older seniors.
In the October 2020 issue of The Hearing Review, Strom et al report that the US Preventative Services Task Force (USPSTF) says that there is insufficient evidence that primary physicians should be required to recommend hearing screenings for adults when there are no signs or symptoms of hearing loss. It is my understanding that the situation is similar in Canada.
Hmm, no signs or symptoms? Seniors can be wily bluffers (I know this because I am now the wily Queen of Bluffing). In their distaste for being diagnosed with hearing loss, seniors may be able to hide their hearing difficulties during a routine appointment – easy to do in a small office with no background noise. But when that same senior is back in normal living conditions, a hearing loss may not be only apparent but potentially dangerous.
Barbara Weinstein, Ph.D., is a renowned researcher whose passion is educating health professionals and the public about the trajectory of untreated age-related hearing loss. She wants the audiology community to raise physicians’ awareness of what happens when hearing health is ignored. In a 2016 article for HearingHealthMatters.org, Ms. Weinstein wrote: "We need to get the word out to primary care doctors and other stakeholders within the health care system that when hearing loss goes unrecognized and untreated, implications are profound in terms of health care expenditures, health care burden, hospitalizations, and quality of physician-patient communication."
Equally profound are the isolation and other mental health issues caused by inadequate mitigation of hearing loss in seniors. My dad escaped any consequences of hearing help avoidance, but many other seniors do not. And because many of them won’t bring up the subject – Hey doc, ask me how I’m hearing – then the ball needs to go into the physician’s court.
Audiologists, what can you do to help change this situation?
Closing note: For the record, my father did get hearing aids, but only at the urging of his lady friend who thought it would be nice if they could converse more easily during their daily 5pm game of crib. He got them and he put them in every day – at 5pm. And at home after the game, he took them out, cleaned them, and put them away again.
