Hearing Care from the Perspective of a Danish Anthropologist

By Ellen Pucke

Alis Kamstrup is an audiologist working as a hearing counselor for the public health care system in Herning, Denmark. She also recently completed her master’s in medical anthropology, and sat down with us to discuss her thesis on people with hearing loss in the Danish system.   

Your thesis describes how people in the Danish workforce deal with hearing loss. What are some of the main conclusions?

My study shows that people in the Danish workforce who have hearing loss do not think of themselves as having a disability…as long as they have access to the accommodations they need. They expect the public health care system and their workplace to provide the help and support they need, making their hearing loss a non-issue. The participants in my study did acknowledge that they sometimes miss out on conversation, but just the same as anyone else would, they said.

You write that the perception of what good hearing care support is, is changing from the patient/client perspective in Denmark. Why is that?

The people I interviewed all demanded a more flexible and understanding health care system and work place, where there is a better understanding of the fact that peoples’ personal lives and work lives are closely intertwined today. For instance, you may receive a phone as part of your benefits package at work, but where do you go if you need assistive technology? Can you ask your employer, or who do you contact in the public system?  Some people live and work far from a hearing care professional and whenever they need to have their hearing aid adjusted it means long hours of transport and lost work time. It can be hard and time consuming just to get an appointment. All of these kinds of things create frustration, in particular for people in the workforce for whom time is a key factor. People need counselors who can inform them about their rights and options.

What do people expect from hearing care treatment?

As society changes, people change with it – or is the other way around? Everything takes place at a higher speed, and technology is creating new, endless possibilities. This has affected many peoples’ expectations. When we can send an SMS to the other side of the world, why can’t we just fit hearing aids remotely? Some people have very high demands, down to requests for detailed solutions. Other people are very humble, and don’t have high expectations for treatment. 

You say that the relationship between hearing care professionals and their patients is asymmetric. Can you explain what you mean?

One person needs help, and one person is providing it. This creates a relationship where one part is weak and the other part strong. But in reality we should consider it as an equal relationship between two parties who both contribute to finding a common solution. The patient is an expert on his/her own life, and the hearing care professional is an expert in relation to hearing assessment, treatment, etc.

What can hearing care professionals in other countries learn from your study?

As a hearing care professional, you must be careful not to categorize your patients. If you only think of people in terms of a few select aspects of their identify, for instance their profession and which type of hearing loss they have, you miss out on a lot of essential information. There is so much more that makes up a person. Successful rehabilitation requires looking at that person as a whole.  

In your opinion, what does ideal hearing care look like?

Ideal hearing care is a system which is accessible, where people feel that they are listened to, and which takes into consideration the individual’s needs and concerns. It is a system where people get the relevant knowledge and are informed about their rights and possibilities. It is a flexible system which provides support for additional fitting and adjustments as needed, preferably locally, and it is a system where people are not left on their own to navigate when they need help. It is a system which is friendly and welcoming.

That being said, I think it is a mistake to approach people with hearing loss as customers who need to be persuaded or who are always right. There must be room for equal exchange. It may take time to establish this kind of relationship, but in my experience you achieve the best outcomes when people feel that they are heard and understood.