Hearing and Older
About one-third of Americans between age 65 and 74 and one-half
of those age 85 and older have hearing problems. They may mistake
words in a conversation, miss musical notes at a concert, or leave a
ringing door bell unanswered. Hearing problems can be small (missing
certain sounds) or large (involving total deafness).
people may not admit they are having trouble hearing. But, if
ignored or untreated, these problems can get worse. Older people who
canít hear well may become depressed or withdraw from others to
avoid the frustration or embarrassment of not understanding what is
being said. They may become suspicious of relatives or friends who
they believe "mumble" or "don't speak upĒ on purpose. Itís easy to
mistakenly call older people confused, unresponsive, or
uncooperative just because they donít hear well.
If you have
a hearing problem, you can get help. See your doctor. Special
training, hearing aids, certain medicines, and surgery are some of
the choices that could help people with hearing problems.
Common Signs of Hearing Problems
See your doctor if:
- words are hard to understand,
- another personís speech sounds slurred or mumbled, especially
if it gets worse when there is background noise,
- certain sounds are overly annoying or loud,
- a hissing or ringing in the background is heard,
- TV shows, concerts, or parties are less enjoyable because you
canít hear much.
Diagnosis of Hearing Problems
Hearing loss can be caused by exposure to very loud noises over a
long period of time, viral or bacterial infections, heart conditions
or stroke, head injuries, tumors, certain medicines, heredity, or
changes in the ear that happen with aging.
If you have
trouble with your hearing, see your family doctor. In some cases,
the diagnosis and treatment can take place in his or her office. Or
you may be referred to an otolaryngologist
(oto-larin-GOL-o-jist). This doctor has special
training in the ear, nose, and throat and other areas related to the
head and neck. He or she will take a medical history, ask if other
family members have hearing problems, do a thorough exam, and order
any needed tests.
(aw-dee-OL-o-jist) is a health professional who can
identify and measure hearing loss. He or she may work with the
otolaryngologist. The audiologist will use a device called an
audiometer to test your ability to hear sounds at different pitches
and loudness. The tests are painless. Audiologists do not prescribe
drugs or perform surgery.
Types of Hearing Loss
Presbycusis (prez-bee-KU-sis) is the most common
hearing problem in older people. In fact, people over age 50 are
likely to lose some hearing each year. Presbycusis is an ongoing
loss of hearing linked to changes in the inner ear. People with this
kind of hearing loss may have a hard time hearing what others are
saying or may be unable to stand loud sounds. The decline is slow.
Just as hair turns gray at different rates, presbycusis develops at
Tinnitus (ti-NI-tus) is
also common in older people. Tinnitus is a symptom associated with a
variety of hearing diseases and disorders. People with tinnitus have
a ringing, roaring, or hear other sounds inside the ears. It may be
caused by ear wax, an ear infection, the use of too much aspirin or
certain antibiotics, or a nerve disorder. Often, the reason for the
ringing cannot be found. Tinnitus can come and go; or it can stop
Conductive hearing loss happens
in some older people when the sounds that are carried from the ear
drums (tympanic membrane) to the inner ear are blocked. Ear wax in
the ear canal, fluid in the middle ear, abnormal bone growth, or a
middle ear infection can cause this loss. Sensorineural
(sen-so-ree-NU-ral) hearing loss happens
when there is damage to parts of the inner ear or auditory nerve.
The degree of hearing loss can vary from person to person.
Sensorineural hearing loss may be caused by birth defects, head
injury, tumors, illness, certain prescription drugs, poor blood
circulation, high blood pressure, or stroke.
If Someone You Know Has a Hearing Problem
- Face the person and talk clearly.
- Stand where there is good lighting and low background noise.
- Speak clearly and at a reasonable speed; do not hide your
mouth, eat, or chew gum.
- Use facial expressions or gestures to give useful clues.
- Reword your statement if needed.
- Be patient, stay positive and relaxed.
- Ask how you may help the listener.
- Set up meetings so that all speakers can be seen or can use a
- Include the hearing impaired person in all discussions about
him or her to prevent feelings of isolation.
Tips to Recognize Hearing Loss
See your doctor if you have:
- Dfficulty hearing over the telephone;
- Trouble following a conversation when two or more people are
talking at the same time;
- Others complaining that you make the TV too loud;
- To strain to understand conversations;
- Problems hearing because of background noise;
- The sense that others seem to mumble; or
- Difficulty understanding women and children talking.
If You Have Trouble Hearing
- Tell others that you have trouble hearing.
- Ask others to face you, speak more slowly and clearly, and not
- Pay attention to what is being said and to facial expressions
- Let the person talking know if you do not understand what is
being said; ask for the statement to be repeated or reworded.
If you are having trouble hearing, the doctor may suggest using a
hearing aid. This is a small device that you put in your ear to make
sounds louder. Before buying a hearing aid, you must get a written
medical evaluation or sign a waiver saying that you do not want a
There are many kinds of hearing aids. An
audiologist will consider your hearing level, ability to understand
speech, comfort in using the controls, and concern for how it looks.
He or she will then suggest a specific design, model, and brand of
hearing aid that best suits your needs.
When you buy a
hearing aid, remember you are buying a product and a service. You
will need fitting adjustments, directions to use the aid, and
repairs during the warranty period.
Be sure to buy a hearing aid that has only the features you need.
The most costly product may not be the best model for you, while the
one selling for less may be just right. Be aware that the controls
for many hearing aids are tiny and can be hard to adjust. This often
gets easier with practice. Find a hearing aid dealer (called a
dispenser) who has the patience and skill to help you during the
month or so it takes to get used to the new hearing aid.
For More Information
More information about hearing loss is available from the
American Academy of
Otolaryngology-Head and Neck Surgery, Inc. (AAO HNS)
One Prince Street
AAO-HNS is an
organization of medical doctors who specialize in care of the ear,
nose, throat, head, and neck. Contact AAO-HNS for physician
referrals. Send a stamped, self addressed business envelope to
receive single copies of AAO-HNS publications.
American Speech Language Hearing Association
10801 Rockville Pike
ASHA Helpline: 1-800-638-8255 (Voice/TTY)
a nonprofit organization of professionals concerned with
communication sciences and disorders. ASHA offers information about
hearing aids or hearing loss and communication problems in older
people. They can provide a list of certified audiologists and speech
American Tinnitus Association
P.O. Box 5
ATA provides information about
tinnitus and makes professional referrals. ATA supports a nationwide
network of self-help groups for people with tinnitus and their
families. Public information includes information about prevention
Self Help for Hard of Hearing People,
7910 Woodmont Avenue
Bethesda, MD 20814
SHHH is an international volunteer organization
composed of people who are hard of hearing, their relatives, and
friends. SHHH provides self help programs and referrals to local
chapters. Contact them for a list of available publications.
National Information Center on Deafness
800 Florida Avenue,
Washington, DC 20002
NICD provides fact sheets, resource listings, and
reading lists on all aspects of deafness and hearing loss including
educational programs, vocational training, sign language programs,
legal issues, technology, and barrier free design.
National Institute on Deafness and Other
Communication Disorders (NIDCD)
National Institutes of
31 CENTER DR MSC 2320
BETHESDA, MD 20892-2320
Information Clearinghouse: 1-800-241-1044
NIDCD conducts and supports biomedical and behavioral
research and training and the dissemination of information on
disorders of hearing, balance, smell, taste, voice, speech, and
language. The NIDCD Clearinghouse offers information to health
professionals, patients, industry representatives, and the public.
For more information about health and aging contact:
The National Institute on Aging Information
P.O. Box 8057
National Institute on Aging
U. S. Department
of Health and Human Services
Public Health Service
Institutes of Health