Introduction
According to (1991), the medical model with its individualized, psychologies and medicalized account of disability has been rejected in favour of a sociological account that views disability as an oppressive social creation. . . the focus shifts from individual impairment to the disabling effects of social organisation and structures designed around and for non-disabled people. Further, disability as the disadvantage or social restriction of activity caused by contemporary social organisations which take no or little account for people who have physical impairments and thus excludes them from the mainstream (1991). From the definition, disabled people are oppressed in terms of the manifested attitudes and the built-in environment from where they move through that seems to be a barrier for the disabled people to have and gain access to the non-disabled people in the mainstream society whether it will be physically, emotionally and intellectually.
In this essay part one describes the selected disability of hearing impairment. Hearing impairment, as a disability, has social effects on people especially in the elders. In part one, we would look into the different areas as to how it affects the hearing impaired person in terms of psychosocial (how the impaired person interact socially), recreation, mobility, communication, daily living, financial and vocational housing. Part two, discusses the impact of hearing impairment in relation to the factors of gender, culture and the age. By gender, it will tackle the similarities and differences between men and women as being hearing impaired. In culture, however, this essay would discuss two ethnic groups in New Zealand, the Maori and the Pakeha as to how they are similar and different in the dealings of hearing impairment. Moreover, the last sub-part of part two would discuss the similarities and the differences of hearing impaired between the youth and the elders. The last part of this essay would provide a brief description over the services that the community have in providing the elderly with adequate attention and care as they go through the disability of being hearing impaired.
Part One
Hearing level deteriorates with increasing age (1971; 1984). (1990a), the influence of genetics, noise exposure, cardiovascular status, central processing capacity, systemic disease, smoking, diet, personality, and stress have all been implicated to varying degrees in the etiology of impaired hearing. A randomized study of the hearing impaired (1990) found that 82 percent of the participants reported that hearing loss had an adverse effect on their quality of life such that hearing impaired people suffers from depression, problems in communication, difficulties in both emotional and social dealings and decline in cognitive functioning. A related study (1990) found that the majority of people reported these difficulties even when there was only a mild to moderate hearing loss. Similarly, (1982) found out that the moderate hearing loss significantly reduces the opportunities for incidental learning to occur.
- Psychosocial
The effects of hearing loss upon interpersonal relationships vary considerably with a number of factors (1997; 1996; 1997; 1984). and (2001) found that significant others of a hearing impaired partner experienced not only communication difficulties, but also increased difficulties in personal and social relationships. In most of the scenarios, the hearing impaired contemplates the difference in communication which leads to miscommunications between the hearing impaired and the non-impaired as its psychosocial effects. The extreme response of the hearing impaired would gradually come to a point of increasing seek for isolation. Consequently, as the feeling of being drift away makes a hearing impaired person may act angry even when someone attempts to break through the barrier to sound ( 1994).
- Recreation
The effect of hearing impairment in recreation is somewhat devastating for the hearing impaired because it is empathized that a hearing impaired seeks for company and understanding to the non-impaired as a means to compromise and not sense the feeling of being disparate. If however, the hearing impaired does not get to feel desirable response and after having experienced numerous embarrassing, frustrating, or tiring experiences while attempting to socialize, the person with a hearing loss may begin to withdraw from social activities (1987; 1984). Simply stated, the recreational activities that was once very enjoyable to the hearing impaired, such as hearing mass, shopping, engaging into social activities, and so on, would no longer be enjoyable and the previous positive experiences associated to the recreational activities would diminished. Further, significant decreases in recreational outlets and in shared recreational time may result (1987) to the extent that this recreational time was shared by family or friends, reduction in time spent together and changes in relationships may occur.
- Mobility
Older people typically experience multiple physical or emotional/social losses for which they need to develop adaptations or compensatory strategies (1976; 1976; 1982, 1986;1985, 1986). All these stressors contribute to the reduced mobility of the elderly since it necessitates the impaired elderly to expend all its energy to deal with the negativities the hearing impaired got into.
- Communication
Communication as the primary functional limitation of hearing impairment, it causes the hearing impaired to have a hard time of initiating and making a clear connection in communication, and is less likely to initiate an open communication since they often feel that they are oftentimes misunderstood resulting to life as being confined to only a few one-on-one social visits with close friends or family, and may eventually end in solitude (1987). Moreover, because of the inability of the hearing impaired to engage in effective communication, significant others leads to not informing the hearing impaired elderly for the upcoming significant events, which in turn, leads to feelings of distrust on the part of the aged hearing impaired. When founded in realistic experiences, mistrust can be considered to be a healthy reaction to hearing impairment (1968).
- Daily living
Hearing impairment to a large extent hampers the daily living functioning. Whether physically, emotionally and mentally, the hearing impaired will have a hard time dealing with these matters especially if without, the support of the family and the society, such that the hearing impaired would need all the support he or she can get to be able to slowly accept the fact of hearing impairment which eventually would lead to hearing loss.
- Financial
According to a Ministry of Health study in 1994, people with disabilities are more likely to be in a low income group ( 1996). With the hearing impaired unable to have a source of income other than that of financial assistance, financially would be inadequate.
- Vocational Housing
The vocational impact of hearing impairment tends to center around the issues of communication problems, education, inadequate vocational guidance, discrimination in employment, over-representation in lower-level jobs, attitudinal barriers in employment settings, and a lack of appropriate adaptive technology (1991). For older persons with hearing impairment who are placed in a long-term care facility, group activities have been identified as factors influencing quality of life ( 1990). While physical and recreational environments within long-term care facilities have been found to be important to quality of life for older residents, human relationships and social contact appear to be more crucial to quality of life (1995;, 1987; 1990; 1990). (1995) have suggested that relationships and interaction between the nurse and long term care resident are pivotal for older adults. Given the meaningfulness of being able to socially engage in the normal daily interaction, for the hearing impaired, it definitely means a lot to them considering that need to be of utmost importance to have.
Part Two
Gender
In 1991, it was reported on National Institute of Aging research being conducted by , who found that men are losing their hearing at younger ages each generation and that men over 30 are losing hearing twice as fast as women 80 years old and older (1991). Across the life span there are one quarter more males than females with hearing impairment. Accordingly, the Statistical Abstract of the United States ( 1995), about 27% of individuals between 45 and 64 years old are using some type of hearing augmentation device.
Men and women share similarities not on the figures of the number of people having impaired hearing, but on the fact that they are dealing with the same impairment. Both sexes’ experiences the same processes in the rehabilitation process, although however, they vary in the way how they are being able to deal with the effects of being impaired. Men could be more irritated of the fact that he has impaired hearing, whereas women could be a lot more accepting of being hearing impaired. Men tend to be less likely to engage into the urge of having a social interaction, while women are more inclined to seek for it.
Culture
The figures below refers to the disability percentage of the ethnic groups in New Zealand wherein the Pakeha are ranked first, followed by the Maori, Pacific Islanders and the other ethnic groups. However, Maori have proportionately significantly higher rates of disability than other groups ( 1993).
Figure 1: Disability by Ethnicity in New Zealand
Source: NZ Household Health survey 1992-1993.
The similarity shared by both ethnic groups is that they have access to the public services. But the differences accounted on the Pakeha as having dominated the use of the public services compare with the Maori. The underlying reason of Maori not being dominant in the rehabilitation process being offered by the public is because the Maori is said to be discourage from using the available services and that Maori’s eschew the used of the specialized facilities because it is contradictory to the views of the Maori about the promotion of well-being.
Age
Youngsters and the elders shares the similarities of being provided with ample rehabilitation program but the difference perhaps can be accounted in the amount of support and outlook in life. It is an obvious fact that youngsters having have had impaired hearing in a tender age gets to have the benefit of full support coming from the family and the society in some sense. Youngsters is better able to adapt to the rehabilitation process and go through with the emotional, physical and mental setbacks brought about by the impact of the effects of being hearing impaired. Mobility wise, the young have great amount of energy and positivism within oneself to cope with and come to terms with the stresses hearing impairment brings to ones life. With the full support especially from the family enables the young to not feel the isolation and that much rejection since they are most of the time given with extra attention and affection at that. The elders on the other hand, may get support from the various concerned groups but the impact of hearing impairment brings is already stressing in itself for an elder and elders would likely have a hard time to come to terms with it. The accepting factor for elders would be hard in a way that they do not get the have the comfort of life the way they used to have prior of being hearing impaired. It is as if, for elders it is hard to let go from the things they thought that should not be taken away in the first place and further, it causes to have a negative outlook in life and for the future.
Part Three
For adults between ages 65 and 74, one in four is hearing impaired, and for adults 75 and older, almost two in five experience disabling hearing loss (1990). (1967) estimated that 90 percent of nursing home residents had hearing impairments. Physical examination, interview, self-assessment, relative or friend assessment, and audiometric findings are all pivotal services for the hearing impaired aged person given in the community. When the nurse is considering the basis for making a nursing diagnosis of sensory/perceptual disorder due to impaired hearing, and (1990) suggest a redefinition of significant variables. The services can be of terms of electronic means, but the companionship means is more helpful for the hearing impaired. For example, in the hearing dog companion, the elders express revitalized courage, confidence, and freedom. The self-help groups program also alleviates the impact of hearing impairment such that the sense of isolation can be minimized and it can encourage having a fruitful exchange of human interaction.
Conclusion
The elder people with hearing impairment are a heterogeneous population that represents diversity such that it can happen to anyone. The effects of hearing impairment on the areas of psychosocial, recreation, mobility, daily living, financial, communication and vocational housing, can be so distracting and hurtful for the hearing impaired because aside of the fact that it is hard to accept on their part, the aged hearing impaired gets to perceived the annoyance, inconsideration and misunderstanding from the non-impaired people in which whom they thought they can depend on in providing them with intangibles support. The impact of hearing impairment as a whole is pervasive, whether in terms of age, culture and gender and that they vary. The complement of services the hearing impaired gets to have should encapsulate the provisions of particular individual, then must reflect that individual's specific needs and not be based on mere diagnosis of hearing impairment alone (1989).
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