KOCHI: Hearing loss affects more than five per cent of the world’s population with around 360 million people currently living with disabling hearing loss worldwide. It makes intuitive sense that a connection exists between hearing loss and depression. When people struggle to hear, communication becomes challenging and loneliness, sorrow and social isolation can quickly follow. The connection between hearing loss and depression is particularly striking for hearing-impaired older adults. About one in five have symptoms of clinical depression
Quality of life in older adults with hearing loss
The quality of life in an older adults with hearing loss can be drastically affected. 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 or in person when a speaker’s face is unseen; hearing in a car, wind, or traffic; understanding speech on TV; understanding cashiers or sales clerks. Individuals with normal hearing often assume that simply saying something louder or turning up the volume will enable a hard-of-hearing elder to hear. Volume is not necessarily the issue; difficulties with sound and word discrimination may be involved. The need to repeat responses adds to negative perceptions of older adults as being slow.
Psychological implications
Inability to hear and discern messages can result in feelings of shame, humiliation and inadequacy. The feeling of shame inadvertently results in reacting in inappropriate and socially unacceptable ways, such as responding to a misunderstood question in an inaccurate fashion. Some elders who are hard of hearing feel isolated or lonely within their own families. They miss the easy banter during family outings or conversations.
Feeling inadequate, stupid, awkward, embarrassed, different or abnormal are some of the negative emotions that plague older adults with hearing loss. The desire to hide hearing aids also often arises from feelings of shame. Many elders who are hard of hearing report subtle and sometimes overt prejudice toward those with hearing aids or implants. To avoid shame, elders with hearing loss sometimes choose isolation. Depression and adjustment disorder can occur as a natural response to hearing loss. On the other hand, some people have pre-morbid mental health issues and hearing loss simply compounds the problem.
Communicating with a hearing impaired individual
It’s important to speak openly and naturally to older adults with hearing loss. Take all feelings seriously and show respect. Don’t speak on behalf of them. If you address the elder in the presence of another family member, avoid using that person as an interpreter if the hard-of-hearing elder doesn’t hear the question. Instead, repeat the question clearly or rephrase in another way and allow the individual to answer for himself or herself.
Mental health in children with hearing impairment
Deafness does not in itself cause emotional, behavioural or cognitive problems or psychiatric disorders. However, children with hearing impairment are at greater risk of developing behavioural problems and neurodevelopmental disorders. Lack of effective communication with care givers, typically in families, and consequent lack of or delayed language development is one of the most important environmental causative factors. It may also affect the child’s cognitive and emotional ability and the ability to develop friendships.
Value of early intervention
There is evidence that if early diagnosis is accompanied by intervention and support before the baby reaches six months of age, parental adjustment is better and the child’s language development will improve. Facilitating better interaction between parents and their deaf child minimises the possibility that the child will develop an attachment disorder or emotional dysregulation. The author is the head of ENT and Cochlear Implant Surgery Department at Lourdes Hospital, Kochi