Are you compensating for your loved one’s hearing loss?

If your loved one has untreated hearing loss and you find yourself constantly having to "translate" (explaining to them what they misheard), you may be compensating for them. Although you're trying to be helpful, in the long run, compensating can be harmful to both of you.

“When it comes to persistent untreated hearing loss, 'help' can turn into habit,” audiologist Richard E. Carmen, Au.D., said. “When a family member [trying to help] too often begins repeating words, sentences, then rephrasing and interpreting thoughts and ideas that were missed, it’s way past time for professional help.” 

Examples of compensating behaviors

The desire to assist is a natural inclination born out of love and kindness, said Dr. Carmen, who is a clinical and research audiologist, author and publisher. He has served the deaf and hard of hearing for more than 50 years. 

“We don’t want loved ones to appear foolish, disinterested, bored or embarrassed and, for these reasons and more, we tend to intervene and compensate for a loved one not hearing well,” he said.

Compensatory behaviors include:

• Speaking louder. Those with hearing loss may speak louder because they can no longer hear themselves normally; loved ones may increase their volume to be heard by the family member with hearing loss.
• Acting as interpreter. Loved ones often repeat and rephrase to help a family member participate in the conversation.
• Isolation. As hearing worsens and communication becomes more difficult, the person with hearing loss and their significant other often opt for social isolation.
• Resistance. The person with hearing loss often resists seeking treatment and at some point, family members may resist providing hearing assistance.
• Hope. Family members rely on hope that their family member will seek treatment. The person with hearing loss often hopes his or her family members will stop suggesting hearing aids.

Hearing loss and resentment

In many cases, hearing loss happens gradually with age. Known as presbycusis, symptoms include trouble understanding conversations, especially in noisy environments, and difficulty distinguishing the high-pitched sounds in speech, such as “s” or “th.”

And, although keeping a family member engaged in the communication circle by using compensatory behaviors begins innocently, the resulting reactions and sentiments that occur often adversely affect family dynamics in one of two ways: 

• Codependence. The family member with hearing loss becomes dependent upon a spouse or significant other to be their “ears.” As the hearing loss becomes more profound, the couple becomes reclusive and avoids social gatherings with friends and family. This increases the risks of cognitive decline, especially for the one with untreated hearing loss.
• Resentment. Those who want their loved one to seek treatment for hearing loss may develop feelings of anger, depression, stress, fatigue and impatience, especially if the hearing loss goes untreated. The individual with hearing loss can develop resentment, too, as family members put increased pressure on them to enlist professional help.

“It’s important to realize that with many years of untreated hearing loss by one family member and development of compensatory behaviors by everyone, it is the entire family that has the hearing problem,” Dr. Carmen said.

For help sorting through these problems, we have tips and advice for easing the relationship strain caused by hearing loss.

What’s the solution?

Because age-related hearing loss happens gradually, family members should be observant. Persistent requests to have others repeat what they’ve said or the inability to hear common sounds, such as a telephone or doorbell ring, are all indicators a loved one may have hearing loss.

Brush up on communication tips for hearing loss, but also don't slip into compensation and risk caregiver burnout. Your loved one will be better off if they don't spend years relying on you to compensate for their hearing loss, especially when treatment is available and effective. The first step? A hearing test. 

“The best way to catch hearing loss at its onset is to receive an annual hearing assessment by an audiologist,” Dr. Carmen said. “Insurances often cover these costs and some carriers will even cover hearing aids.” Medicare typically pays for hearing tests for older adults, for example, and the VA helps veterans with hearing loss or tinnitus.

In many cases, hearing aids will be the recommended treatment. Of course, getting to this point may be the hardest part of the journey: If your loved one has been in denial about their hearing loss, this is normal and quite common. 

It may be useful to point out to your loved one that hearing aids are good for their health. They may not be aware that hearing loss is linked to cognitive decline and causes listening fatigue and overall exhaustion, for example. It also may help to share transformative stories of how hearing aids helped people regain the sounds—and quality of life—they were missing.