Hello, I'm Gail Hannon. And I'm Sherry Eberts, and we are your hearing hacks. We are so pleased to be here with you. You know, hearing loss does not come with a how-to guide, and this makes it challenging for newly diagnosed people with hearing loss. It makes it challenging for them to gather the information that they need. This session, empowering your client to live more skillfully with hearing loss, provides a roadmap for your clients on their journeys, and how you, as their hearing care provider, can better support your clients through all stages of their hearing loss journeys. Their relationship with you is an integral part of that journey, which for most of us is a lifelong trip. Now, we don't use the term skillfully lightly. As two women with hearing loss, we have learned the hard way that there is an easier way. We can become better at living skillfully with hearing loss. We can get better at living through all the different conversations of our lives, and we can become more skilled at getting the most out of any listening situation. We can take charge, and we can be in control of our hearing loss journey. Not just as bystanders, but we are full, active participants who deserve to hear and be heard. Another reason we like the word skillfully is because a skill is something you can learn. It's something you can practice, and you can get better at it, and it's something that can be taught, and that's where all of you come in. We believe that a skills-based approach will help any person with hearing loss, regardless of how long they've had it. And this approach is based not only on our personal experiences, but on thousands of other people like us. Our principles are rooted in lived experiences, and they align with hearing science, tremendous advances in technology, and the development of modern hearing care principles like person-centered care. Now, we have been individually dedicated to this philosophy for many years because we have experienced the life-changing difference that it makes. So here's what we're going to cover today. First, why we need an operating manual by sharing our stories, and then most of the presentation, we'll talk about our three-part framework for how to live a better life with hearing loss. And then finally, we'll discuss your role in making that all happen. I first found out that I had hearing loss when my mommy told me. I was two, two and a half. I had congenital hearing loss, cause unknown, but a lot of the usual suspects. My mom was a nurse, and she noticed that around two, two and a half, something was going on and turned out to be hearing loss. Now, it was mild as a child, and they didn't want to put a hearing aid on me because the wisdom of the time for mild hearing loss in children was that a body aid could damage the residual hearing that I had. It would be many years before I got a hearing aid. Mild as a child, moderate as a teenager, whether I wanted it or not, I really could have used it. And it wasn't until I was 20 or 21, and I had graduated from a pediatric ENT to big person ENT, I went and said, I think I'd like a hearing aid. They said, absolutely. And within a month, I had one, and my life changed. It was very loud, but also it just made a difference in how I lived my life, how I communicated. And for the next 20 years or so, I wore a succession of hearing aids. My hearing was getting worse, but hearing technology was getting better. And around the age 40, I went to two hearing aids, which, again, another life-changing event for me. But there was something even bigger going on in my life at that time, and I was expecting a baby. For the first time in my life, my hearing loss took on a new urgency. Wow, I was going to have to be responsible for this baby. And how would I hear him, crying in the night? Found that out. Husband jabs you, baby crying up you get. But what if I didn't hear him burp? Would he blow up? I had all these questions and no one to give me answers. No one I could even ask. So I went to a conference of people with hearing loss and another life-changing moment. I went into that conference, one person, and I came out another. A woman sat down with me, and she had a baby, and she reassured me that I could do this. But I learned so many other things about myself at that conference, interacting with other people with hearing loss. I learned that I wasn't alone. I learned that there were so many things that I could do to make my life better. And I started to do that from that day on. I became very involved in hearing loss advocacy, and I started creating content from writing presentations, performance, because my passion was to create better understanding of the impact of hearing loss on our lives. Even to this day, I have become very passionate about hearing loss. I got a cochlear implant about seven years ago, another big event in my life. So here I am, a hearing health advocate. I'm a speaker. I've written two books, including the recently published book, Here and Beyond Live Skillfully with Hearing Loss, with my fabulous co-author, Sherry Eberts. And I continue to work every day to create better understanding of hearing loss. So I first noticed my hearing loss in my mid-20s, but my journey began well before that, as a child, watching my father struggle with his own hearing issues. And he was highly stigmatized by it. He would do almost anything to keep it a secret. He even had his hair grown, you know, long over his ears well after that was fashionable. I remember at family parties, he'd be found, you know, off by himself. And as a child, I didn't really understand why. But when I developed my own hearing loss, I understood. He was probably having trouble hearing, and he just couldn't bring himself to keep trying. So when I first discovered my own hearing loss, I hid it, following in his footsteps. I felt embarrassed and ashamed, and I'm not sure exactly why. Was it something I had just learned from him, or was it the societal stigma that still lingers around hearing loss? But whatever the cause, these feelings lasted for many years. But once I had children, everything changed for me, because I saw them watching me do the same things I had watched my father do, hiding my hearing loss and laughing at jokes I hadn't heard and sitting off by myself with my back to the party. And I realized I was passing on the same stigma to another generation, and I knew it had to stop. So I finally decided to accept my hearing loss, and so I did. And I started wearing my hearing aids all the time and teaching my family and my friends how they could help me hear better. I refuse to let my hearing loss isolate me. It's not always easy, but it's definitely worth it. And now, like Gail, I'm an advocate for people like me. I write a weekly blog at livingwithhearingloss.com and produced a hearing loss documentary called We Hear You During the Pandemic, as well as writing Here and Beyond Lives Skillfully with Hearing Loss with Gail Hannan. Through my advocacy, I hope to help others live more comfortably with their own hearing issues as well. So you can see from our stories there are similarities and differences and, of course, ups and downs, because just because you've been living with hearing loss for a long time doesn't mean you're necessarily good at it. And that was true for Gail and me as well. And so when we sat down to start writing the book and we began to compare notes about our journeys, we realized that over the years and through trial and error and by meeting and learning from other people with hearing loss that we each have found our own way to a similar set of skills and strategies that helped us live well with it. And when we talked about this, what we realized was that when we shifted our goal from hearing better to communicating better, that made all the difference. We realized things would be better if we could just live skillfully. But why are some people more successful than others at living with their hearing loss? People with hearing loss share similar challenges, and we also have opportunities to thrive that are similar. Obviously, there's a wide range of abilities and ability to pay and all of those things. But still, Sherry and I didn't have any of these resources early in our lives that are available now, and yet people still struggle. They avoid getting help. They avoid getting information, and they get in their own way through negative practices. So why aren't they using all this fabulous information and technical resources? They don't know about them. They don't understand or believe in their benefits, or they don't know how to use them. One of the key influences on how well a person thrives is their life experiences and their personal attributes. It starts with the degree and type of hearing loss, but it's also their personality. How open are they to change? How comfortable are they in expressing their needs? How well do they understand hearing loss, both in general and their own in particular? What are their attitudes towards hearing loss and their family's attitudes? How have they absorbed society's attitudes? And also, access to hearing health care. Do they have it, both financially and proximity to hearing health care? A second major influence is the service that you provide. On the one hand, we've all, both of us with hearing loss, have experienced that hearing care person who made us not want to go back, who we felt was not sympathetic to our fears and our emotions or our financial situation, and who seemed to simply want to slap a hearing aid on us and call it a day. The other side, the positive experience of most of us, is that qualified hearing care professional who is not only a good technician and who communicates well, but who endorses and recommends a full range of communication strategies to benefit the client, me. The third influence is peer resources. Like I was just talking about that, reaching out for help. This is transformational, and it can be transformational for your clients as well. Other people with hearing loss fill in so many gaps in information. They give us accurate advice on the day-to-day things in hearing loss. They give us a boost on our journey. We can get information from consumer websites and consumer groups, both in person or online, and this interaction helps reduce our isolation and our emotions about living with hearing loss. Okay, so what does it mean to live more skillfully with hearing loss? The first step is knowing what to expect, because if you don't know where you're going, it's pretty hard to get there. Understanding the big picture lets us see that ups and downs are part of the process. For example, it takes time to adjust to hearing devices, and if we know that, the fact that they don't work perfectly right out of the box is not going to be seen as a failure, but just as a normal part of the process. The second step is embracing a trio of integrated strategies to improve communication, and you can see only one part of that trio is technology. The other two parts are not, right? Changing our attitudes about hearing loss and non-technical communication strategies. And then the third step is putting it all together, taking what we learned about the journey and the three-legged stool of strategies and applying them to every area of our life. So let's take a closer look at the hearing loss journey itself. It is very, very helpful when the big picture of hearing loss comes from you. Hearing care professionals are key in setting the stage and laying the groundwork for our success. We need to see that hearing loss is, for most of us, permanent, and it was only with hindsight that Sherry and I realized that we were even on a journey. The twists and turns and the blockades and the breakthroughs, all of these would have been easier to handle with some foreknowledge. For most of us, hearing aids and cochlear implants are not a standalone cure. Most of us still use visual cues and other methods. It's important that we come to accept the emotions of hearing loss and we understand that people communicate through emotion. These are normal, and we are not alone, or we are not wrong in feeling sad and angry and maybe even embarrassed that communication now takes so much more work than it used to. The big picture shows that there is help and support available and that asking for this support is not helplessness. It's strategic. And while all journeys are unique, we go through similar stages. Now, we've spent thousands of hours talking with other people with hearing loss, and like Gail said, every hearing loss journey is unique, but most of us pass through a series of typical stages. And the first one, we call it debating with yourself. And this is where you're wondering if you're having trouble hearing or if everyone has just started mumbling. You can struggle with denial, looking for anything or anyone else to blame but your own poor hearing. And this stage can last many, many years. It certainly did for me. The second is validating, and this is where you all come in. So we go for the hearing test, and it might not be what we wanted, but now it's a reality. We have hearing loss. That takes us to the third step, which is taking charge. And this is really the most exciting part of the journey because we finally have decided to do something about it. For most people, this means getting a hearing aid, and as Gail mentioned, these are not a stand-alone solution for hearing loss. So we start to explore other strategies too, and that's really where here and beyond can be very helpful. Living skillfully is the fourth step, and this is kind of the ultimate goal. It may not be smooth sailing every day, but we are equipped to handle the hiccups, and when they do happen, we try a new strategy and keep going. And then there's refreshing and restarting, and this is really what makes hearing loss a journey rather than a puzzle with a finite answer. So something changes. Maybe you get new hearing aids, or your hearing loss changes, or there's a pandemic, and it changes all the rules of communication. So any of these things might set you back to an earlier part of the journey, and so it begins again. Now, these stages don't happen overnight, and each of us takes our journey at our own pace. Now, excuse me. The second part of living skillfully is embracing integrated strategies or skill sets that have a single targeted purpose to improve communication. This is our three-legged stool. Now, a three-legged stool never wobbles, even on uneven ground. So this stool with three legs is the solid communication, the solid foundation that we can stand on. It's the basis of good communication, and the three legs are mind shifts, technology, and communication game changers. Now, each of these skill sets is important, crucial, but when the three of them work together, that's when the magic happens. I have the potential to change my journey. The person with the most power in my hearing loss success is me. This is a moving statement and really a life-changing one because it's the moment you discover you're in charge of your hearing loss journey, and a lot of that comes down to attitude. A diagnosis of hearing loss comes with emotional burdens that paint hearing loss as embarrassing, shameful, and some of these beliefs come from external sources like ads and TV shows or other media that still use poor hearing as the brunt of the joke or to make somebody appear foolish or out of touch, and without realizing it, we internalize these feelings. We might look down on ourselves, causing us to hide our hearing loss so we don't appear weak or broken. Now, here is an attitude selfie that people with hearing loss can take to reveal common negative attitudes that they might hold about their hearing loss. These mindsets are unproductive, and they can lead to negative outcomes, and just like the stages of the journey, this list was compiled from thousands of people like us that we have met through our years of adequacy work, and also we may have held these ourselves at some point. Why me? Nobody understands what I'm going through. I want to hear better the way I used to. Oh, I don't like to advertise my hearing loss. People will think I'm old or slow. My family and friends, they always forget about my hearing loss. Hearing aids are ugly, they're expensive, and they don't always work. Oh, I don't want to bother anyone with my hearing loss needs. Who would want to hire me or love me or be my friend? I get angry at myself, and I get angry at others when we make communication mistakes. Everywhere I go, there is no access for people with hearing loss. Our attitudes towards hearing loss affect our emotions and also our behaviors, and this is an important thing to understand, because it means that life with hearing loss can be better just by changing our attitudes. These better attitudes create better conversations because we're willing to ask for the assistance that we need. And they can even help our technology work better because we're more open to experimentation and change. When we can reframe our unproductive, destructive thoughts and reposition them as constructive, actionable statements, we will create a healthier approach to hearing loss. Now, we're not trying to be overly simplistic here, right? Mind shifts are not cures for hearing loss, but when people with hearing loss actively support their hearing aids with other strategies, including an improved emotional attitude, they can communicate better. And this will also improve their working relationship with you. Gail's gonna give us a couple of examples. Okay, well, the first example, I'm gonna think back to that conference that I told you about. And at the end of the conference on the third night, a few of my new hearing loss friends and I went out for a drink and we went to a nearby pub. And when we entered, it was empty except for a table of four people sitting in the corner, presumably hearing people. Now, I don't know if you've ever gone out for drinks with a group of people with severe hearing loss. Let me tell you, we are loud, loud. So we were having a good time, but I, so new to all of this, was very aware of those looks what we were getting from people in the corner. And I'd always been sensitive about maybe speaking too loudly with my hearing loss. But then all of a sudden I thought, so what? So what? This is what hearing loss is like. I had learned, I had moved from, nobody understands what I'm going through to knowing that I'm not alone and that I can learn from other people. And it made a huge difference in my life. And the other mind shift is a technical one. The mindset was hearing aids don't always work. Around when I was moving to binaural hearing aids, I got the little CICs. This is around 1995 and they were brand new and so brand new that they weren't quite perfect yet. And I was at home with my husband and the battery cage was plastic or something had broken off. And I started venting a full-blown hissy fit. And my husband went, whoa, Gail, they are not doing this just to tick you off. You need to have more respect for technology. And I was like, okay. And I did, I shifted my whole attitude towards technology. I'd been wearing it for 20 years, but I realized I resented it. I changed my attitude towards technology and started working better for me from then on. So how do your clients, how would they put mind shifts into practice? Well, and that's it, it does take practice. One strategy is we call optimizing rather than perfect. Just as hearing aids, just as we shifted our goal from hearing better to communicating better, same thing as here. We aren't aiming for perfect, we're aiming for what will work. Have an open mind, use different tactics and maybe try again tomorrow. And then practice, practice does build confidence by practicing these attitudes and putting them into action and perhaps even using a mantra, which is an affirmation of belief and a positive intent. This can go a long way. And also prioritizing self-care. This is a huge one for me. And some of it I have to give credit to my good friend, Sherry Eberts. Making hearing, good hearing, better hearing, better communication, part of a healthier life makes a big difference. And in order to deal with the stress of hearing loss, the stress of difficult situation, being healthy, trying to eat better, sleep better and practice attitudes of forgiveness and gratitude and not being so hard on ourself. Doing meditation and exercise, all of these things have helped me live better and to create new mindsets about my hearing loss. All right, so let's turn to the second leg of the stool, technology. And for many people with hearing loss, this can be very intimidating. You'll remember that negative attitude we found in the selfie, right? Hearing aids are ugly, expensive and don't always work. But to secure this leg of the stool, we need to reframe that attitude into something like Gail was describing. Technology is my friend. My devices let me hear sounds I had forgotten or had never heard before. They connect me to other people and to the world. So why are so many people reluctant to adopt hearing technology? I think part of it is that they don't always have the correct expectations. So hearing aids are not like glasses. We all know that on this call, they don't return your hearing to normal. It's just not possible yet. But I think this is what many people expect. They don't really know differently and their friends and their family don't know differently. So we need to do a better job educating potential users about what hearing tech can and cannot do. Hearing aids improve speech comprehension, especially in a quiet environment, but they may not be enough in certain situations. So we need other technologies, including things like remote microphones, smartphone apps like speech to text and sound alerts and external accommodations. I had never heard of CART. This is where a person types in real time what is said, like creating captions or a hearing loop before I went to my first hearing loss convention. And this is really a huge missed opportunity to get clients back out to lectures, the movies and the theater, and to utilize all of these great accommodations that do exist. And also OTC. This can really be a great entry vehicle for some people who may be resistant and also a good backup solution in a pitch. Our two must haves are Bluetooth and until AuraCast is everywhere, T-coil. So it's actually a pretty exciting time to have hearing loss, but even so we need other things besides the technology, the non-technical strategies. And this is our third leg of the stool. I want to communicate better and it takes more than technology to do this. I need softer skills too. Sometimes even small changes in communication behavior can have a huge impact on the quality of the conversation. Now, most people, most of your clients are already using some of these tactics to some degree without even realizing it. One of the most important tools here is self-identifying. Letting people know that you have hearing loss either in general or in the moment. This can be tough for some people because of the stigma we've talked about, but it might also go against their private nature about something that they consider personal. Sometimes they don't even know the proper term. You know, what do I call myself? Hard of hearing and I have hearing loss, hearing impaired, a little deaf. And you know what? We don't care what term people use. More important than the label is to be open about your hearing loss. A favorite mind shift of ours is being open about my hearing loss will help me communicate better. Trying to hide my hearing loss will only lead to misunderstandings. Speech reading. This is a natural process, but it also can be learned. You can get better at it. It's a skill. And if some of your clients are struggling, we really recommend taking a speech reading course, which also includes communication strategies. There are some great online ones. So it's something to think about for your clients. Then there's self-advocacy. Knowing how to have our needs met. And when we advocate for ourselves, we are simply asking for what we need. We're not asking for favors. This is what we need to have better conversations with you. I mean, people aren't mind readers. We need to tell them what we need and we don't need. Because if we don't advocate for ourselves, what do we do? We bluff. And I call bluffing the evil twin of self-advocacy. Learning not to bluff is a positive communication behavior. It is almost impossible to stop doing it completely because we bluff for so many reasons when conversations get away from us. We don't have the assertiveness or communication skills. We want to hide our hearing loss, the listening fatigue, but conversation and communication will get better if we bluff less. And it's important to make communication best practices, the standard for all sides, with all the people in our lives. And, but we have another favorite tool. Sherry's going to tell you about it. Yeah, we really do love this one. So here is our mental checklist tool that can be used to improving any listening situation. It's quick and it's an effective process to determine what needs to change in order to communicate better. So the first step is hearing check. Can I understand what my communication partner is saying? And if the answer is yes, then great. But if the answer is no, we move on to evaluate. And here's where we take a look at what we need to do to improve the situation. This could be environmental fixes, like more light for speech reading or a different seat, but it could also be communication partner issues, like they need to speak louder or slower. It's also a good time to take a look at the tech tools and see if an app or an accessory might help. And then comes the hardest part, but we cannot skip this. We must articulate our needs and ask for what we need from others. And this creates a situation where our partners benefit too. So sometimes we might feel a little bit awkward about doing this, but it actually benefits everyone when we mention what it is that we need. And then there's revise and remind. And this is kind of like refresh and restart on the hearing loss journey. So something changes, a musician arrives or the noise picks up, or more likely our communication partners slip back into old habits. So we just go through the steps again, even if it's just to remind people of what was already suggested. It's simple, it's effective, and with practice, it will become second nature. The final feature of living skillfully is applying the three-legged stool to all aspects of a client's life. Everything that is affected by hearing loss can be improved communication-wise. Hearing hacks are specific tricks and tips for each individual situation. And we devote a large section of our book to hearing hacks. And we have a hearing hack for almost everything. Leisure events, family activity, dining out, exercise, and learning what these are and using them makes a big difference. And as hearing loss advocates, we also consider ourselves hearing hacks. And applying all of this to the most important area of our lives, relationships, it's crucial. Hearing loss saves the biggest punch for communication-based relationships. And there's new, you know, like new relationships. There is a filtering process unique to people with hearing loss. So for example, like the hearing people would say, nice person, check. Fun to be around, check. Intelligent, check. But we have an extra question. Can I understand this person? And if that's not a check, we might be in trouble. But with some hearing hacks and with some of our three-legged stools and some skill and honesty, we will be able to communicate better. But with existing relationships, we don't get to choose those relationships. They exist. We have trouble understanding our family and our friends and our colleagues, and they get frustrated with us. But there are ways to make it work by applying the three-legged stool of mental attitude technology and changing some of our behaviors. Now, for example, Sherry and her family have had some highly charged, apparently, but very rewarding focused family discussion to set ground rules about how to communicate better on hikes or in restaurants. And in my house, technology has saved my marriage. A TV streamer made a big difference. We can both listen to TV at our own level. And, but there was one suggestion I tried to introduce to our relationship. I thought it would be great if my husband wore glow-in-the-dark lipstick so I could understand him if he wanted to speak to me in the middle of the night. That didn't go across so well. But it is a big hearing hack to make partners and support networks within our family, within our circle of friends and within our colleagues, and especially with you, our hearing care professional. So let's turn to the final part of our talk, which is your role in the successful client journey. People with hearing loss are looking to you to be our partners and our guides as we take on the challenges of hearing loss. And Gail and I are both longtime proponents of person-centered care. So this quote really sums it up. The best hearing care professionals are communication specialists who create personalized solutions, including both technology and non-technical strategies. And both the professional and the client have roles and responsibilities in meeting this goal. So the clinician, like I said, should be the guide, painting that big picture that we've been talking about and setting appropriate expectations for the devices, creating personalized solutions is critical. So you need to take the time to understand the client's lifestyle and their particular communication needs, respecting their knowledge and their emotions. People with hearing loss are the experts in their lived experience, just like you are the expert in hearing science. Incorporate all types of technology and reach beyond the technology to include all types of communication game changers. One thing that often gets overlooked is your office and making sure that that is client-friendly. So consider offering telehealth so family can participate more easily or having a tablet with auto captions to help with the check-in counter and even using texts and emails to make appointments rather than a phone call. Please share information resources like books and magazines in your waiting area and make pamphlets from a local HLAA chapter or a peer mentoring or a lip reading course. And of course, providing all important information in writing. Gail already talked about peer resources and that support can really be life-changing. It helped me build confidence. It taught me so many of the tips and the tricks that I use well to live with hearing loss and maybe most importantly, it helped me feel less alone in my struggles. Now we often get asked when is the best time to share all this information with clients, right? It's overwhelming and it can be hard to fit it all in in every appointment. And it's also hard maybe for clients to absorb all of it especially at that first fitting appointment. So our advice is to space the information out over time. You can share a little bit at each appointment. You can share some in your newsletter or by recommending books or other online resources that you'd like. And you might feel like you're repeating yourself from appointment to appointment, but that's okay. The repetition is gonna help us to really absorb that information. And all of these things that you do will really show respect for your client and reinforce your position as a caring partner. But we have responsibilities too. If you practice client-centered care, you include your client in the decision-making process. But regardless of where your client is on the journey, receiving this information from you is a new experience. Collaborative decision-making is something new. We're used to being told what to do without much discussion and we don't always follow up as directed. But to help you to help us, our job is to share our hearing loss journey, share our struggles, and be honest about the difficult communication situations in our lives. And we must ask you questions and we must respect your expertise as well as our own. And we need to be open to new strategies, but you need to help us carry out our role. In fact, I would say that you need to make us aware of what our duties are. So thank you so much for your attention. And we just wanted to end with this one last thought. Living skillfully with hearing loss is an ongoing process. And so for each of us, the journey continues. And we invite you to take this journey with us. Thank you so much for your time today. You know, for more information on the client journey and the patient perspective, please reach out to Sherry and me with any questions you have, any comments. We have listed here our websites and email addresses. And we also invite you to take a more detailed look at our book, Here and Beyond Live Skillfully with Hearing Loss that we wrote together during the pandemic. This is our philosophy. This is what we believe. This is what we practice. And this is what helps us in our hearing loss lives. In this book, we've shared everything we know about living the best hearing loss life possible. We hope you'll find it useful. And we know that your clients will.

hearing loss

empowerment

skillful living

communication strategies

person-centered care

technology

collaboration

quality of life