Family-Centered Care

Gradual change is hard to detect and not just for amphibians

My husband knows when I struggle to hear and fills the blind spot in the dialogue with my HCP. Family-centered care ensures we work together towards solutions that fit our true needs.

There is one highly experienced audiologist who keeps an eye on me and recently she asked how I was fairing. “Oh,” I grumbled. “My fitting is all wrong. Nothing sounds right anymore. Everything is so muffled and blunted. I think AutoSense is not working right either.” Gloom and doom. Sigh.

My wise colleague lifted a single eyebrow, cocked her head and asked,

“Ah…, your fitting is wrong?”   (Need I add here she does my fittings for me?)

“Oh, yes. Nothing sounds right anymore.” I moaned.

“Oh,” she amusingly smirked, “and when was the last time you changed the filters and tubing on your hearing aids?”

Oops.

 

Boiling frogs 

For someone who works for a hearing aid manufacturer, I can only cringe when I admit that my hearing aid maintenance regimen could be likened to the reputed behavior of frogs in gradually warming water. An old fable suggests a frog in a pot will not notice the water warming and can subsequently be boiled to death without attempting escape, if the change is gradual enough. Thankfully, Wikipedia provides evidence to the contrary, but the adage hangs on for one good reason – gradual change is hard to detect and not just for amphibians.

The boiling frog fable is a metaphor for the term ‘creeping normality’, where significant change can be accepted as normal if it happens slowly and in unnoticeable increments over time. It is easy to see why the metaphor applies. Since my hearing aids don’t look or sound significantly different on a day to day basis, I don’t think much about them. But in aggregate, dust and sweat clogs my microphone filters, my earpiece tubing oxidizes and hardens, even grime collects on the electrical contacts for the batteries. The gradual accumulation creeps up on my devices until, one unexpected day, the proverbial pot boils over and I begin frantically jumping around, complaining about my fitting or some ‘broken’ functionality. After the fact I ask myself why, more often than I wish to admit, do I let myself stew in a pot of poor hearing again and again?

Before I abash myself for procrastination, I first need to step back and realize the problem lies not with my hearing loss or with my perceived personal laziness. Rather creeping normality is a natural behavior that afflicts everything from individuals with no hearing loss, to groups of people, and even whole organizations. Although there is no sure fire cure for not noticing, there are a few steps I try to take to keep the temperature in check.

I do appreciate that wonderful audiologist who checks up on me. And…. once a year I do my chore. I go to her for a check-up where we execute the usual protocol – an examination of my tubing and filters, a hearing test, and a run through the fitting software to ensure the software in my aids and accessories is up to date. On the surface this appears to be a mechanical process, but by going through the steps she is able to form a picture of my needs as a patient, noting not only the changes in my hearing but also any changes in how I am perceiving my environment. Transitioning through these seemingly boring tasks opens the discussion about where I feel I am having difficulties, information that isn’t apparent in my audiogram.

The most important person at these annual gatherings is my husband, Urs. (Yes, that is his name and no, you do not need to pronounce it). Although I can tell my audiologist what bothers me or when I feel I am not hearing well, Urs’ input is golden because he can explain what I am missing. Mundane noises such as our nuisance of a cat meowing for food or the ring of the doorbell. Urs knows when I am hearing him, when I am not, and when I am frustrated. As a consequence of creeping normality, I often don’t notice when the water temperature has increased 20 degrees because I am expending so much effort in listening, but my dearest does.

Honestly, there has been a moment or two when bringing my husband along was quite… annoying, because it can feel like he and my audiologist are only talking about the bad, the ways I can’t hear, and frankly that can be irritating. But there is a method to this madness. Our discussions bring forth the salient problems. Urs’ observations and perspective fill a blind spot in the dialog between me and my hearing care professional. Additionally, my family benefits when my audiologist can explain how my hearing loss can affect communication.

For example, my audiologist explained that I have ski slope hearing loss, meaning I can hear men’s voices with no problem in good acoustical conditions, but even in the best conditions I have problems hearing our daughter speak because her voice lies in a range of frequencies where I have profound loss. For our family, it was then clear that I did not favor one child over another, but rather I was able to notice my son’s deeper voice more often than my daughter’s softer tones. This discovery lead my lovely lady to change her behavior. She now takes the time to get my attention before speaking. It also created awareness with Urs and my son, who both now will bring my attention to my daughter if I am not taking notice.

Humbly, I admit, I am a shirker. I would rather skip that annual pilgrimage and go to yoga. Even when I do make it to the audiologist (whose office is the same building), I would much rather tell her, “Just do what you feel is best”, but the problem with that solution is my audiologist can never know all the situations I get myself into. She needs more information, and that is why I take my family, people who know when I struggle, so we can work towards solutions that fit our needs.

Let’s be frank – Frogs don’t really stick around to be boiled to death, but creeping normality does exist. I know there is no sure cure for the slow acclimation due to creeping normality, but by taking the time for that annual expedition to the audiologist and involving those who know me best, I can be more aware of my hearing and … just maybe.. avert the proverbial pot from boiling over. Frogs won’t stand for it, neither should I.

 

If you would like counseling tools for family-centered care, take a look at the Phonak Counseling Tools webpage.

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