A loss of hearing can strike people at any age, but most cases affect older peoplein fact, it is the third leading chronic health complaint among older adults, after arthritis and high blood pressure. Even though the ear is a remarkable piece of sound-receiving equipment, designed to last for decades without repair or replacement parts, with age it inevitably grows less acute. The first sign of trouble is often difficulty hearing high-frequency sounds, like birds singing or children’s voices.
At the same time, age-related hearing loss is occurring at younger ages these days because of exposure to sounds that have become a part of modern life—rock concerts, headphones, stereo equipment, jet planes, jack hammers and dozens of other noisemakers that create decibel levels capable of wearing out the extremely sensitive receiving equipment in our ears.
It isn’t easy to admit to hearing impairment; it’s too often taken as an embarrassing sign of old age. But the truth is that most people suffer some degree of hearing loss after age 50—and for half of all men and a third of all women over 65, hearing loss is advanced enough to make social communication difficult.
Called presbycusis, from the Greek meaning "old hearing," this age-related degeneration of the inner ear results in lowered sensitivity to high frequencies (you don’t catch those high notes or the doorbell the way you once did) and a loss in the ability to discriminate among speech sounds (people seem to mumble). Or you may be aware of a persistent low hiss or ringing in the ears. Any one of these symptoms should send you to your doctor for advice. Some of this hearing loss is preventable and much of it is modifiable.
Symptoms of Hearing Loss (Progressive)
- Progressive loss of hearing after exposure to loud noises or with age
- Difficulty hearing high-frequency sounds
- Difficulty distinguishing words during conversations, especially when in noisy or crowded circumstances
- Difficulty hearing over the telephone
- A need to turn up volume controls on televisions, radios and other sound equipment
Helping Someone Cope with Hearing Loss
If you know someone with hearing loss (with or without a hearing aid), there are many ways to make that person’s life easier. Indeed, a little thoughtfulness in this domain can counteract the tendency among some elderly people to withdraw from normal conversational give-and-take into depressed isolation.
When you talk to someone with a hearing problem:
- Speak a little louder, more distinctly and in short, simple sentences. Don’t shout; shouting distorts.
- Don’t overarticulate. Just be sure to face your listener squarely.
- Make sure your mouth isn’t obstructed by food, chewing gum, a cigarette or your hands.
- Make an extra effort to bring hearing-impaired persons into the conversation.
What Causes Hearing Loss (Progressive)?
Damage to fine specialized hair cells and other sound-sensing structures in the ear underlie most cases of presbycusis. A common cause—or at least a common accelerator—of this damage is excessive noise. Medical conditions and certain medications can also contribute to hearing loss.
Another cause of impairment is conductive hearing loss, which occurs when earwax or fluid builds up in the ear canal and interferes with the functioning of the outer and middle ear or when an infection in the inner ear blocks sound wave transmission from the eardrum to the inner ear. Damage to the ear canal, eardrum or tiny bones of the middle ear can also cause this type of hearing loss.
What If You Do Nothing?
Some cases of hearing loss are temporary—for example, the buzzing you may experience after attending a loud rock concert or being exposed to some other loud noise for several hours. In this instance, a night of rest usually restores normal hearing. But hearing loss due to presbycusis is permanent, as are other types of hearing loss and these require a doctor or other specialist to identify and treat the underlying cause.
There are good reasons to get the problem treated. Hearing loss can isolate you, diminish your effectiveness at work and detract from social and family life. It is a source of emotional stress to you and to everyone who deals with you. Also, if you get used to not hearing, you may find it harder to adjust to a hearing aid.
Home Remedies for Hearing Loss (Progressive)
Most hearing problems can be alleviated by a hearing aid (though only about one-third of those people who need hearing aids actually have them). Usually, having one device for each ear is most effective. Before you buy a hearing aid, see your doctor. In addition, take these steps to cope with difficulty hearing.
- Don’t be shy. Ask people to repeat or slow down if you don’t understand.
- Cut out background noise. Turn off the radio or TV during conversation.
- Look for the quiet space. In noisy places, station yourself near sound-absorbent surfaces (curtains, books or upholstered seating) and stay clear of echoing expanses of plaster and glass.
- Use sign language and speech reading (e.g., lip reading and visual cues) to foster communication.
Hearing Aids: Many Choices
If your doctor recommends a hearing aid, you’ll need a written evaluation to buy one (unless you are over 18 and sign a form waiving an evaluation). You should also take your hearing test results along to a reputable dealer so that the dealer can match a hearing aid to your particular problem. Medicare will pay for an evaluation of your hearing loss if requested by a physician, but not for the hearing aid itself.
All hearing aids consist of a microphone, amplifier, a speaker to transmit sound, volume control and battery. Three popular types are behind-the ear devices; tiny in-the-canal models, which hardly show but are hard to adjust (and the batteries don’t last long); and in the-ear models, which have similar disadvantages to in-the-canal devices. Smaller hearing aids didn’t amplify sufficiently and tended to distort sound. But new technologies, especially digital designs with microchips, have greatly improved hearing aids.
The audiologist you consult should be able to help you pick a model that suits your needs. Be sure to tell the person who is fitting you which environments and activities are most important to you. (Most audiologists also sell hearing aids—but be wary of one who sells only one model or brand.)
It pays to shop around. Look for a dealer who will give disinterested advice and reliable after-sales service. Don’t assume that only the most expensive model will do.
Most dealers offer a 30-day free trial period for hearing aids. It may take a few visits and some patience to adjust an aid to your needs and to make sure it fits comfortably.
There are many commonsense ways of avoiding hearing loss.
- Turn down the headphones. When wearing headphones, never use the music to drown out other noise. If you want to use headphones while your companion watches the ball game on television, perhaps you should move to another room rather than compete with the television noise. If you’re on a bus that is making a deafening racket, lay your headphones aside. If you can’t hear any sounds around you, you’ve got the volume too high.
- Avoid excessive noise. If background noise in any setting drowns out a normal conversational voice, you should try to escape or reduce the noise as soon as you can. If you have to shout to be heard, something is wrong. If you must be exposed to high noise levels while you are working or commuting, give your ears a break during leisure time. Don’t go to the noisiest restaurant or nightclub in town.
- Use earplugs. If you have to be in noisy environments frequently, carry a pair of earplugs and use them. They won’t keep you from hearing a concert, for example; they’ll just keep the decibels from damaging your ears.
Beyond Home Remedies: When To Call Your Doctor
See your physician if you detect even mild hearing loss. Most hearing loss is correctable, but delay in dealing with the condition can only intensify it, sometimes irreversibly. It could also be a sign of another medical problem that needs attention.
What Your Doctor Will Do
An internist or another primary-care physician will probably do some simple preliminary testing. For more systematic testing, your doctor may refer you to an audiologist (a specialist in hearing problems) or an otolaryngologist (ear, nose and throat specialist), who will take a complete history and perform hearing tests to determine the type and extent of the hearing loss. The specialist can also make recommendations about hearing aids. If an infection is present, your doctor may prescribe antibiotics. If damage to inner ear bones is responsible for your hearing loss, reconstructive surgery may be recommended to correct the problem.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media