Clinical Practice

Proper hearing loss language may drive better outcomes

Using person-centered language that acknowledges your patient’s struggles but also conveys respect is a good first step towards making the idea of wearing hearing devices more palatable.

The language of hearing loss can be tricky. When I first developed hearing loss, I would casually tell my communication partners, “I don’t hear well,” hoping they would take the hint and speak louder so I would not have to fake my way through another conversation. But as my hearing loss worsened, I needed to find a more effective way to describe my situation to others.

Options included:

  • I have hearing loss.
  • I have trouble hearing.
  • I am deaf.
  • I am hearing-impaired.
  • I am hard of hearing.
  • I wear hearing aids.

The choices were many, but none seemed to fit just right. “I am hearing-impaired” sounded old-fashioned and came with visual images of large and unwieldy horn trumpets. “I am deaf” seemed to overstate the situation since my hearing aids help me hear well in many situations. I still struggle with this question today, utilizing different words depending on the situation. Most often I tell people “I have hearing loss” or “I am a little bit deaf,” but usually a more complicated explanation is required if I really want my communication partner to take note.

The language of hearing loss exists in a broader context

To figure out the language of hearing loss, we must first understand the trends in disability language more broadly. Historically, disability was discussed within a medical model. Doctors referred to a person’s inability to do something that a “normal” body could do. For hearing loss this often meant terms like “deaf and dumb” or “hearing impaired.”

Over time, person first language emerged, stressing that the person comes first and the disability second. For example: “A person with hearing loss.” This wording is often used in public documents, on websites, and by hearing loss organizations because it is respectful, but it can be wordy and cumbersome to use.

Recently, identity first language has become popular in the disability community. This assumes that the person part is a given and implies membership in a community of others with that same disability. Examples include: “I am disabled” or “I am blind.” For hearing loss, identity first language is complicated by the Deaf community, which has defined Deafness culturally to include using sign language as the primary mode of communication. For “deaf” people who do not sign, the word doesn’t seem to fit, leaving us without an effective one-word descriptor.

Using proper language breaks down stigma

Discussing disability is challenging for many people, because they are unsure what words they can use without offending someone. This holds them back from mentioning a person’s hearing loss or other physical challenge, making it an unmentionable shrouded in stigma and shame. When people know the right words to use, conversations are easier, breaking down barriers of communication. The resulting dialogue can generate creative solutions to problems, helping provide a more inclusive environment for everyone.

A respectful tone is also important, and can sometimes be more critical than the actual terminology used. Proper tone begins with treating the person with a disability as a competent and empowered individual, rather than a liability, particularly when needed accommodations are being requested. Asking the person with hearing loss what you can do to help them hear is often the best way to generate a useful exchange that can improve outcomes for both sides.

Reducing stigma is critical in driving better hearing outcomes because stigma is one of the main reasons people with hearing loss resist using hearing aids or other hearing devices. Crushing stigma will lead to higher and more consistent usage rates of hearing aids and other hearing devices over time.

Your language choices help set the appointment tone

Audiologists are often the first hearing care provider that a patient sees. That first appointment will help set the tone for that person’s hearing loss journey. Avoid medical model terms like hearing-impaired, which sound outdated and can be off-putting. Most patients approach their first audiologist appointment feeling sad and frustrated with this new development in their lives. Using person-centered language that acknowledges your patient’s struggles but also conveys respect is a good first step towards making the idea of wearing hearing devices more palatable.

These guidelines will work for most patients, but because there is no 100% consensus within the community on these terms, hearing loss vocabulary preferences may vary. If your patient prefers different nomenclature, respect his wishes. The language of hearing loss can be as personal as the audiogram itself.

 

Shari is a hearing health advocate, writer, and the founder of Living With Hearing Loss, a blog and online community for people living with hearing loss and tinnitus. You can connect with Shari via Blog, Facebook, LinkedIn and Twitter.

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Previous comments
  1. I like and use: ‘ I don’t hear very well’ and point to my ear. People usually speak up 🙂
    I thought this was a good line you wrote:
    ‘so I would not have to fake my way through another conversation’. How true 🙂

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