Hearing Problems and Hearing Aids

How common are hearing problems in older people?

By age 65, one person in three has some hearing loss. By age 75, it's one person in two. People who don't hear properly sometimes give inappropriate answers and are wrongly thought to be confused or uncooperative. People with hearing difficulty can get so frustrated that they stop trying to communicate and become withdrawn.

What are types of hearing loss that affect older adults?

Presbycusis (progressive loss of hearing)

Presbycusis is a gradual decline in sound reception that occurs as you get older. This happens because the eardrum loses its elasticity and the bones of the ear become stiffer. Sounds, particularly higher tones, are muffled. Words, especially against background noise, are difficult to understand. At the same time, loud noise may be painful so when people raise their voice in an effort to be heard, they may be told, "Don't shout. I'm not deaf!" People with presbycusis should ask others to speak slowly and clearly. Hearing aids can be very helpful.

Conduction deafness

Conduction deafness is when sound waves are blocked as they pass through the ear. People with conduction deafness hear sounds from outside as muffled, but their own voice may seem louder than normal. Because of this, they often speak softly. The most common cause of conductive deafness is ear wax. Removal of the wax, after first softening it, will make a lot of difference. Other causes of conductive deafness in older people include ear infections, perforated ear drum, and damage to the small bones in the inner ear that conduct sound waves.

Central deafness

Central deafness can also affect older people, although it is far less common than either presbycusis or conduction deafness. Central deafness is due to a problem within the hearing centers in the brain. Sounds can be heard, but language cannot be understood. Central deafness may follow a long illness with high fever, long exposure to loud noise, head injuries, stroke, tumors, and certain drugs. The deafness is permanent, but speech therapy may help communication.

What should I do if my hearing is getting worse?

See your health care provider. He or she will examine your ears and may send you to an audiologist (hearing specialist) for special hearing tests. You may have wax that needs to be removed. A hearing aid may be recommended.

Meanwhile, don't try to hide your hearing problem. Tell people and ask them to speak clearly. If you don't hear the first time, ask people to repeat what they said a little louder. Ask people to face you when they speak, and watch their lips and body signs. Learn to sit in groups or in an audience so that you can hear better.

What are hearing aids?

Hearing aids are instruments that amplify sound for people who cannot hear well. They have a microphone to pick up sound, an amplifier to increase the sound, an ear piece to transmit the sound to the ear, and a battery for power. These separate parts are generally packaged together in small in-the-ear hearing aids. People have difficulty with different areas of hearing and require different levels of sound amplification. Be careful to select a hearing aid that meets your specific needs.

Selecting a hearing aid

Different styles of hearing aids exist:

• A body aid has an earpiece connected by a wire to a small body-worn case containing a microphone and amplifier. It is the most powerful type of hearing aid.
• A behind-the-ear hearing aid has an earpiece that connects to a short tube, microphone, and amplifier.
• An in-the-ear hearing aid uses an earpiece that contains a microphone and amplifier and sits inside the user's ear. About 80% of hearing aid users wear this style.
• An in-the-canal hearing aid is similar to an in-the-ear hearing aid, but is smaller and sits deeper in the ear.
• A completely-in-the-canal hearing aid is smaller still, out of sight, and deep inside the ear canal.
• Eyeglass hearing aids have the hearing aid in the eyeglass frames. These are rarely used today.

Be sure to look at different hearing aids before you make your choice. Don't forget the importance of warranty, maintenance, and repairs. If possible, take advantage of a free trial period to be sure. The most expensive hearing aid may not be the best for you.

Getting used to your hearing aid

Once you have found the hearing aid that meets your needs, you will soon get used to wearing it and learn to adjust the controls to pick up sound in different situations. Today's hearing aids are able to screen out a lot of background noise. They are small, easy to wear, and can make a great difference in your life.

How can I help my hearing aid to help me?

Even with a hearing aid, there are several strategies you will find helpful to make communication easier. Don't be shy. Tell people you have a hearing problem and politely ask them to face you and speak clearly so that you can hear better. Watch lips and watch body signs. If you don't catch what was said, ask the person to repeat it, or ask, "Did you say ....?"

In groups or in an audience, try to position yourself where you can see the speaker. Don't be afraid to ask a speaker to speak up or use a microphone. If you are in a crowd and can't hear someone speak because of background noise, suggest you both move to the edge of the crowd where the competing noise is less.

What other hearing assistance devices might I use?

Amplified telephone receivers and amplified headsets for listening to music or watching television can be very helpful. You can also install a flashing light system in your home instead of a ringing telephone or doorbell. Many churches and auditoriums have special headphones installed for people with hearing problems. Take advantage of them.