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Looking for help in all the wrong places

Victorian, Brande

doi: 10.1097/01.HJ.0000403503.42347.f2
Departments: From the Editors

I recently received a surprising email from a coworker asking if I had any advice for an old college friend who was struggling with a hearing loss. The email contained a message she received from her friend that shed light on a significant issue and opportunity in the field.

It read:

I have a question and I thought maybe you'd be the one to ask. I'm considerably hard of hearing now, all but deaf in the left ear with 35% hearing in the right. With my hearing aid, environment is everything. If it's loud in the room, I can't hear anything but noise. If people speak louder to compensate for me not hearing them, it gets worse.

I'm looking for work. Should I disclose my hearing as a disability? I want to be fair to whoever employs me, but I know environment is everything now. Is it harder for people like me to get jobs? Or do they have jobs for people that are hard of hearing?

I can still talk on my cell phone, and pretty much hear as long as there is no noise in the room, but even a little noise from the car air conditioner causes distortion. I have always been a secretary. I've also worked as a receptionist, but can I do that now if I'm not sure I can hear the phone system? If it was in a quiet room, I bet I'd be ok. But I had to leave my job at a call center because of my hearing loss, as the room was loud.

Anyway, I didn't know if you knew of anything or what you should do when applying for a job. I want to be fair to everyone, but I don't want to be unemployable either, and I don't know if they really mean that they won't discriminate when it comes to the hard of hearing. Any ideas?

This woman's message is wrought with issues—hearing loss that appears to be quite severe, distorted noise in her hearing aids, sporadic trouble with telephones, and most of all, fear regarding employment and her rights as a person with a disability.

While I certainly felt for her plight, I couldn't shake the question that was at the forefront of my mind. Why would she reach out for help from someone she hadn't seen in more than 20 years who isn't a medical professional or an employment specialist rather than her audiologist?

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As I look at a few of the articles in this issue, an underlying theme surfaces. From our cover story looking at new developments in auditory training (page 25), to Raymond Hull's article on incorporating environmental design in hearing rehabilitation (page 18), to Bob Martin's column about managing patients’ complaints of loudness and noise (page 44), the central idea behind each piece is providing services outside of the fundamentals of performing a hearing test or fitting a hearing aid.

As this email shows, the basic function of hearing is just a starting point for the issues that arise when someone loses that ability. Time and reimbursement constraints certainly make it difficult to thoroughly address every concern a patient may have, but of equal importance is making sure that patients aren't looking for help in the wrong places. As is often brought up in discussions concerning the professional expertise of individuals in this field, unqualified friends or information found on the Internet should not be the authority on hearing care; patients should be coming to you, the hearing healthcare provider.

To that end, it's important to create an environment in which patients feel they can express these concerns, and to take the time to ask questions that they may not feel comfortable bringing up otherwise. It's a step that can go a long way in improving the lives of patients and, just as important, the outlook of professionals in the field as the sole providers of hearing care.

While I couldn't offer my coworker's friend any advice beyond suggesting she speak with her audiologist, I decided the best thing I could do for her is to publish her letter here as a reminder of the questions your patients have and an example of who they may be going to for answers.

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