En español | Hearing loss is extremely common: About 1 in 3 people between 65 and 74 years of age, and nearly half of those older than 75, have trouble hearing, according to the National Institute on Deafness and Other Communication Disorders.
But it typically occurs gradually — often as if the volume of sounds such as people's voices is slowly being turned down while ambient white noise grows louder. That means it's easy for someone to miss or ignore their own hearing loss, sometimes for years.
Other people often notice it first. So if you're popping in on or spending the holidays with a loved one, particularly if they are 65 and older, and notice signs of hearing loss, it's important to encourage them to get tested. Early intervention can make a big difference in their long-term health and wellness, says Stefanie Wolf, AuD, a clinical audiologist with Audiology of Nassau County in Rockville Centre, New York: “It's true that hearing loss is extremely common with age, but that doesn't mean you need to accept it. It can be socially isolating, is linked to depression, as well as dementia and falls, and it's completely treatable — the earlier the better.”
Some common signs of hearing loss:
1. The household entertainment is loud
“If their TV is blaring, they should have a hearing exam,” Wolf says.
2. They seem to be working hard to understand you
You can usually tell when someone isn't comprehending what you're saying. It could be their hearing. Your loved one may also ask you to repeat yourself or complain that you or others are mumbling. (One more reason a hearing test is important is it can rule out dementia, which can easily be confused with hearing loss.)
3. Their responses don't match the conversation
Higher frequencies are often the first to go when hearing becomes diminished. That means vowel sounds, which people tend to express more forcefully and in a lower pitch, come across more clearly than consonants, which are higher in frequency. The result: It's challenging to discern if someone is saying “That was a great fair” or “That was a great pear.” If you notice that they respond inappropriately to comments or questions, it may be because they're mishearing the words.
4. They're speaking loudly
“Whenever I'm in a restaurant, I can usually tell who has hearing loss because they're talking too loudly for the situation,” Wolf says. We raise our voices when we can't hear ourselves properly.
5. Alarms don't get their attention
A timer dings, the doorbell rings or their phone chimes and they don't seem to notice. “Not hearing alarms is obviously concerning on many levels, and is a definite sign they should see an audiologist,” Wolf says.
6. Telephone conversations are harder for them
People with hearing loss may struggle to understand what's said during phone calls because they can't see the other person's mouth moving, Wolf says. Take note if a loved one seems to have trouble hearing and/or is pausing to turn up their phone's volume while on a call.
7. They're a little unsure on their feet
Walking is a multisensory experience: Your body is seeing, feeling and, yes, hearing the environment around you as you move through it, helping you keep yourself steady. “You don't think about your auditory sensory response to the floor because you're used to it,” Wolf says. “But when it's compromised, so is your balance.”
One study of more than 2,000 adults ages 40 to 69 published in the Archives of Internal Medicine found that people with a 25-decibel hearing loss, which is classified as mild, were nearly three times more likely to have a history of falling. Every additional 10 decibels of hearing loss increased falling risk 1.4-fold. If your loved one seems unsteady, hearing loss could be a cause.
8. They avoid or disengage during social situations
There are many people who hear well enough to get by in the quiet of their home, but can't filter out the background noise from parties, restaurants or other bustling places to focus on normal conversations. “Even a slight amount of hearing loss can cause problems in noisy environments,” Wolf says. Notice if your loved one clams up during big family gatherings or seems frustrated or fatigued during conversations or at social events.
What to do when you notice signs of hearing loss
Now comes the hard part: Telling someone that you suspect he or she may have hearing loss and encouraging them to have it checked. Many people don't really want to address the issue, Wolf says, for many reasons. They don't want to be bothered; hearing aids cost money; they've grown accustomed to how they hear and think it's not really a problem; and, very common, they think wearing a hearing aid will make them seem old.
"The younger people I see are generally much more willing to accept hearing loss and to adopt technologies that can dramatically improve their hearing,” Wolf says. “We need to normalize it, like reading glasses, for everyone.”
If they seem reluctant to see an audiologist, you can suggest they do a little at-home test using an online hearing test app like uHear and Hearing Test. Even though they aren't very accurate (because of issues such as background noise and headphone quality) and in no way replace an ANSI calibrated hearing test in a doctor's office, Wolf says, they may encourage your loved one to think about how well — or not well — they're hearing. “I like these tools because they can provide enough motivation for someone to go get themselves properly checked out,” she explains.
Finally, Wolf adds, be sure to remind your loved one that treating hearing loss isn't just about improving their ability to perceive sounds; it can contribute to their overall health and well-being.