Abstract :

Senior citizens though they have retired from the daily outside job, but they need to have certain levels of activity at home and at times outdoor. Hearing inability does come in as a hindrance to communicate. Though they have Hearing issues they tend to shy off from Hearing aid use(Mahmoudi Elham,et.al, June 2018).They find themselves cornered and difficult to express their thoughts, ideas and opinion. The Stigma is so deep that people tend to avoid using hearing aid though they suffer.

In this study we tried to provide the various studies by different authors on this topic. We can come across some common challenges which are uniform throughout the society and in different landscapes. Further, we have tried to consider the probable way out of this evil. But this study is limited to literature review and there might be some board areas which need further studies and research.

Keywords :

Senior Citizen, Hearing Aids, Quality of life, Ageism, Hearing Impairment

I. Introduction

We are in the 21st century where we have the access to new modern technologies. The technological gadgets which were not available earlier are now easily available. This has made our life quite easy. But even though we have availability we do not use it due to certain stigma.

According to Population Census 2011 there are nearly 104 million elderly persons (aged 60 years or above) in India; 53 million females and 51 million males have hearing loss. A report released by the United Nations Population Fund and Help-Age India suggests that the number of elderly persons is expected to grow to 173 million by 2026.

Hearing Aid does provide a change in our quality of life. The challenges of communication which we face due to heard of hearing in neutralized to a great extent due to the amplification support. But there remains the question of acceptability. The question of what others will think, say becomes more important than the actual hearing. People are ready to conceive there hearing impairment to others, rather than using the aid.

It’s commonly seen in an around people putting their hands on their ears to make the sound audible. The ask to repeat or then tend to make the distance closer to hear the sound. But when they are asked to use hearing aid, they say they have completely normal hearing. Rather, they ask being again and again asked to use hearing aid when they do not have any problem at all

How do we define Social Stigma?

Social stigma is the artificial barrier which we create. We restrict ourselves from doing some activities. We care of what others will say rather than what we need. These thoughts are age old and have run for generations. There is hardly any scientific clarity for the same.

So, far as Wikipedia social stigma relates to the disapproval of, or discrimination against, an individual or group based on perceivable social characteristics that serve to distinguish them from other members of a society. Social stigmas are commonly related to the culture, gender, race, socioeconomic class, age, sexual orientation, body image, intelligence, and health. It (Stigma) can also be against oneself, stemming from a negatively viewed personal attribute those results in a 'spoiled identity.

Sternasty et.al, March 2021 in their work Barriers to Hearing Aid Adoption run deeper than price tag does informs the social stigma which hampers the purchase and usage of Hearing aid. Similar, study can be seen in the work Maidment, et.al April 21, where they mention the adoption of Hearing aid and its challenges.

Social Stigma and Hearing Aid Use

A study published by Margaret Wallhagen, Ph.D., did identify that Hearing loss has a strong connection with the feelings of altered perception. The example cited is abled versus disabled hearing impairment. The study suggested this perception in delay in seeking treatment.

 The study by Wallhagen further breaks down the stigma into three specific parts Alteration in self-perception along with ageism and vanity. Vanity is generally associated with persons do not like to look old. People have a mental perception that they wear hearing aid they will be looking like an old person.

The concept of stigma has a long history which originates from the Greeks. They used for alter bodily sign that exposed something negative about a person’s moral status (Goffman, 1963). Most current literature, however, refers to Goffman’s own work and his use of the term to mean “an attribute that is deeply discrediting . . .” (p. 3) that can lead to overt or experienced rejection, isolation, judgment, or discrimination (Dobbs et al., 2008; Sandelowski, Lambe, & Barroso, 2004). Even Goffman’s subtitle, “notes on the management of spoiled identity,” connotes the pejorative meaning of the term.

If stigma is an important underlying factor in the denial of hearing loss and rejection of hearing assessment and treatment, a solid understanding of this concept is necessary for developing programs to help older adults and their families better manage hearing loss and promote maximum functioning and quality of life. Yet, although articles regarding stigma’s association with other chronic conditions, such as HIV/AIDS (Holzemer et al., 2007) and mental illness (Peris, Teachman, & Nosek, 2008), can be found in the nursing and medical literature, few data are available on how and why hearing loss and the use of hearing aids are perceived as stigmatizing. The purpose of this article was to explore the dimensions of stigma as experienced and expressed by older adults and those with whom they most frequently communicate.

Implication of Stigma on Hearing

In the Literature review we have identified many factors which relates to the non usage of Hearing aid.  In most societies, there is a stigma associated with hearing loss. The general population perceives individuals with hearing loss as being “old,” “cognitively diminished,” “poor communication partners,” and generally “uninteresting.” (Kochkin 2017) noted that hearing loss is often misunderstood as an intellectual challenge or a deficiency in personality and character.

Stigmatization is a social construct that can be studied from the vantage point of outsiders—people who do not possess the stigmatizing trait. Studies (Elizabeth conevey, et.al) that have investigated the “hearing aid effect” are examples of research on the perceptions of outsiders concerning the stigma associated with hearing loss. As noted above, studies have shown that outsiders consider people with hearing loss to be old, senile, and socially unfit. In addition to possessing negative attitudes about individuals with stigmatizing conditions, outsiders often avoid and/or ostracize individuals with stigmatizing conditions.

Stigma can also be studied from the vantage point of insiders—people who possess a stigmatizing trait. Usually, insiders are aware of the prejudicial views held by the outsiders. Some insiders display self-stigma; they hold (consciously or not) the same prejudicial views about their stigmatizing condition as do the outsiders.

Self-stigma invariably involves a threat to one’s own identity. Often, people who experience self-stigma display a high level of stress, shame, and lower self-esteem and self-efficacy. In one of the ethnographic videos developed by Ida Institute anthropologists, Bill, an adult with an acquired hearing loss, described his perception of hearing loss saying, “[Being diagnosed with hearing loss] was the same as being told that I would have to wear adult diapers.”14 A detailed account of the phenomenon and manifestations of self-stigma is beyond the scope of this article. For a comprehensive look at social stigma and self-stigma associated with hearing loss, (Gagn et al.)

People who experience self-stigma are likely to develop maladaptive behaviours. For example, people with self-stigma will deny that they have a hearing loss. In most instances, the stigmatizing trait (Patrica McCarthy, et. al) can be concealed (or the person with hearing loss believes that it can be concealed).

Outcome of Stigma and its effects

Different authors have tried to share their thoughts and ideas about stigma. Through various literature reviews we can conclude that this social evil can only be overcome if there is transparency. People have to come out of their thoughts of looking old and other negativity.

They have to disclose their problems to the hearing care professional that can provide the best solution. Even the looks of the hearing aid has something to reveal. May be we need to have a technological makeover which will relate to the overall looks of the hearing aid. May its time Hearing aid should be made appealing and look like a fashion statement which is applicable in case of glasses.

It’s up to the manufacturers to take the inputs and work in the R&D to have need design which is acceptable to many. Further, it needs to be stated that we are only considering old age and people above 50+ categories. People do suffer Hearing problem in the middle age as well. May be a new design and fresh look can appeal people who try to avoid using hearing aid. We can take care of the issue and deal with this evil in the below mentioned points.

           

• Low adherence in hearing aid use is connected to fear of stigma related to hearing impairment and hearing aids.
            
• Hearing health services should include counseling to deal with individual’s experiences and fear of stigma.
         
• Stigmatization is a social process that concerns individuals with hearing impairment in contact with their social environment.
           
• Hearing health professionals should consider including close relatives and/or partners of hearing impaired individuals in discussions of starting hearing aid rehabilitation.
            
• In consulting patients with hearing impairment professionals should give advice about how to deal with questions of hearing aid, hearing impairment and fear of stigma at work.

Conclusion

Hearing Aid is one of the solutions to the impairment. Though the success rate varies from person to person. It’s for sure it does have an impact. The success rate depends from choosing the hearing aid to the point of post-sale hearing management. The new digitization of technology such as Artificial Intelligence, Cloud Computing etc. there are more new advancement in the offerings. Further, it will increase the success rate satisfied Hearing Impaired persons and more people having this ailment will look for solution.

Maybe, the technological innovation and more usage of Hearing aids among the middle aged group will increase the acceptability of hearing aid use. The stigma of nonuser will take time to get removed from the society. The onus is on the manufacturer and hearing care professionals to work forward with the mental challenges of the users.

 

 

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