HACC

I have a lovely, patient wife—most of the time. I know I strain her patience when, probably 90% of the time, I respond to something she says to me with, "What?" She had commented enough times about my becoming hard of hearing to make me take advantage of one of those free hearing evaluations, which proved I have not gone deaf. Yes, I have lost some of my ability to hear high frequency sounds and that does create a problem for me because voice recognition depends in a large part on these wavelengths, as does the ability to recognize certain letters of our alphabet, so some words seem to have gaps in them. My brain fills in that blank, but it takes a fraction of a second to do so, and in that space my brain ask for more information. "What?" That is due to HACC.

Imagine a six-way intersection with a cop in the center that lets one car proceed at a time. Take away the cop and shortly there is confusion as several cars attempt to enter the intersection at the same time. (You may have experienced something similar to this when the traffic light controlling flow at a multiple intersection is not functioning.) The human brain can only process one piece of information at a time and in order to 'multi-task' it must select which input to attend to in some kind of order. Younger brains prioritize more rapidly than older brains; the cop is on duty. As the brain ages, it becomes less able to choose between pieces of information and gives more that one the same priority. This causes a lag in understanding what was heard. So the brain prioritizes that input and asks for more information; thus the request to have the speaker repeat what s/he had said. Most often this is not caused by hearing loss, although it may be exacerbated by it, but by information overload from other stimuli occurring at the same time such as background noise or movement that demand the same priority. (I can not 'hear' dialog in a movie if the music or background noise are nearly as loud as the speech—HACC.)

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As one ages, a significant part of understanding what is said depends on seeing as well as hearing. From birth we pay careful attention to faces and words are accompanied by expressions, especially around the mouth. (Note the cognitive dissonance when watching a foreign film with dubbed English.) The younger brain is not as dependent on lip movement because it more quickly and effectively recognizes speech sounds. The older brain is much more dependent on seeing lip movements. Have you noticed that when talking to an older person, s/he seems to look more attentively at you? They are trying to 'see' what you are saying as well as hear it. Generally you do not have to raise your voice when speaking to a senior citizen, you just have to look directly at them. When you turn away, the cop goes off duty, and the brain can't decide which of many stimuli to process next, and your interlocutor has to ask you to repeat what just you said. Generally you will look directly at the person this time and s/he will 'hear' you now.

There is another manifestation of HACC that occurs when you talk to an older person on the telephone. Because voice recognition depends so heavily on high frequency sound, an older relation whose high frequency discrimination has deteriorated will have trouble recognizing that it is you on the other end even if you call frequently. You may be greeted by a momentary silence while the senior's brain waits for other pieces of identifying information, or by a more direct, "Who is this?"  Be not insulted or hurt. In fact avoid confusion on both parts by telling the older person immediately who you are. Since HACC and high frequency hearing impairment are a normal part of aging, they are to be expected, and require awareness and tolerance on the part of the younger speaker. If the oldster needs you to speak louder and slower s/he will (or should) ask you to.

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