Don’t Turn a Deaf Ear on Hearing Loss

October 22, 2021

“I feel like my relationship with Grandma isn’t what it used to be. She can’t hear what I’m saying, so I’ve kind of stopped talking to her. Now she seems sad and withdrawn.” This was the lament of a 22-year-old man whose favorite discussions were always the ones he had with his 90-year-old grandmother.

Unfortunately, this is an all-too-common scenario. In addition to physical and functional complications, hearing loss can introduce significant social and emotional challenges, particularly among the elderly.

Age-related hearing loss, or “presbycusis,” occurs in 25 percent of people aged 65-74 and 50 percent of people 75 and older. It is a “severe social health problem,” according to one study, reported to reduce quality of life by bringing on various adverse emotional, behavioral and cognitive reactions.

As the holidays are approaching and we’ll likely be spending more time with elderly family members, let’s explore ways to help someone experiencing age-related hearing loss. But first, let’s look at some key questions and considerations.

Why Do Older People Develop Hearing Loss?

The most common sensory deficit in old age, cochlear degeneration usually occurs in both ears and is caused by changes in the inner and sometimes middle ear. Certain cells in our ears no longer respond to sounds as they once did. Other factors leading to hearing loss can include heredity, long-term exposure to loud noise, earwax or fluid buildup, and common geriatric health conditions such as diabetes, high blood pressure, stroke, brain injury and tumors. Some ototoxic medications like aspirin, NSAIDS, diuretics and antibiotics can also contribute to hearing loss.

Signs of Hearing Loss in the Elderly

While older people often work hard to hide the fact that they’re having trouble hearing, it is fairly evident to others, especially if they’re trying to have a conversation. Often, frustration ensues on both ends. But sometimes, the condition is a little more subtle, and seniors themselves don’t even realize they’re struggling to hear (see more on this below). Here are some telltale signs that you or a loved one may be experiencing age-related hearing loss:

• Difficulty following conversations, especially with more than one person
• Trouble hearing over the telephone
• Frequently asking others to repeat themselves
• Trouble understanding what women and children are saying, due to the higher frequency of female and younger voices
• Trouble hearing over background noise
• Perceiving that others are mumbling
• Turning the television to loud volumes to be heard

Complications of Age-Related Hearing Loss

• Social isolation. The inability to hear inhibits one’s ability to converse and engage, which can have a devastating effect on the ability to make or maintain social connections. As a result, those with hearing loss sometimes withdraw from situations involving other people. There is also a unique stigma associated with hearing loss, of which seniors and others with hearing loss are keenly aware. 
• Mental health decline. The emotional ramifications of hearing loss are considerable. The isolation discussed above can lead to loneliness, anxiety, depression and despair.Often, hearing loss results in greater dependence on others, which can lead to feelings of inadequacy, frustration, embarrassment and guilt.
• Cognitive dysfunction. There is significant scientific evidence that seniors with hearing loss are at greater risk of developing dementia, whereby the degree of hearing loss correlates with the degree of dementia. Research has shown that hearing loss leads to a faster rate of atrophy in the brain. The social isolation and resultant lack of conversation that comes with hearing loss can also contribute to the onset of dementia.
• Behavioral reactions. Hearing loss is difficult to accept. Sometimes seniors are in denial and engage in behaviors designed to mask their situation. These might include bluffing, or pretending they’re hearing when they’re really not, blaming others for mumbling or speaking too softly, or demanding that the world adjust to them, rather than admitting their condition and trying to improve or manage it.  
• Safety risks. Hearing loss introduces a whole host of dangers for seniors. Driving hazards are inevitable when they can’t hear oncoming cars, traffic sounds, horns, or sirens. Household hazards include the inability to hear the phone or doorbell ringing, smoke alarms, weather warnings, or dogs barking.

How Can You Help Yourself or a Loved One with Hearing Loss?

Many a joke has been made in popular culture about older people who can’t hear well. From the stereotypical doddering grandpa yelling “Eh?” with a hand cupped to his ear (grossly misinterpreting what was said) to the younger person shouting at a senior in order to be heard, old people and hearing loss are common comedic bedfellows.

But hearing loss is not funny, and those affected are not laughing.

There are both tangible and intangible ways to manage your own hearing loss or help a loved one experiencing it.

Coping With Your Own Hearing Loss

• First, admit to yourself that you are experiencing hearing loss. This may be more difficult than it seems, even for practical reasons, because age-related hearing loss typically causes distortion of sound, not the absence of sound. When an older person says they can hear, they’re often telling the truth. But they can’t hear high frequency sounds as well, which is what causes a distorted effect, not an “ear plug” effect.
• Seek medical attention specifically for hearing loss. Don’t assume your primary care doctor will automatically notice or ask you about hearing loss. Tell your doctor (ideally an ear, nose and throat specialist) the symptoms you’re having as soon as you notice them. There’s a “use it or lose it” dynamic here, whereby the brain’s auditory cortex will worsen if measures aren’t taken to improve or maintain hearing function as soon as possible.
• Tell others about your hearing problem so they can adapt appropriate behaviors and responses (see “Coping with a Loved One’s Hearing Loss” below).
• Don’t be afraid or ashamed to ask people to repeat themselves, speak more slowly and clearly, face you when they’re speaking, or speak louder without shouting.
• Focus on the facial expressions and gestures of the people with whom you’re speaking.
• Whenever possible, arrange to gather with people in quiet places with little background noise or other distractions.
• Search reputable sources to learn about the latest hearing device technology and/or medical options that might be appropriate for your situation. If this is too daunting, ask a loved one to research on your behalf.
• Make an appointment with an audiologist to have a hearing evaluation and be fitted for hearing aids that are specific to your type of hearing loss. 

Coping with a Loved One’s Hearing Loss

• Practice patience, patience, patience. Yes, it’s frustrating to have to repeat yourself or go ‘round and ‘round trying to convey a point. It’s even more frustrating for your loved one, who needs and deserves respect and grace in this difficult situation.
• To have a conversation, arrange to meet your senior in a quiet place with little or no background noise.
• Speak slowly, loudly, and deliberately, but do not shout. Shouting only distorts your voice and makes it more difficult for your loved one to hear what you are saying.
• Use facial expressions and gestures to more fully convey what you’re saying. Make sure adequate lighting is available so your expressions and gestures can be easily seen.
• Use different words to express the same thought if your loved one isn’t grasping what you’re saying.
• Don’t eat, chew gum or hide your mouth when speaking. Don’t turn your back or look away when you speak.  Many seniors have learned to rely on lip reading.
• In a group, ensure that only one person is talking at a time.
• Offer to help research hearing device technology, appropriate medical treatments, and other solutions.  
• Attend medical appointments with your loved one. Understanding all that is said in a doctor’s office is difficult even for people who hear well. It’s doubly important to be a second set of ears for your senior with hearing loss.
• Maintain a posture of relaxation, positivity, and – again – patience.

What’s the Buzz on Hearing Aids?

A quick search of the web shows us how many hearing aids are on the market, from simple over-the-counter amplification devices like Pocketalkers to custom-fit, high-powered hearing aids that require a prescription. Deciding which one is right for you, if any, takes time, research, medical advice, and yes, money. Indeed, hearing aids come in a wide variety of styles and costs; depending on what is needed, they will be more or less expensive.

In addition to cost and capabilities, there are other things to consider about hearing aids:

• Not everyone will benefit from a hearing aid, but many will. Click here to learn about the basics of hearing aids and which option might be best for you.
• Hearing aids cannot repair cells that no longer respond to sound.
• They cannot restore hearing to what it was when you were younger.
• They can help you hear better, especially in enclosed spaces with background noise
• It takes time to adjust to a hearing aid; it is not like putting on a pair of glasses. Several visits to your hearing specialist may be required to fine-tune a device to your individual needs.
• You may wish to consult trusted resources like Consumer Reports as you search for a hearing device.