Hearing Loss in Older Adults — Its Effect on Mental Health
A day in the life of a hearing impaired older adult may include struggles with the following:
- hearing alarms or telephones;
- understanding someone while talking on the phone;
- understanding when several people are talking;
- understanding when a speaker’s face is unseen;
- understanding speech in a car, wind, or traffic;
- understanding speech on TV;
- understanding whispers;
- understanding people in a large room;
- understanding unclear or accented speech;
- being unaware when someone is talking;
- understanding speech in public places;
- ordering food;
- understanding cashiers or sales clerks;
- enjoying “sweet nothings” in a romantic situation.
Older adults with hearing loss face many of the same fears that anyone with a disability encounters. They worry about loss of significant relationships or jobs or about being perceived as incompetent. Communication breakdown problems may show up in physical symptoms such as tension, exhaustion, and psychological symptoms.
Sometimes hearing loss exerts a direct impact on mental health. Depression and adjustment disorder can occur as a natural response to hearing loss and its subsequent impact on the quality of life. On the other hand, some people have pre-morbid mental health issues and hearing loss simply compounds the problem.
Inability to hear and discern message and meaning can result in feelings of shame, humiliation, and inadequacy. It can be highly embarrassing to be unable to behave according to applicable social rules. The feeling of shame linked to hearing loss stems from older adults inadvertently reacting in inappropriate and socially unacceptable ways, such as responding to a misunderstood question in an inaccurate fashion. Older adults may think “How stupid I must look!” “How embarrassing!” or “What will others think?”
Feeling inadequate, stupid, awkward, embarrassed, different, or abnormal are some of the negative emotions that plague older adults with hearing loss when the condition manifests itself in an unpleasant way. The desire to hide hearing aids often arises from feelings of shame. Hearing aids render visible the fact that an older adult differs socially from others. Society’s value on physical perfection and beauty affects everyone, including older adults. Many elders who are hard of hearing report subtle and sometimes overt prejudice toward those with hearing aids or implants. The ancient terminology of “deaf and dumb” carries a new meaning.
Hearing impaired older adults may feel shame related directly to difficulties in understanding what is being said. Inability to understand verbal communication results in feelings of isolation when elders are left out of group conversations. To avoid shame, elders with hearing loss sometimes choose isolation. Either situation is unfortunate.