What are the biggest difficulties deaf or HOH people face nowadays?

Good questions. First, I encourage you to understand that while the Deaf population and the hard of hearing population have some overlapping issues, their difference are very significant. "Big D Deaf" identifies the Culturally Deaf population that considers their deafness a 'difference' rather than a disability. They use manual communication almost exclusively. I say 'almost', because some of them have been taught to use some oral speech from childhood, but even then, most prefer not to use speech. American Sign Language is their first language. They loudly claim they do not want to be 'fixed'.

Among the hard of hearing population there area variables that create differences. A lot has to do with the age of onset of the hearing loss. When it happens after the onset of language development it's very different than if the partial deafness is there from birth or early childhood. Language development is a key to communication with both the spoken word and the written word. Data from the National Institutes of Health indicates that there are over 48 million Americans who have hearing loss. Approximately 2 million of that number are culturally Deaf. Yet, because they are visible, due to the manual communication they use, many believe they are the majority.

Hard of hearing people who lose hearing as adults, often spend more energy denying and hiding it than they do finding a way to remedy it, Consequently many do not get the help they need, or they wait years before becoming so frustrated they seek help. Other statistics indicate that 75% of the people who could benefit from hearing aids don't get them. Stigma and denial are among the primary reasons for that, but the high cost of quality hearing aids is a huge barrier.

You ask what technology helps us. All of the populations with hearing loss benefit from visual support. Captions make a huge difference for all of us. Masks worn currently, due to COVID19, create a huge barrier to all of us because we all depend on facial expressions and lip movements to supplement whatever means of communication we use. Cochlear implants have been miraculous for many people who wish to stay in the hearing mainstream. The culturally Deaf population does not like cochlear implants because when successful, they have removed people from the Deaf Culture Community. Hard of hearing people who get cochlear implants consider them miracles. Hearing aids are also miracles for people with degrees of hearing loss that can be helped by them. The advances in hearing aids have been remarkable in the last few decades. Hard of hearing people in the know, know that technologies that connect with those modern hearing aids can keep one in the hearing mainstream. The key word is 'connect'. Not all hearing aids will connect with hearing loops or BlueTooth devices. Both means of connection are extremely important. This writer believes that all quality hearing aids should include both means of connection. That means both telecoils and BlueTooth components.

Caption phones are life saving for many people with hearing loss. They have come a long way in the last two decades. Hearing Loops and other assistive technology in theaters, work places, performing arts centers, meeting rooms, worship centers, libraries, etc. are extremely helpful to the population that wants and needs to hear. ASL interpreters are in demand by the Deaf population. Both are necessary to provide full 'communication access'.

I am a bimodal user of a cochlear implant and a hearing aid, My brain has become accustomed to using both technologies. It is amazing. I love the hand held BT mini mic that relates to both devices. It helps me in noisy settings such as restaurants, social gatherings, etc. I love the telecoils that connect me to room installed technologies and also make it possible for me to connect simply and inexpensively to my laptop, my cell phone, other audio devices, etc. I cannot imagine not having access to all of these technologies.

The key to living well with hearing loss is to know what is available and what will work for YOU. Far to many from the hard of hearing population have been led to believe that nothing can help them. Far from the truth, but one has to be open to talking about it and learning about it. HLAA has been my guide since 1983. The chapter meetings and national conferences provide opportunities to meet other people. UNfortunateluy, COVID 19 is preventing HLAA from holding in person meetings, but there is a lot of information available at the website. And, we will get back to real meetings soon. Meanwhile, Zoom and Google Meets have provided get together options. Just learning I wasn't alone back in 1983 was life changing. HLAA is the tool for learning. http://www.hearingloss.org

Julie O

Julie O...... I really liked this post. You are obviously very experienced at working with hearing loss and have a lot of knowledge. Hoping you can share some advice. Had a visit with my audi this week. Until six weeks ago I had in-ear Oticon hearing aids. I had more hearing loss and they were no longer effective. My audi said that the aids I had could not be made any stronger and I would have to go with a stronger microphone. Set me up with aids that have the ear mold. The mold slides partially into my ear. The left one is fine. The right one will not stay in place in my ear and stops working with any head motion. I have been back in twice. Audiologist tried to modify the aid by shaving it and making it a little smaller. Still did not work. This week she said there is nothing more that can be done for me. Another doctor suggested that I look into a choclear implant but she was not encouraging. Told me it involves months of rehabilitation, hard work and extremely difficult. I have a hearing test next week and then see her again and she will send the report in to see if I might be a candidate for an implant. Meantime I want to look into some of the items mentioned in the posts on this site and don't know where to start. So questions: 1. What are telecoils, how do they work, and do you need a special phone to use them. 2. Is there a computer that does captioning? 3. Is there an answering machine that captions (I can no longer hear my message machine)? 4. Is there anything that connects to the TV to make hearing easier?

I also have a balance and vertigo problem 24/7 and find it very difficult to do research on the computer for information. Also there seem to be many options and it becomes confusing.

If you have time and can answer any of these questions I would really appreciate it. Or if anyone else on this site has any ideas for me please share. Thank you so much. Judy

Hi judyca7, I'll try to answer some of your questions. My experience is based on living with hearing loss for many years, and getting involved in HLAA. I have learned so much from other hard of hearing people...more than from anywhere else.

First, the information you are getting about cochlear implants seems awfully biased. Yes, it will take some rehabilitation, but you can do that. Some people are able to rehab faster than others. A lot depends on your willingness to work on it. After a CI, your brain has to adjust to hearing differently. In most cases, the auditory nerve that sends signals to the brain has not been stimulated for a long time. It's functional, but has to be reinvigorated. My personal experience of getting a CI after over 30 years of progressive hearing loss was very positive. I was able to understand sounds I had not heard in years shortly after activation, and understanding speech came to me within a few months after activation. It sounded funny at first, but within a few months it sounded very clear.

The CI was done in my poorer ear. However, I had worked hard for two years to rehab that bad ear by using hearing aids with telecoils to listen to audio books. Prior to that I had not ever used an aid in that ear. I am sure that dormant hearing ability was stimulated a bit even though I tested out with a 95 decibel loss. When the sense of hearing goes unused for a length of time auditory deprivation may occur. It's kind of like having one's arm in a cast for a long time. That arm has to be exercised to regain muscle and flexibility, etc.

Attitude is a big factor in determining candidacy for cochlear implant surgery. One has to have realistic expectations and the realization that you will probably have to work at learning how to hear differently. I use the word 'differently' tongue in cheek...because what I hear now with my CI and hearing aid working together sounds completely natural to me. That includes music.

Telecoils are extremely helpful in both hearing aids and in CIs. A telecoil is a component inside a hearing aid or CI processor that acts like an antenna that connects to an audio system. It doubles the value of a hearing aid. It's like a separate system within the hearing aid itself that can be used in different ways. However, you have to learn to use it and have equipment that connects you to those things you want to hear. This should be a 'teaching moment' for every one who sells hearing aids. Unfortunately, many just ignore that opportunity.

Here's how it works. If there is an assistive listening system called a hearing loop in a room with a public address system (church, theater, performing arts center, business center, your own TV room, etc.), all you have to do is push a button on a hearing aid or CI processor to activate the telecoil. That turns off the hearing device's regular microphone, and picks up sound directly from the microphone being used by the speaker. It's like having binoculars for your ears as it cuts out all the extraneous noise in the area. You only hear what you want to hear. A small loop can be worn around one's neck and plugged into an audio device too. I use a 'neck loop' with my laptop all the time. It works great on Zoom, and when listening to YouTube presentations.

The hearing aid industry has been trying to eliminate extra components in hearing aids for years. Why? To make them smaller. Eliminating the telecoil in any of them has not made them better. The industry is also pushing BlueTooth technology. BT is great, but it does not replace telecoils. It also adds considerable cost, while a telecoil adds about $10. You need both if you want the whole package. That is true in CI processors too. Hard of hearing people in the know, who want to remain in the hearing mainstream will all tell you that.

If you look at advertisements for hearing aids, they all promote denial by saying their hearing aids are invisible. "No one will know you're wearing it", etc. How crazy is that? Why should people who need help hearing feel embarrassed for getting help? I respect the field of audiology, but find it disappointing that this stigma based attitude in marketing the products that help us continues.

Why you have trouble keeping an ear mold in one ear is mystifying. When having new ear molds made over the years, I have often had to have them filed down a bit. That's not unusual. They are created a lot like dental inlays. An impression is taken of the place that needs to be filled, and it must be perfect to be right.

I hope you can find the answers you need. Hearing aids are our first line of defense, but cochlear implants can help those of us with serious to profound hearing loss. An international consortium recently determined that CIs should be used more than they are. I believe there is information about that at http://www.hearingloss.org I understand you don't like searching on the internet, but there are a lot of answers there. Have you tried participating in any Zoom meetings held by HLAA chapters? Many are inviting anyone interested to join the discussions. As I said earlier, I've learned more from people like me than from the pros. Part of that is because we people can openly ask questions, complain a bit, share feelings, and get the kind of help we need. It helps to meet and talk with people who share the same concerns. Peer support rocks!

Sorry so long, but you asked a lot of questions. 🙂 Julie

Julie O...... I really liked this post. You are obviously very experienced at working with hearing loss and have a lot of knowledge. Hoping you can share some advice. Had a visit with my audi this week. Until six weeks ago I had in-ear Oticon hearing aids. I had more hearing loss and they were no longer effective. My audi said that the aids I had could not be made any stronger and I would have to go with a stronger microphone. Set me up with aids that have the ear mold. The mold slides partially into my ear. The left one is fine. The right one will not stay in place in my ear and stops working with any head motion. I have been back in twice. Audiologist tried to modify the aid by shaving it and making it a little smaller. Still did not work. This week she said there is nothing more that can be done for me. Another doctor suggested that I look into a choclear implant but she was not encouraging. Told me it involves months of rehabilitation, hard work and extremely difficult. I have a hearing test next week and then see her again and she will send the report in to see if I might be a candidate for an implant. Meantime I want to look into some of the items mentioned in the posts on this site and don't know where to start. So questions: 1. What are telecoils, how do they work, and do you need a special phone to use them. 2. Is there a computer that does captioning? 3. Is there an answering machine that captions (I can no longer hear my message machine)? 4. Is there anything that connects to the TV to make hearing easier?

I also have a balance and vertigo problem 24/7 and find it very difficult to do research on the computer for information. Also there seem to be many options and it becomes confusing.

If you have time and can answer any of these questions I would really appreciate it. Or if anyone else on this site has any ideas for me please share. Thank you so much. Judy

Hi judyca7, I'll try to answer some of your questions. My experience is based on living with hearing loss for many years, and getting involved in HLAA. I have learned so much from other hard of hearing people...more than from anywhere else.

First, the information you are getting about cochlear implants seems awfully biased. Yes, it will take some rehabilitation, but you can do that. Some people are able to rehab faster than others. A lot depends on your willingness to work on it. After a CI, your brain has to adjust to hearing differently. In most cases, the auditory nerve that sends signals to the brain has not been stimulated for a long time. It's functional, but has to be reinvigorated. My personal experience of getting a CI after over 30 years of progressive hearing loss was very positive. I was able to understand sounds I had not heard in years shortly after activation, and understanding speech came to me within a few months after activation. It sounded funny at first, but within a few months it sounded very clear.

The CI was done in my poorer ear. However, I had worked hard for two years to rehab that bad ear by using hearing aids with telecoils to listen to audio books. Prior to that I had not ever used an aid in that ear. I am sure that dormant hearing ability was stimulated a bit even though I tested out with a 95 decibel loss. When the sense of hearing goes unused for a length of time auditory deprivation may occur. It's kind of like having one's arm in a cast for a long time. That arm has to be exercised to regain muscle and flexibility, etc.

Attitude is a big factor in determining candidacy for cochlear implant surgery. One has to have realistic expectations and the realization that you will probably have to work at learning how to hear differently. I use the word 'differently' tongue in cheek...because what I hear now with my CI and hearing aid working together sounds completely natural to me. That includes music.

Telecoils are extremely helpful in both hearing aids and in CIs. A telecoil is a component inside a hearing aid or CI processor that acts like an antenna that connects to an audio system. It doubles the value of a hearing aid. It's like a separate system within the hearing aid itself that can be used in different ways. However, you have to learn to use it and have equipment that connects you to those things you want to hear. This should be a 'teaching moment' for every one who sells hearing aids. Unfortunately, many just ignore that opportunity.

Here's how it works. If there is an assistive listening system called a hearing loop in a room with a public address system (church, theater, performing arts center, business center, your own TV room, etc.), all you have to do is push a button on a hearing aid or CI processor to activate the telecoil. That turns off the hearing device's regular microphone, and picks up sound directly from the microphone being used by the speaker. It's like having binoculars for your ears as it cuts out all the extraneous noise in the area. You only hear what you want to hear. A small loop can be worn around one's neck and plugged into an audio device too. I use a 'neck loop' with my laptop all the time. It works great on Zoom, and when listening to YouTube presentations.

The hearing aid industry has been trying to eliminate extra components in hearing aids for years. Why? To make them smaller. Eliminating the telecoil in any of them has not made them better. The industry is also pushing BlueTooth technology. BT is great, but it does not replace telecoils. It also adds considerable cost, while a telecoil adds about $10. You need both if you want the whole package. That is true in CI processors too. Hard of hearing people in the know, who want to remain in the hearing mainstream will all tell you that.

If you look at advertisements for hearing aids, they all promote denial by saying their hearing aids are invisible. "No one will know you're wearing it", etc. How crazy is that? Why should people who need help hearing feel embarrassed for getting help? I respect the field of audiology, but find it disappointing that this stigma based attitude in marketing the products that help us continues.

Why you have trouble keeping an ear mold in one ear is mystifying. When having new ear molds made over the years, I have often had to have them filed down a bit. That's not unusual. They are created a lot like dental inlays. An impression is taken of the place that needs to be filled, and it must be perfect to be right.

I hope you can find the answers you need. Hearing aids are our first line of defense, but cochlear implants can help those of us with serious to profound hearing loss. An international consortium recently determined that CIs should be used more than they are. I believe there is information about that at http://www.hearingloss.org I understand you don't like searching on the internet, but there are a lot of answers there. Have you tried participating in any Zoom meetings held by HLAA chapters? Many are inviting anyone interested to join the discussions. As I said earlier, I've learned more from people like me than from the pros. Part of that is because we people can openly ask questions, complain a bit, share feelings, and get the kind of help we need. It helps to meet and talk with people who share the same concerns. Peer support rocks!

Sorry so long, but you asked a lot of questions. 🙂 Julie

Need new mold - free of charge. Did not fit right- every audiologists I went to will do fitting again. It’s on them always. I am a candidate for cochlear implant. . I am holding off as long as I can. My old 15 year old aids are failing. But I am mostly retired. I handled as best I can. Tcoils connect with loops- wiring that with aids have tcoils ( Amtrak has them, Meetings with fellow loss folks - almost like a fm receiver) Bluetooth is different and a lot of audiologists telling folks to have that rather than tcoils. No way

I encourage you NOT to put off going the CI route if you are a candidate. I waited a long time before getting a CI. I watched others I knew who had gotten them with awe. Still I waited. My only regret is that I didn't do it sooner. It made a positive difference in my work life, although I was only a few years short or retirement. then. It has made an incredible difference in my ability to enjoy my grandchildren.