Maybe you have always been blind or had low vision and you are now gradually noticing that certain voices and sounds are a struggle to hear. Or maybe you have been deaf or hearing impaired most of your life, and seeing facial expressions is no longer available as the "boost" cue that once was the case.

Or, maybe you have drawn the card in life that dictates a diminishing of both sight and hearing at around the same time. The resulting life changes that any of these scenarios can conjure can result in something very much akin to panic.

Vision and hearing both play a very significant role in enabling us to form and maintain social connections. Both also lend themselves to a gigantic array of adaptations, alternative techniques, and work-arounds. No matter how many degrees remain in your visual field or how many decibels your ears can catch, the obstacles that are thrown your way by the combination of vision and hearing loss, can, with practice and resourcefulness, be circumvented. There is, in short, always a way.

Since most AccessWorld readers are familiar with vision loss as a primary concern, I will focus more here on the addition of compromised hearing. Similarly, although our vision and hearing are used to accomplish millions of tasks, the primary focus here will be in the context of social interactions.

Although the senses themselves provide entirely separate input, methods for adapting to decreased sight or hearing are often quite similar. Let's get started in looking at some of the tools and techniques that can work to keep you in the game when you can't see the faces or hear every single consonant.

Hard of Seeing

If you have been blind or had low vision for a long enough time to have developed solid adaptive skills, then you know that there is another way to do just about everything that you once thought required 20/20 vision. The first tremendously successful step is to give up faking it! Carry a white cane or braille note taker or magnification device — any tool that enables you to do what you want to do and, of equal or greater importance, identifies you to others as a person who simply does not see very well. Your other senses can be called into action to pick up information that your eyes are not able to grasp or grasp fully for you. Ears can tell you where people, traffic, machinery, and other sound-generating objects, alive or inanimate, are located. Your sense of smell can help you navigate to the coffee shop, recognize some people, or determine when the lasagna is ready to come out of the oven. Your sense of touch — literally from your head to your feet — can see random objects on the carpet, the particular jacket you plan to wear, or your dog's satisfyingly fluffy coat after a visit to the pet groomer! Elaboration on any of these topics can be beneficial at another time, but the purpose here is to focus on incorporating hearing loss into the life of an individual who has more or less already mastered the alternative techniques of blindness. Many people describe hearing loss as a kind of additional vision loss. You have learned to "see" certain aspects of your environment by using your ears; when that method fails or begins to fail, the impact is something like more vision loss.

"Near Hearinged"

We say that a person is near-sighted or hard of hearing. The conditions imposed on the person experiencing the diminished sense are pretty much the same, so I have mused more than once over the inconsistencies in our language that settled on these particular phrases. I like to say that some people are also hard of seeing and I, for one, am rather "near hearinged".

That is, if I am close enough to the person or machine I want to hear, I can usually manage pretty well, just as a friend of mine with low vision can see pretty much of the action on the movie screen if we sit in the front row at the theater.

Whimsical phrases are fun, but in explaining to others, I usually use the expression "hearing loss" or "hearing impairment."

Again, the very first vital principle in managing hearing loss successfully is to forget about faking it! For years, I pretended to hear things I did not hear or that I was distracted when I had missed something. The energy involved in this kind of charade is reason in itself to let it go. I made mistakes in conversation or, worse, allowed people to conclude that I was not interested in what they had to say.

Today, my approach is totally proactive.

Meeting a group of friends at a restaurant, I might circle the table before choosing a seat. Or, if I can hear that there is a wall on one side, I'll ask if I can sit with my back to that wall. This serves as a kind of sound shield, protecting your ears from all the extraneous sound that is not at your own table. Whether there is a wall or not, try to sit as much in the center of the group as possible. This will balance the voices of your own group and give you a better chance for hearing them in particular.

If you have a choice of venues before gathering with friends or colleagues, try to avoid cavernous rooms with high ceiling and hard surfaces. A converted bank or factory might make a charming dining spot visually, but it is social suicide for a person with both low vision and a hearing impairment. Smaller establishments are often better, although extremely popular spots with elbow-to-elbow dining will produce just as much of a disharmony of sound as the large echo-laden place, so there are no absolutes.

In a friend's home or professional meeting, some of the same guidelines for choosing your location apply. Central location, as much as possible, or next to the person or person who will be doing most of the talking is where you want to be.

And this brings us back to the "forget about faking it" rule. In any situation where hearing might be challenging, speak up about it proactively. Directly and simply. Try: "I have difficulty hearing," or "I wear hearing aids, so I will need to sit in the front row, or ride near the front of the tour bus…" or whatever the situation might be.

Explaining your situation up front nets such markedly more pleasant results than suffering in silence. When you explain your hearing situation, you will find that people are consistently accommodating. They trade seats. They speak more clearly. If a microphone is available, then turn it on. And, best of all, there is almost always at least one other person in the group who thanks you for expressing the need.

The Magic of Technology

Just like every category of technology known to us today, hearing aids are by no means the cumbersome and often inadequate boxes you may recall your grandfather using.

Today's hearing aids come in a variety of configurations, are mostly digital, and often offer multiple programs for varying hearing environments. And, if you are still stuck on that nonsense of not wanting people to know that you have a hearing disability, not to worry. Most hearing aids today are so small that they are rarely visible.

For people who also have vision loss, hearing aids that block the ear canal are not a good idea. These also block the ambient sounds so essential to awareness of one's surroundings. Audiologists are trained to help you figure out what's best, but be prepared to be your own advocate when it comes to having the ear available to the ambient sounds. Many of us find that we are educating audiologists about vision loss while they are teaching us to use our hearing devices.

There are as many hearing aid options as there are automobiles these days, but I'll describe the pair I currently use. Each consists of a small wire in my ear, extending from a molded curved piece that "hooks" behind my ear. One is called "open fit" and the other "closed fit." To the untrained eye, with both in my hand, they look pretty similar, except that one has a slightly larger piece that fits in the ear canal. This is called the t-point and it allows some ambient sounds to enter the ear while also amplifying voices and other sounds.

A button on the curved piece behind the ear cycles among six programs, fine-tuned by the audiologist for a variety of hearing situations. For example, you might want to ?zoom? in on the person's voice in front of you, exclude some of the background noise in a crowded venue, or pair with an FM or Bluetooth device.

This latter brings us to an entirely other category of outstanding hearing devices. When paired with your hearing aids, an FM or Bluetooth might deliver, for example, the sound of the professor at the front of your classroom, the TV in your living room, or the audio book or music on your smart phone directly into your hearing aids. Others in the room can still hear that sound source in the usual way, but your device paired with your hearing aids delivers it up close and personal.

Listen Up

The sense of hearing begins to decline in the mid-20s for most people, but it takes time for most to notice that there is a problem. Already having vision loss means we often notice the change sooner. There is no shame in having a hearing impairment. There is no shame in having a visual impairment. The only shame is in letting life go by rather than stepping up, learning some fascinating new tips and techniques, and moving blissfully forward with your multisensory (sometimes technologically induced) adventure.

There is never a good reason to fake it!

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Author
Deborah Kendrick
Article Topic
Managing Combined Hearing and Vision Loss