Hearing Loss and End of Life

The ability to hear is always important but perhaps takes on added importance in those last days of life. As audiologists, we are often asked to help our patients hear better during those last days by assuring that their hearing aids are adequate and functional, as well as we are sometimes asked to provide personal listening devices.

There is the suggestion that hearing is the last sense to go before death and there is growing evidence of this possibility. In the article “Signs of Death” written by William Lamers M.D. for the Hospice Foundation of America he states that, “Caregivers, family, and physicians should always act as if the dying person is aware of what is going on and is able to hear and understand voices. In fact, hearing is one of the last senses to lapse before death.” 

“The Institute of Medicine (IOM) released Dying in America, a major consensus report on improving the quality and availability of services for people nearing the end of their lives. Core components of quality end-of-life care included:

• Frequent assessment of the patient's physical, emotional, social, and spiritual well-being.
• Management of emotional distress.
• Counseling of patient and family.
• Attention to the patient's social and cultural context and social needs.
• Attention to the patient's spiritual and religious needs.

These all require communication with the patient which is seriously affected by the reality that in North America one in three people over 65 are hearing impaired. “

References:

(bit.ly/IOM-Dying http://bit.ly/IOM-Dying)

The Hearing Journal: January 2015 - Volume 68 - Issue 1 - p 18,19,22

doi: 10.1097/01.HJ.0000459739.71381.16

Cover Story

https://hospicefoundation.org/Hospice-Care/Signs-of-Approaching-Death

Reaching Out

Just had lunch with these three beautiful, intelligent, special women. I was invited to join them as they got together do discuss, support and share with one another as well as to further develop a true friendship that has taken ahold. I was humbled in their presence partaking in the generosity of their hearts. While all three are people I consider friends our paths crossed when they each at different times became my patients. Each of these women has been and are on their hearing journey that has led them to the decision for cochlear implantation. While the paths that led each of them have been different there has also been a commonality amongst them. These are strong, determined, intelligent people that have a will to succeed, they are positive thinking fighters, fighting for better hearing.

In this group Tammy was the first to take on this challenge and as her hearing changed she dove in with both feet determined to do better, to be better, to excel. There was going to be no stopping this woman from regaining her ability to use hearing as a part of her life. Tammy was such a success with her implant because of her attitude and hard work as well as her intellect.

Ann was such a similar soul capable and brilliant. Someone who simply had found ways that might seem improbable to navigate the hearing world with a significant hearing impairment. Ann’s stories of strategies for compensating for her loss still make me laugh at the creativity with which she managed life never hiding from her loss but facing it in a bold way. The beauty of this story is that when Ann was considering a Cochlear implant it was Tammy who was such a wonderful and powerful influence in helping Ann to take on this challenge. Interestingly both these individuals have enjoyed great and measureable success with their implants.

Tamara the third individual in this group is another brilliant young woman that amazes me with her accomplishments inspite of her significant hearing impairment that has been a part of her life from birth. From the time I met her I was amazed by her apparent ability to function so “normally” knowing the degree of her loss. I have come to appreciate the tenacity with which this woman approaches life taking on challenges head on not willing to accept the unacceptable. At this meeting both Tammy and Ann were meeting with Tamara to encourage and support her as she had also just had the surgery for a cochlear implant and are going to continue to support her as she follows in their footsteps on this journey to hear.

It was with such joy that I spent my lunch talking with these friends feeling encouraged in my own journey as they shared their experiences. The lessons for me were not necessarily simply about Cochlear implantation but were about life and the goodness of the human soul. The message to me was about being willing to support each other even as total strangers taking the chance to become meaningful friends. Watching these women I have learned about determination, about overcoming about digging deep but most of all about reaching out.

24 Years Of Thanks

Thanksgiving is one of those holidays that has always been a meaningful one in our household. As many of you know, my wife and I have six boys that range in age from 12 to 22. While this holiday is about the Turkey and all the fixings more importantly it is about gratitude and taking stock of our blessings and how fortunate we are. One of our specific family traditions that takes place right before saying grace is that we go around our table with each person present required to share what they are thankful for. We have one simple stipulation that the only thing that can’t be used in Thanksgiving is gratitude for family as we consider that a given. This tradition is one that my boys often groan about but they still expect that it is something that will always take place at Thanksgiving.

I thought I would take this time to share my thoughts of thanks relative to my clinic. October is actually the month that I opened my doors to this clinic in 1993, 24 years later I am amazed at how little I knew about life and people and business way back then. I am so thankful for the clinic that is my home through the week and the patients that have become my family. There are so many patients that have been with me from the beginning or at least from those early days. It is such warmth that I feel when I get to spend time with those that have been with me on this journey. Along this way I have been blessed to have met so many people with so may stories and experiences. I love what I do because of whom I get to do it for. I have also been blessed with a staff that cares for my patients deeply and personally.  From our humble beginnings our clinic has grown. It is rare to go out into the community and not run into a patient or a patient’s family member. I love this.

So while our rule at home for things we are thankful for excludes family I am breaking that rule at work and expressing thanks for the amazing people that have been through the doors of our clinic in the last 24 years.

Comedy Of Errors

“Why does my hearing loss make it so hard to get the punch line in jokes ”? This is a common question that I have heard quite often from my patients. Well there is a reasonable explanation that is related to the hearing loss. You see there are several factors that affect how we understand involved in the telling of a joke. Now I am no expert on comedy but there are a few things that I think we can all see readily that affect whether we think something strikes us as funny or not. So the main body or the set up of the joke may be easy enough to follow as it seems to make sense and the words connect almost in story telling fashion however the punch line is meant to take us by surprise, it is supposed to be unexpected and not easily predicted. Some comics would deliver the punch line in a quieter voice or almost under their breath perhaps a mumble. This delivery style is with purpose and adds to the humor. Sometimes it is not only delivered more softly than normal conversation but also a little bit quicker in order to keep the listener off balance. The point is that all of these elements of joke telling can make it very difficult for the listener that has a hearing loss to follow and hear/understand the punch line. The hearing impaired listener may just laugh along whether they get the joke or not and hope that they are laughing in the right place.

For those that do not have a hearing loss but do spend time with those that do perhaps this is something that was not understood. The hearing impaired often feel less than fully capable in certain situations and may prefer not to be in that position where they struggle. No one wants to be viewed as someone that doesn’t “get it”. So the next time you want to go out with your significant other , family member, friend, or coworker etc.  that has a hearing loss perhaps it may be best to avoid the comedy clubs.