How Hearing Loss Impacts Relationships: Whose Problem Is It?

Editor’s Note: The book by Richard E. Carmen, AuD, “How Hearing Loss Impacts Relationships: Motivating Your Loved One” is intended for the spouse, significant other, family, or friend who is confronted the frustrations that stem from untreated hearing loss in someone they care about. Chapter 2 of the book, “Whose Problem is it?,” is condensed and reprinted here with permission from the author.

One day not long ago my staff had gone home and my office was closed, but a patient we’ll identify as Mrs. Thunder walked in. Her hearing aid was not working. So I invited her to have a seat in the waiting room while I took the aid back to my lab for inspection. While examining it I suddenly heard a sound in the waiting room I couldn’t identify. I quickly poked my head around the corner. There was Mrs. Thunder in a flurry yanking fistfuls of cellophane-wrapped hard candies from the candy jar and stuffing them in her little purse. If she could have heard the sound she was generating, no doubt her conduct would have been different.

Upon finally coming out to the waiting room with her repaired hearing aid, I offered her some hard candies from the large jar. “Oh no thank you,” she insisted. “I never touch them!” I just smiled and assumed she had a lot of grandchildren.

The fact is that everyday sounds are not heard by most people with untreated hearing loss. To experience what your loved one goes through living with loss of hearing, purchase a set of earplugs. Many hearing care offices provide them at no charge (gun shops and drugstores also carry them for a couple dollars). Wait for a day without a busy schedule, then upon rising in the morning, insert the earplugs and wear them all day until you get back in bed. I bet you don’t make it through the day without removing them at least once or altogether. Even a one-hour experience will be worth it.

It could be helpful to carry a notepad with you, but not necessary if you have a good memory and can honestly reflect back on your experience. What you want to bear in mind are all the nuances you miss. The intonation in a person’s voice. A missed word. Even subtle vocalizations that are not words but carry great meaning. Take note of your level of operating in the world on these terms. The missed joy in hearing pleasurable sounds is only one small part of this equation. The frustration, embarrassment, and myriad of other emotions that accompany people repeating themselves can all build toward explosive stress and tension.

While you do this for a day, you must realize that your loved one may live much this way every day. This means missing oral communication and many other sounds. That is, action taken or not taken (or thoughts perceived or not perceived) based on what we hear or do not hear. Compassion for people who do not take their share of responsibility in obtaining healthcare becomes a big challenge. While we may feel we know what’s best for someone else, it’s hard to be inside their skin.

Key: Developing compassion will enable you to better understand the challenges confronting you both.

Co-Dependence

If you serve the endless and unrewarding needs of your loved one by being his ears for him, giving into his demands against your better judgment, repeating what he misses, interpreting messages, making him feel he’s okay as he is without the need to seek any remedy for his hearing problem—you are in a co-dependent relationship. He depends on you to hear and understand, and you, willingly or not, have made yourself (or been coerced into) an indispensable resource for his hearing needs. You must ask yourself how willing you are to break this cycle.

There have been endless jokes about co-dependency that touch the lighter side of this troubling, dysfunctional problem. Why did the man cross the street?—To help the chicken make a decision. And then there’s the woman who was denied jury duty because she insisted she was the guilty party. While the Internet is a good resource for the humorous side of co-dependency, it can also be helpful in revealing the more serious problem it poses in relationships. 

Hopefully, the relationship with your loved one is far more meaningful than the simplicity of what I’m going to say next, so bear with me. In terms of the essence of co-dependence in communication with your loved one, a reason your loved one may need you is for your good hearing, and one reason you may need him is that it fulfills a purpose in you that may tie in with your need to feel good about yourself. By your action in helping him hear, it can make you both feel better, but it will never solve the underlying problem of him hearing better. If you have half a heart, it’s human nature to want to pitch in and assist somebody in need. However, in this case, as alluded to earlier, you are perpetuating the problem. In fact, it’s worth restating: you are part of the problem! Now don’t throw this book down in disgust because I’m picking on you. Examine your relationship to recognize if what I’m saying applies to you, then do something about it.

Key: If you cannot be honest with yourself about the issues, it’s impossible to be honest with him/her.

Co-dependence has been applied to a wide variety of healthcare issues far beyond the scope of hearing loss. The concept of co-dependence really developed in an effort to understand the role of the spouse or family member in relation to the alcoholic. For our purposes, this means that the hearing spouse enables the hard-of-hearing spouse (that is, facilitates the problem) by interceding and covering up the problem so that everything appears to be fine to the outside world. The hallmark of a co-dependent is that need to look good to the world at large. Sound familiar?

Co-dependence can occur by active support, such as constantly repeating yourself and doing anything to get your loved one to hear what is missed, or by passive support, such as you not admitting he has a hearing problem. This reflects a terribly dysfunctional relationship usually based on dishonesty with yourself or your loved one. If you’re reading this book, you cannot be engaged in passive support. Nevertheless, active supporters may not realize the depth of their own involvement.

Let’s Just “Fix the Problem”

A typical inclination you’re likely to have is to “fix the problem.” This is the tendency with co-dependency. Before you can address his issues, you need to get a handle on what you’re perhaps doing to contribute to the problem.

Key: You cannot fix the problem if your loved one believes there is no problem.

You cannot get your loved one to seek treatment for hearing loss based on your insistence. It can only come by his awareness of its effect in his world, then his taking responsibility for it. In the meantime, this sets you up for countless frustrations that seem to have little to no resolve because it continues to affect your world and he seems oblivious to it.

It is less important that you try to change his stubbornness—because you probably can’t—and more essential that you understand what you feel and what options are available to you. If this is the person you chose to partner with in life, it’s terribly important that you identify from where your own negative feelings arise.

One of the more common emotions you may have noted in this questionnaire was resentment. It is closely tied to anger and together is the most common emotion a person will experience with a hard-of-hearing loved one who does nothing about the hearing loss. First you resent the action you must take on behalf of your loved one. Then you get mad at yourself for taking that action (like continually repeating yourself). Then you express this anger directly at your loved one! In the meantime, your loved one has no idea from where this tornado came. All these incidents can silently gather within you and can eventually culminate in your own rage and anger.

In your present search for help by reading this book, you’re on a path to break this vicious damaging cycle. The early stage of co-dependence with hearing loss is merely reaching out to help your loved one hear better. This starts quite innocently, but eventually gets to a point of habitual self-defeating coping mechanisms. Ultimately, as a co-dependent, you try to control more and more of your loved one’s hearing needs because “He may miss something” or “because you love him” and “That’s what a good _____ [wife, daughter, son, spouse, friend] does.” As a result, your loved one comes to depend more and more on you without developing the need to seek professional help. In fact, why should he? It’s perfect the way it is. 

Or is it? Have you developed a rich and rewarding relationship with one another or have you taken each other hostage in the dance of co-dependence? 

One of the downsides to co-dependent hearing help is that old resentment you can develop. Most people get tired of the effort it takes to be someone else’s ears. It becomes difficult to relax and enjoy yourself if you must “listen up” during every conversation. It also becomes a strain and distraction for you because you lose your concentration and connection in conversation when you must continually repeat and interpret.

Some could say, “I don’t mind having to do this.” This certainly seems selfless and altruistic, but if your loved one can be helped through hearing aids, this is classic co-dependence. It will never solve the core problem of having your loved one hear better on his own, at family gatherings, at work, on the telephone, during leisure moments without you, and so forth. You should stop being his ears unless he either cannot be helped with hearing aids or wears hearing aids and still needs the extra hearing clarification you provide.

Conversely, you cannot live in a vacuum completely devoid of the influences of co-dependence, nor is that our goal here. That is, you have to be involved in your loved one’s quest for better hearing, but cautious that you do not overstep your boundaries or his, making yourself solely responsible for him acknowledging the problem and seeking help.

Your Own Self-Realization

The single identifier of a co-dependent loved one tied to someone with hearing loss is that need to help. Coming to terms with your mission of helping your loved one will better enable him to finally take action. So long as you continue to help him, you are pulling out the carpet of motivation from beneath him. 

Key: If your loved one has not yet tried hearing aids, be sure your co-dependent behavior is not a major factor in his resistance. Then prepare yourself for change.

Change of any kind is never easy. The change we’re looking for in your loved one is huge—independent hearing. However, to avoid a recipe for emotional or communication disaster, it will take consistent and predictable effort on your part. Here are some of the ingredients required by you to help your loved one in a transition toward awakening him to the need for hearing aids. They parallel the basic rules for communication previously presented and are fundamental to the steps toward resolving his co-dependent hearing issues. The more you and all family members adhere to these guidelines, the more your loved one can anticipate what to expect from everyone. These tips will help you establish firm boundaries within which you can help a loved one: 

1. Stop repeating yourself! Explain that you’re on a “Hearing Help Quest”—one that involves him by allowing him the opportunity to realize how often he asks for help. Do not stop helping him. All you need to do is preface what you repeat for him by each time saying, “Hearing Help!” In a short amount of time he will realize how often you say this. In turn, he will come to realize how often he depends on you. You both may even start laughing about it. (This suggestion is only for a loved one who resists the idea of getting help. Your offer of saying “Hearing Helper” might serve his needs best in the privacy of your home.) 
2. Stop raising your voice (then complaining you’re hoarse). This results in stressing your throat and vocal chords.
3. Stop being the messenger by carrying the communication burden for your loved one. Do not report “He said” and “She said” when he needs to be responsible for getting this information directly from the source.
4. Do not engage in conversation from another room as tempting as this is and as convenient as it appears. This sets up your communication process for failure. 
5. Create a telephone need. This means for you to stop being his interpreter on the telephone. Allow him to struggle and even fail in order to recognize how much help he needs. We’re looking for motivation (to hear) from him—not you. By continuing to help him in this regard, you are depriving him of one more communication channel that he may well be able to use effectively with hearing aids (especially receiving calls on a speaker phone).

Levels of Resistance

There are many levels of resistance from which you will need to identify your loved one’s level as shown in Table 1. This is not to suggest that your loved one will move from one level to another or that there is any sequence to these levels. There is not. However, all resistant hard-of-hearing people get trapped at a point that results in inaction. It’s this inaction you will need to identify in Table 1. Once you recognize it, you will then know how to best proceed. There may even be two or three levels of resistance coexisting. 

Denial. This usually takes the form of two characteristics: 1) Does not believe he has a hearing problem; and/or 2) Cannot talk about the hearing problem. Denial of hearing loss in the early stages of its progression is actually quite common. I remember when my waist shifted from belt size 30 to 32. I called the salesman over to ask if my favorite belt manufacturer was trying to save on leather by making shorter belts! The first thought was not the possibility that my waist was a little chunkier.

When confronted with the truth of a situation, if one persists in rebuking whatever truth confronts them, this is denial. In more clinical psychological terms, denial can be defined as a “Failure to acknowledge an unacceptable truth or emotion or to admit it into consciousness, used as a defense mechanism.”

When we consider the many painful experiences a hard-of-hearing person goes through with hearing loss, they might seem justified in denying the problem. After all, who would welcome such turmoil? But true denial of hearing loss occurs before the emotions have even struck. That is, if one misses hearing something, he attributes it to being the way someone said it or the circumstances of room acoustics or brushes it off as nobody can ever hear so-and-so anyway when she speaks. The notion that the problem is his is so repressed it doesn’t register in his consciousness.

When people realize that the problem is their hearing and not the circumstances of the environment or something else, it can be alarming. Hearing healthcare practitioners inform their patients of this daily, with many patients hoping the problem is not their hearing.

Armed with this information and choosing to do nothing about it when a hearing healthcare practitioner offers help is not denial, but resistance. While true denial is rare among hard-of-hearing people experiencing hearing loss for years, resistance is common, as the survey pointed out at the beginning of this book. The vast majority of untreated hard-of-hearing people in the US (22,000,000+ people) do not seek treatment for reasons that cannot be rationally justified (as cited in Table 2-1). 

Key: The fact that treatment is not sought is denial of treatment and cannot automatically be construed as denial of the presence of hearing loss.

In the extreme case of real denial, you should proceed cautiously because it’s the psyche’s way of dealing with the problem. To confront someone in real denial could result in psychological decompensation—a disintegration of their defense mechanisms that have been protecting them. You do not want to suddenly thrust your loved one into crisis, confronting issues before he is psychologically prepared to deal with them. In such cases, psychological intervention by a licensed and trained therapist might be an option. This will be discussed further in the next chapter.

The fact that your loved one may not be able to talk to you about his hearing problem does not preclude that he cannot talk about it or that it is denied. He may not feel safe with you, feeling that perhaps you may have an ulterior motive (like treatment), you may berate him, or the topic brings up feelings of embarrassment, and so forth.

Under the umbrella of therapy, you can safely express your concerns in his presence without the greater risk of decompensation. It also gives the person who would like to talk about it (a non-denier) an opportunity to express his views on the matter in an environment of safety and comfort. Since getting him to agree to go to therapy in itself may pose a problem, you can do so on the grounds that it is you who needs to discuss issues, without being specific and leaving his issues out of it altogether. Therapy also does not necessarily presuppose long term. Sometimes only a few sessions are so valuable that it launches people into taking the action necessary.

Once in therapy, you can express you love him and want to be able to communicate better. You can reveal how his problem impacts the life of everyone in the family and that his decision not to acknowledge it or do nothing about it presents unnecessary challenges for the entire family. This open dialog will be the stepping stone upon which all future hearing aid treatment is based. If this dialog gets as far as him being willing to see a hearing healthcare practitioner, taking a hearing exam and even trying hearing aids, it would be ideal to do so under the guidance of this therapist.

Inaction. This usually takes two forms: 1) He can’t hear but seeks no treatment, or 2) He had a hearing assessment but did not follow hearing healthcare practitioner’s recommendation of getting hearing aids.”

If your spouse or loved one complains he cannot hear but does nothing about it, there’s one or more issue blocking him. You merely need to find out what that is and do something to solve it. Don’t merely listen to him verbalize the problem and accept it. Some people who decline to seek treatment for hearing loss feel it is a sign of weakness or aging. Others perceive it as an indicator they are handicapped, an idea some refuse to accept. The root of the problem must be uncovered before proper action can be taken.

Key: Influence change rather than embracing inaction.

Jump ahead and take a look at Table 4-1 and note the top reasons hard-of-hearing people give for not using hearing aids. If you can nail down his true objection, you can address it. If he won’t tell you, then the problem persists. The state of inaction may seem to you a place he’s been teetering for years, but I assure you it can take only a small push from here to propel him forward into action. You must be persistent in your discovery of the obstacle(s) in his way and tolerant of his resistance. Kindness will go a very long way. If he knows he has your sincere support, it may be enough for him to get going.

Some resistant hard-of-hearing people go as far as the hearing assessment but shortchange themselves and their family by not getting hearing aids. Again, you must uncover his particular objections. Do not beat it out of him! If this is your spouse, you know him well. Search for explanations. Try to match your loved one’s needs and demands with the most appropriate personality type of the hearing healthcare practitioner you select. Your loved one must have an open, honest relationship with a hearing healthcare practitioner he likes, trusts and is really comfortable with.

You know best how to get to the core of the issue. Go for it. Find the objection and work with him to resolve it. Inject humor and love, something often missing for years in such relationships because of the hearing loss (and overall life challenges).

This may go against you personally because you may be feeling so angry for so long that contemplating kindness or forgiveness in order to get him on his feet may seem beyond your call of duty. Think positively and optimistically. It’s contagious. Your support is pivotal to the results everyone is seeking.

Failed Action. Failed action is simply a process where one has made efforts toward treatment but for whatever reasons, the end result was no hearing aids. This may have been due to any number of facts or misfortunes which include stubbornness, negative attitude, control issues or passive-aggressive behavior. It could also have been due to problems in the hearing aid fitting, the wrong time to proceed due to other problems, financial considerations and so forth.

Here are some common experiences of hard-of-hearing people who went as far as getting hearing aids, but failed in their use. See if you recognize familiarity with any of these as they relate to your loved one: 

• Insisted on hearing aids not recommended and now cannot hear with them (may be stubbornness).
• Purchased hearing aids but he won’t wear them (may be stubbornness).
• Took the hearing test and made purchase of hearing aids only to prove they cannot work for him (can be a negative attitude)
• Purchased hearing aids but only wears them when he wants to, not when he always needs to (may be a control issue or passive-aggressive behavior).
• Purchased hearing aids, but turns them off most of the time while wearing them (may be a control issue).

Stubbornness. If you are dealing with failed action, he is the closest of all levels to getting help. It may not seem so living with his state of mind, but a small bump can get him back on track. Failed action is sometimes better than no action at all. In fact, the average American waits seven to ten years before taking the positive action of getting hearing aids. You are not likely to be spending that kind of time in failed action. If something goes wrong, it can be rectified.

If your loved one received hearing aids that he wanted, but not the ones recommended by the hearing healthcare practitioner, it usually comes down to either a financial or cosmetic issue, more often the latter. In the 1990s, hearing industry manufacturers developed the smallest hearing aid ever (completely-in-the-canal or CIC aids). They were at the time the most expensive hearing aids on the market but wearers didn’t care. People were gladly willing to pay the extra money so the hearing aids couldn’t be seen. 

The downside to this breakthrough in miniaturization was that many people who should not have been wearing them began ordering them. It was not possible to install a power circuit into a tiny shell, so lots of hard-of-hearing people were not hearing well, but they looked great because no one could see the hearing aids. This problem persists even today. 

You’ll know your spouse or loved one has arrived when you hear him say, “I don’t care what they look like, I want to hear better!” It’s not uncommon in practice to find a patient wearing CIC hearing aids who suddenly accepts behind-the-ear instruments and is flabbergasted at not only the quality of sound, but what he has been missing because of his issues around vanity. Hearing healthcare practitioners are trained to know what will sound best for their patients.

Negative Attitude. I would be lying if I said that a hearing aid trial is a piece of cake for everybody. It is for some and not for others. It requires a positive attitude. Some frustrations can be expected. This is a whole new experience, but some people let little frustrations get in the way. This is where your support will be critical. Maintain a sense of humor. This is not the end of the world.

No matter the problem, if your loved one is frustrated with something around the hearing aid experience, get back with your hearing healthcare practitioner. Work as quickly as you can to address whatever problems arise in order to avoid unnecessary delays and frustrations. Do not wait for things to get better on their own. They sometimes don’t and it’s not worth the risk. In the worst case scenario, your loved one may simply throw the hearing aids in a drawer. One bad moment for some people can make the entire experience negative. This is one of the most important roles for the family. The hearing healthcare practitioner will welcome your loved one back so the problem can be solved. 

Some people who are pushed into hearing aids too soon in their unresolved resistance end up rejecting them. They will use any excuse to justify that these things just aren’t for them. This is why it’s so important to have a good sense of timing and respect for your loved one’s readiness.

Control Issues. If your spouse purchased hearing aids, but either wears them only when he wants to, not when he needs to, or turns the volume off most of the time while still wearing them, this is indicative of control issues. This is purposeful behavior (unlike passive-aggressive acts), perhaps even an attempt at feeling he still has control of his world.

Some hearing aids of the past (typically analog) could not regulate sound. With the advent of digital hearing instruments, most have become self-regulating (loud sounds are softened, soft sounds are made louder). Thus, if your loved one finds that he can hear television well without hearing aids (maybe he’s using an amplified earphone set), can talk on the telephone with no problems (maybe he has a built-in amplifier/telecoil), then maybe he only needs the hearing aids for specific situations. Therefore, he innocently turns them off or removes them.

On the other hand, if you notice he’s not wearing them, cannot hear you, and this is a repeated pattern, there’s a problem. This brings us to the next more serious issue:

Passive-Aggressive Behavior. Passive-aggressive behavior occurs by subconscious sabotage of another person and is seen often in couples. This behavior does not occur occasionally or by accident. 

An example of passive-aggressive behavior is telling your spouse that you’re going out with friends later on and to please remember to wear his hearing aids so he can be part of the conversation. You get to the restaurant and he’s forgotten the hearing aids. Bet this has happened a few times in your life if your loved one owns hearing aids!

If your spouse wears hearing aids, passive-aggressive behavior gets real murky because this can be a two-way street. For example, you make plans to go out to dinner with another couple. You make the reservations at a new trendy restaurant that is very noisy and hard to hear. Your spouse remembers to wear his hearing aids but is overcome by the background noise and is left out of most conversation for the evening. In this case, you sabotaged your husband. 

Passive aggression is covert behavior that on the surface does not appear to be what it is. It can be displayed as stubbornness, but is also characterized by procrastination, obstruction, and inefficiency. On the surface it masks itself as kindness or cooperation when in fact there is deep, underlying hostility. Such a person is resistant to getting help that will end the problem. There may be a million excuses or you may even get a commitment, even a date, but it never happens. Worse, despite the fact that your loved one depends on you, he finds fault with you. This slowly builds your own hostilities and resentments.

This covert way of expressing hostility is found commonly among couples quite apart from hearing loss. This learned behavior style centers around and leads to lack of intimacy. It is not a healthy way to coexist or manage relationships. Nevertheless, it can be surmounted. Coming up shortly are 10 steps to independent hearing. This will help you put a handle on this problem if you sense it characterizes your relationship—on one or both sides.

Who Owns the Hearing Loss?

This book assumes you already know your loved one has a hearing problem and for all intents and purposes he knows it. You just need to find a way to gently nudge him to do something about it. He cannot do something about it until he literally “owns” it, takes possession of it, holds responsibility for the problem. 

One of the easiest things you no doubt already have tried is to get him seen for a hearing assessment with a hearing healthcare practitioner. I suspect that, if this had been your easiest option, you’d have done it already and you wouldn’t be reading this book. In order for you not to be a co-dependent partner, the appointment-making must originate from the hard-of-hearing spouse. This demonstrates that he owns his hearing loss—not you.

Another effort toward him owning the problem is for him to take a hearing screening questionnaire (a good one is offered at www.nih.gov/nidcd/10ways.htm). If he has been extremely resistant to hearing help, this may be a relatively safe and harmless way for him to begin to recognize that there is a problem. However, the manner in which you present the invitation for him to take it will be crucial to his receptivity to actually taking it.

If you throw the screening test in front of him, you are ensnared into co-dependency again. While you cannot operate totally devoid of interaction with him if you are to help him, you must choose your interactions carefully, minimizing (but not necessarily eliminating) co-dependent behaviors.

You cannot approach your loved one with the intention of proving that he has a hearing loss even if you think it’s in his best interest. You need to find a way that either makes this fun or informative for him. This is not intended as a diagnostic procedure, but rather for general inquiry and hopefully discussion.

If you or your loved one answered “yes” to even one question in the online test, there may be a problem. If any three questions were Yes, this only confirms what you already suspect or know; he has a hearing problem. This strongly suggests that he needs to be seen by an audiologist (whose practice centers around the assessment and rehabilitation of people with hearing loss, including prescribing appropriate hearing aids), a hearing instrument specialist (whose practice centers around the actual dispensing of hearing aids), or by an otologist (a medical practitioner whose practice centers around diagnosis and medical treatment of hearing loss).

It is possible that your loved one’s hearing problem can be very simply resolved. It could be a slow but progressive accumulation of earwax or a chronic middle ear infection due to a build up of fluid. Both can be medically addressed, successfully treated, and fully resolved with no residual hearing loss remaining. However, without an assessment, it becomes impossible to determine the problem. 

Something seemingly as benign as earwax can fester and lead to infections and a wide variety of bacterial or fungal growth in the ear canal (such as salmonella). Infectious middle ear fluids that are not treated can lead to permanent sensorineural hearing loss. 

If you were successful in getting your loved one to take the hearing screening and it indicated a possible hearing problem, the next step is to make the leap to a more reliable assessment by a hearing healthcare practitioner. If he still resists, he needs to know the potentially serious consequences of his neglect (discussed at length in the next chapter). The old notion that discretion is the better part of valor never was truer than now. Let knowledge, common sense, and your own intuitive feelings guide you.

Denial • Does not believe he has a hearing problem. • Cannot talk about the hearing problem.Inaction • Complains he can’t hear but seeks no treatment. • Had a hearing assessment but did not follow audiologist’s recommendation of getting hearing aids.Failed Action (includes): • Stubbornness • Negative Attitude • Control Issues • Passive-Aggressive Behavior

Examples of Failed Action: • Insisted on hearing aids not recommended and now cannot hear with them (may be stubbornness). • Purchased hearing aids but he won’t wear them (stubbornness). • Purchased hearing aids only to prove they cannot work for him (may be a negative attitude). • Purchased hearing aids, but turns them off most of the time while wearing them (may be a control issue). • Purchased hearing aids but only wears them when he wants to, not when he always needs to (may be a control issue or passive-aggressive behavior).

10 Steps to Your Loved One’s Independent Hearing

Now that you have a better understanding of co-dependence, it’s time to address independence. There are 10 easy steps to help you resolve the dilemma of co-dependency by recognizing the simple and practical guidelines for your loved one’s independent hearing. These steps basically unravel your co-dependency. While the following can apply to both of you, you cannot snag him into this issue as long as he remains resistant to hearing help. Therefore, these points apply only to you for the time being: 

1. Stop supporting a system of communication that does not work.
2. Set new boundaries by changing your priority in communication from needing to help him hear to only managing your own communication needs.
3. Accept the probability that he will fail in communication and that’s okay because it’s part of a process toward treatment.
4. If you do not remain his ears, he may find someone else to lean on. That’s okay. Just don’t make him wrong for it.
5. Trust yourself, maintaining your own high self-esteem without having to fall back into a cycle of hearing for him just because he expects it. 
6. Control your fear—you cannot use your own fear of conflict with him as an excuse to avoid making changes that will benefit you both (because you already have conflict!)
7. Be truthful with yourself and start being truthful with him on how his hearing problem impacts you, speaking from your heart, not from anger.
8. Give him choices, options, and helpful alternatives, but do not give him demands, threats, and consequences.
9. Find in this book just one sensitive way to broach the topic of him seeking treatment. 
10. Accept no excuses, but realize that, no matter what you do, he may not change and it’s not your fault.

Richard E. Carmen, AuD, is a clinical audiologist and editor of The Consumer Handbook on Hearing Loss & Hearing Aids, and the author of How Hearing Loss Impacts Relationships (Auricle Ink Publishers, Sedona, Ariz; www.hearingproblems.com).

Original citation: Carmen RE. How hearing loss impacts relationships: Whose problem is it? Hearing Review. 2005 [Apr];12(4):50-55,76.