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Hearing loss, part 4: When should I get my hearing assessed and what can be done for hearing problems?

The Bottom Line

  • Whether or not you have a clinically normal audiogram, you should seek help if hearing problems are making it difficult for you to enjoy activities and relationships, especially if your friends and family members want you to get help.
  • Hearing aids are a common solution if you need sounds to be louder, but they will not solve all hearing problems.
  • After you decide what your goals are then, depending on your hearing test results and your goals, a hearing health professional can give you advice about solutions involving changing communication behaviours, using technologies, or modifying environments.

When should I seek help as my hearing changes?

Audiometric thresholds are often used as the yardstick in deciding when a person needs help with hearing loss, especially when the use of hearing aids is being considered (see Part 3). The audiogram (a chart showing your hearing test results) is used to decide if you are missing important sounds and if making sounds louder might help you to hear better. However, the audiogram alone does not tell enough about the kinds of problems people might still be having when sounds are loud enough. Even when hearing thresholds are in the clinically normal range, and even when people with hearing loss use hearing aids, there can still be problems due to damage to the nerves that connect the ears and the brain.

Deciding when to seek help may depend less on the audiogram and more on when an individual realizes that hearing problems are beginning to hamper their activities and relationships with other people. A recent study of non-auditory factors associated with success with hearing aids found that success was greater for people who:

  • reported more hearing difficulties in everyday life,
  • had the support of other people such as family and friends,
  • had more positive attitudes about using hearing aids and
  • had previous experience with hearing aids (1).

If you have begun to notice that hearing problems make you feel that

  1. it is difficult to follow conversation or
  2. you do not want to participate in activities that are important to you,

      then it is probably time to think about getting help. You may also want to think about getting help if your family, friends or co-workers have begun to notice that you are having trouble hearing or if they are having trouble enjoying activities with you because of your hearing problems. It will be easier for you to find solutions for your hearing problems if they are willing to support you in getting help.

      Are there solutions for hearing problems?

      If you need sounds to be louder, then hearing aids could be a useful solution. Progress continues to be made in designing hearing aids to help people hear better in noisy situations, but many hearing aid wearers still find it difficult to hear clearly, especially when they are in busy or noisy situations. But for problems related to clarity and understanding speech and noise, other solutions besides hearing aids can help. These other solutions should be considered, whether or not you try a hearing aid. Options should be selected based not only on your audiogram, but also on your communication needs. Your communication needs depend on the people and the situations where you need to use your hearing.

      If you are having trouble hearing in your everyday activities then the first step is to think about which problems matter the most to you. When, where and with whom are you having hearing problems that you would like solve? Once you have a clear idea about your goals for improving your hearing, then having a hearing test is the next step. After your audiogram is completed, a hearing health care professional, such as an audiologist, will be able make recommendations regarding options for improving hearing and solving hearing problems to achieve your goals. These options will likely include a combination of changing communication behaviours, using communication technologies, and modifying and selecting communication situations or environments:

      Behaviours

      As a person with a hearing problem, you can make changes to your communication behaviours. For example, communication behaviours can include being sure to watch the faces and gestures of people who are talking to you. Taking advantage of visual information will make it easier to understand what you are hearing. Your family members, friends, co-workers and others can also learn to change how they behave during communication. It can be very helpful if they make sure to get your attention before speaking to you. By working together, misunderstandings can be prevented or repaired quickly without disrupting your conversations with each other.

      Technologies (2;3)

      Hearing aids can be used in a wide range of situations. It may also be helpful to use specialized devices instead of or in addition to hearing aids. There are many specialized ‘assistive’ devices for listening in specific challenging situations. These specialized devices can help when you are using the telephone, watching television, or attending events in public places such as theatres or places of worship. For example, by using headphones and your own wireless amplifying system for the television you could avoid arguments with your family about turning the television up too loud. To comply with laws about making public places accessible to people with disabilities, just like ramps and elevators are available for people in wheelchairs, theatres and places of worship often provide visitors who have hearing loss with hearing assistive systems that can be used to help them hear better when they are attending events at the facility. These assistive devices can be used whether or not you have a hearing aid. Hearing health professionals, such as audiologists, can advise you on your rights and what might work for you in the situations where you need help.

      Environments

      Environmental solutions involve learning how to select or modify places to minimize listening difficulties. This can include reducing noise (for example, turning down the background music), minimizing distractions in your home or office, or selecting stores, restaurants or other public places that are quieter if you want to be able to hear and converse more easily. New standards for sound environments in health care facilities are currently guiding the design of public places such as hospitals.

      In this four-part blog post series we cover various aspects of hearing loss:

      • In part 1, we discuss how changes in hearing and cognition (for example, memory) affect communication and social interactions in healthy older adults;
      • in part 2, how hearing impairment may be related to cognitive impairment and dementia;
      • in part 3, what hearing tests can and cannot tell you about your hearing problems; and
      • and in part 4, when you should get your hearing assessed and what solutions might help you if you or your friends or family are having problems.

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References

  1. Hickson L, Meyer C, Lovelock K, Lampert M, Khan A. Factors associated with success with hearing aids in older adults. Int J Audiol 2014 Feb;53 Suppl 1:S18-S27.
  2. American Speech-Language Hearing Association. effective communication a human right, accessible and achievable for all. 9-22-2014. http://www.asha.org/public/hearing/Hearing-Assistive-Technology/.
  3. National Institute on Deafness and Other Communication Disorders (NIDCD). Assistive Devices for People with Hearing, Voice, Speech, or Language Disorders. 2014. http://www.nidcd.nih.gov/health/hearing/pages/assistive-devices.aspx.

DISCLAIMER: The blogs are provided for informational purposes only. They are not a substitute for advice from your own healthcare professionals.

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