1	Can't Ignore the Loss... Reactions to Hearing Loss Marilyn Call, L.C.S.W Utah State Division Of Services to the Deaf and Hard of Hearing Director
2	The Impact of Hearing Loss Of the approximately twenty million individuals in the United State who are Hard of Hearing only about six million have hearing aids. The majority do not take steps to deal with there hearing loss. Current advertisement campaigns for hearing aids often perpetuate myths and shame.
3	Goals Look at the person behind the ear Look at hearing loss as a systems issue Look at purchase of hearing aids as step one Look at how “loss issues” impact adaptation Look at the audiologists roles in addressing information gaps and making appropriate referrals for long-term supports.
4	Intervene in each system Micro-Meso-Macro
5	The Impact of Hearing Loss Reactions frequently reported by people who are hard of hearing: Frustration Anger Depression Anxiety Guilt Embarrassment Shame Muscle tension Fatigue Headaches Increased blood pressure
6	Continued Reactions frequently reported by people who are hard of hearing: Increased blood pressure Stomach problems Bluffing—pretending to understand Withdrawing from the situation Dominate the conversation Decreased self-esteem/confidence Difficulty thinking clearly Inability to concentrate
7	The Impact of Hearing Loss Reactions to communication problems frequently reported by family members: Frustration – at not knowing what to do to be understood Guilt – feeling that misunderstandings are their fault Embarrassment – when they know he is misunderstanding someone Confusion – caused by the variability in the person’s ability to understand what is being said Irritation – caused by having to repeat a lot Anger – caused by the person’s failure to pay attention Overwhelmed – by the person becoming too dependent
8	Look at the Person Behind the Ear Purchase of hearing aids and wearing them is just Step One.
9	“Welcome to Holland….” Carol Turkington The underlying sense of loss can block successful adaptation to hearing loss.
10	A person’s perception of hearing loss will influence the grief responses.
11	Perceptions Are Influenced by What Is Written on Your Belief Window
12	Other Mediating Factors Onset, gradual, sudden, or age related Lifestyle & job Financial situation Coping skills, “past experiences” with loss? Social supports Ego strength Multiple losses
13	Grief Defined Grief is… A healthy human response A natural and necessary reaction to significant change or loss in our lives Grief reactions influence our Feelings Physical sensations Thoughts Behaviors
14	Grief Reactions…Physical Sensations Lack of energy Tightness or pain in the throat or chest, breathlessness Headache, dry mouth Sense of depersonalization, detachment, nothing seems real
15	Grief Reactions…Physical Sensations (continued) Sleep disturbances Stomach distress or feeling of hollowness Restlessness, anxiety, irritability Absence of appetite
16	Grief Reactions…Thoughts Disbelief: “It can’t be so.” Confusion: “I can’t think anymore,” “I don’t know what to do.” Idealization Fear of going crazy Suicide: “Life has no purpose.”
17	Grief Reactions…Behaviors Sleep disturbances Appetite disturbances Absent-minded behaviors Social Withdrawal Relationship problems Restless/over activity
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20	Tasks of Mourning Accept the Reality of the Loss Work Through the pain of Grief Adjust to an environment that is different Withdraw emotional energy from grieving the loss and reinvest it into life
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22	The Impact of Hearing Loss Underlying sense of loss may be related to the feeling of “no longer being the person I once was.” Some examples of manifestations of this sense of loss are: Loss of ability to fully participate socially Loss of ease of communication Loss of intimacy in relationships Loss of ability to contribute vocationally Loss of income Loss of the sense of physical security Loss of ability to enjoy music, plays, movies or other leisure activities Loss of independence
23	The Impact of Hearing Loss For family members the underlying sense of loss may be the feeling that this is no longer the person I knew before, or this relationship is no longer the same as it once was: Loss of ease of communication Loss of intimacy in the relationship Loss of shared activities Loss of freedom Loss of income Loss of trust
24	Living with hearing loss groups
25	Confronting the Myths The hearing aid myth: Analogous to eyeglasses; they return hearing to something close to normal! The lip-reading or speech-reading myth; people automatically become good lip-readers when their hearing fades. The severity of hearing loss myth: Dangerous misconception that mild or moderate hearing losses are not very significant in terms of being able to understand what people are saying.
26	Myths The “They’re out to get me” myth: Many people who are hard of hearing hold the faulty assumption that when people fail to meet their needs communicatively, that these people are insensitive, inconsiderate or worse. The selective hearing myth: “He can understand me when he wants to.”
27	Close the information Gaps Consumer’s Lack of Knowledge: The majority of people who are hard of hearing and their family members are living with a mystery: They don’t understand or can’t afford hearing aids. They do not understand how the ear works and how it malfunctions They are unable to functionally interpret their audiogram They do not know the causes of communication breakdowns, i.e., speaker, environmental, listener
28	Information Gaps They do not know the crucial difference between not understanding and misunderstanding. They do not know about assistive alerting and listening equipment available, self help groups, and/or other national and local resources. They do not know how to alter their communication behavior in order to prevent or reduce communication breakdowns.
29	Ways to Integrate These Concepts Into Your Work With People Who Are Hard of Hearing Encourage talk about the challenges & listen, listen listen Validate the loss Demonstrate ALD’s Make appropriate referrals for ongoing support To DSDHH, SHHH, ALDA, Mentors Talk to the families about changing communication rules Suggest books and Websites Men’s Search for Meaning Communication Rules related to Hearing Loss..Trychin
30	Suggested Books For Professionals 1. Grief Counseling and Grief Therapy by J. William Worden (3^rd edition) 2. Life After Trauma by Dena Rosenbloom, Ph.D. & Mary Beth Williams Ph.D. 3. Five Secrets to Personal Productivity Published by Fraklin Covey. “Belief Window Chapter” 4. Listen With the Heart by Michael A. Harvey 5. Everything written by Sam Trychen
31	Division’s Services Thank you for coming! If you wish further information or assistance, please contact: Sue Ordonez, Hard of Hearing Specialist Utah Community Center of the Deaf and Hard of Hearing 5709 So. 1500 West, Taylorsville, 84123 801-263-4879 (voice) 801-263-4863 (tty) 1-800-860-4860 (v/tty) Email: sordonez@utah.gov
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