Perceptions of Age and Brain in Relation to Hearing Help-Seeking and Rehabilitation

Objectives: This study used a qualitative approach to explore the perspectives of adults with hearing impairment on hearing help-seeking and rehabilitation. Two superordinate themes, Age and Brain, emerged from prior analyses and are investigated in the present article. Design: In-depth semistructured interviews were completed in four countries with 34 adults (aged 26 to 96 years) with hearing impairment. Participants were asked to Tell the story of your hearing. Participants included individuals with different levels of experiences in hearing help-seeking and rehabilitation. The themes of Age and Brain emerged from the data based on qualitative content analysis. These major themes were analyzed further using interpretative phenomenology to create models of themes and subthemes as they related to hearing help-seeking and rehabilitation expectations and experience. Results: Age was discussed by 68% of the 34 participants. The data were sorted into three themes: Expectations, Self-Image, and Ways of Coping. Brain was discussed by 50% of the participants. The data were sorted into three themes: Cognitive Operations, Plasticity, and Mental Effort. Conclusions: Adults with hearing impairment think of their age and their brain as contributing to their hearing impairment, disability, help-seeking, and rehabilitation. Although hearing impairment associated with older age was typically construed as a stigma, not all perceptions of aging and hearing impairment were negative. Some participants viewed older age and its influence on relationships or priorities as a reason for seeking out hearing health care or as the determining factor in deciding to wear hearing aids (HAs). Some expected hearing impairment with older age, thus they found it easier to accept wearing HAs than they may have at a younger age. They discussed the brain in terms of the cognitive operations that may either inhibit or improve speech communication. Participants believed that they could train their brains to improve their communication (and sometimes avoid the need for HAs) or to increase their HA benefit. Age and Brain interconnected in a number of ways. Participants believed that older age led to cognitive decline, which resulted in decreased speech understanding. Participants also believed that the cognitive decline that accompanies older age may limit HA benefit. Hearing healthcare providers may wish to clarify negative messages about age and brain with their patients and provide information about how older brains are capable of changing and benefiting from HA use and comprehensive audiologic rehabilitation programs.