The health of our brains and our hearing is inextricably linked but while there are a variety of aids available to assist those with hearing loss, retraining the brain to accept sounds signals again is a very different proposition.
It is not without a sense of irony that speech pathologist Dr Dimity Dornan concedes she sometimes feels her message is falling on deaf ears.
Made a member of the Order of Australia for her ground-breaking auditory with families and hearing-impaired children throughout Queensland, Dr Dornan is renown among the audiology community for having helped initiate new born hearing screening in Queensland hospitals and for founding numerous hearing health education and development programs.
The first speech pathology graduate at the University of Queensland, and the first speech pathologist to work at the Royal Brisbane Hospital, the highly decorated doctor is clearly not shy of a challenge. Yet the one problem she has been unable to find a solution for is how to get the country’s active seniors to take hearing loss more seriously.
A hearing impairment that would be treated as a serious health issue in a child is usually met by active seniors with either avoidance or denial, she says.
Men the worst offenders
Dr Dornan, who founded specialist diagnostic audiology and hearing rehabilitation therapeutic service Hear and Say 27 years ago as a not-for-profit enterprise, says approximately 466 million people worldwide have a disabling hearing loss – including 180 million aged over 65 who have a hearing impairment that impacts on understanding normal conversational speech.
Typically it is about midlife when some adults begin to notice their hearing starts to get poorer across high frequencies and the quality of their hearing begins to deteriorate. By the age of 75 about seven in ten Australians, mostly men, have a hearing loss that separates them from the people that they want to form relationships with, Dr Dornan says.
“We don’t really know why but it is slightly more prevalent in men. Men are also notoriously the ones who won’t go in and do something about their hearing loss.
“They will often ignore the fact that they have a problem and keep their head in the sand. It’s typical for men to take between 10 and 12 years after identifying there’s something wrong to go and get their hearing checked.”
She says at the beginning the hearing loss is often subtle. People may turn up the volume on their televisions or stereos, miss words in a conversation, go to fewer public places where it is difficult to hear, or worry about missing an alarm or notification. However, once it worsens, the impact is far more detrimental.
Vanity no excuse
Dr Dornan says being able to communicate is the cornerstone of a healthy lifestyle in ageing. People need to make themselves understood and to understand others to remain cognitively and socially engaged with families, friends, and their community.
“If left untreated, this impacts not only communication but also socialisation as well as a loss of autonomy or independence. There is often associated anxiety, depression and cognitive impairment. This is for two reasons – because the brain is not receiving stimulation it is looking for but also because the isolation and depression is causing it as well. It’s a very double edged sword but it is largely undetected and largely undertreated in older people.”
While there are an array of different devices available to aid active seniors to hear, vanity often means that even those who have been persuaded to get hearing devices, refuse to use them.
“There’s definitely a vanity thing, there’s no two ways in the world that this is not a fact. Mostly its due to either the stigma attached, they don’t like the look of them or they haven’t had the brain training to help them make the most of them and for them to be useful. In recent times the devices have got a lot more discreet but I think people just haven’t cottoned onto that as yet.”
Dr Dornan says waiting ten or 12 years to get treatment for hearing impairment is “way too late” because hearing health and brain health are inextricably linked.
If you don’t use that part of your brain for that amount of time then hearing pathways are reassigned for other purposes and can never be changed back, she says.
“Sixty-five percent of the things we can do to care for our brain we have no control over but the remainder we can. Of those, hearing loss is the one that has the best outcomes for the brain and the one that is most important to keep preserved. We need to be careful that we care for our hearing even if we’ve just got a little bit of loss so that we can hear for life. It’s to do with how much stimulation the hearing part of our brain gets – if you don’t use it, you lose it.”
Brain pathways key
Dr Dornan, who has spent much of her career working with families with young members challenged by hearing impairments, says much of her work with children informs the work she undertakes with adults.
While there are similarities between the two groups, there are big differences as well.
“If a child is born with hearing loss they usually have not heard in utero. The last 20 weeks in utero is the time when the baby’s brain pathways for listening are stepped out and quite a lot of auditory growing pathway development takes place. They then have to learn those and that takes time. We can do that by training the parents to fast track the development of their auditory brain pathways by different ways.
“But with older people who have heard before, they’ve obviously got the brain pathways and it’s a case of giving them back their hearing.”
Typically if an adult is diagnosed with a hearing loss, they will possibly get a hearing device but nobody teaches their brain to use it and, if they’ve had deprivation of hearing for a long time, then sometimes their brains are no longer able to do that.
Compounding the issue is that most places that provide hearing devices don’t provide brain training as well.
Dr Dornan says the reasons for this are two-fold. The first being the fact there are few professionals experienced enough to offer this degree of training while finding different models that people can afford to pay for or can be covered by different funding structures can also prove difficult.
“Having your hearing looked after is kind of like an insurance policy, you may not need it but it’s one of the things you can do something about to protect your brain,” she says.