Aging and What To Do About It - Hearing loss

About three out of ten persons over age 65 have some hearing loss; at age 70 to 80 this percentage increases greatly.


While some hearing loss can be blamed on bad listening habits (tuning out people and conversation a person does not want to hear), the two major causes are conduction loss and nerve defects. A person with conduction loss hears high-pitched sounds best; a person with nerve impairment hears low sounds best. A combination of the two is called mixed hearing loss.

Conduction loss can be caused by excessive ear wax, diseases of the ear, disturbances of the eardrum, or abnormalities inside the ear. It can also be caused by otosclerosis , a bony growth over the window to the inner ear. Most of these conditions can be treated by an ear doctor ( otologist ). He can remove wax from the ear, repair or replace eardrums, remove bony growths, and loosen or remove fixed ear bones.

Nerve defects (sensorineural hearing loss) may be another story. They are caused by wear and tear on the ear, disease, certain drugs, and blows and skull fractures, and usually cause permanent damage that cannot be helped by surgery or medical treatment.

Some persons complain about ringing in the ears ( tinnitus ) that may start without warning and vary in intensity and quality. What causes tinnitus in one person may not cause it in another, but often it is caused by wax in the ear, middle ear infection, arteriosclerosis, or certain drugs.

Hearing Aids

In most cases a hearing loss can be helped with a hearing aid or surgery. But if you think you have a hearing problem your first task is to see your physician. If your problem is not medically treatable, and if your physician believes a hearing aid will help you, you should see a dispensing audiologist. The American Speech-Language-Hearing Association, 10801 Rockville Pike, Rockville, MD 20852, will supply a directory of certified practitioners on request. If you have trouble finding an audiologist, an experienced hearing-aid dealer may be able to advise you on the device best suited to your needs. The National Hearing Aid Help Line (800/ 521-5247), a service of the National Hearing Aid Society, provides lists of dealers certified as dispensing audiologists.

A hearing test at a hearing aid clinic may be your next stop. Here trained audiologists will scientifically measure your hearing and assist you in trying on different kinds of aids. The audiologists do not sell hearing aids, but can tell you what kind is best for you. Basically, there are four basic kinds of aids:

  1. • Body types that operate with a cord running to the receiver mold in the ear from a miniature microphone carried in a pocket, pinned to the clothing, or worn in a special carrier. These devices are about one to one and one-half inches long and weigh about two ounces. They are more suitable for profound or severe hearing loss.
  2. • Behind-the-ear types that weigh only about one-half of an ounce and fit behind the ear. A plastic tube leads from the microphone, amplifier, and receiver to the earmold that fits in the ear.
  3. • Hearing aids that fit inside the ear canal and weigh about one-sixth of an ounce. This model is hardly visible and has become the most popular among hearing aid wearers.
  4. • A type that fits in the outer ear.

A fifth kind of hearing aid, one that is built into eyeglasses, has a very limited use.

Buying a Hearing Aid

No single hearing aid is ideal for every hard-of-hearing person. Thus testing is essential if you are to find the right aid (which is why you should not buy one through the mail). You may want to bring a friend or relative when you are being fitted. A familiar voice serves as a yardstick to help you judge which aid is best. Some things to consider are the quality of the sound, the aid's ability to help you understand speech in both noisy and quiet places, comfort, ease of use, and price—including the earmold and the expected costs of upkeep.

It takes time to get used to a hearing aid. An aid amplifies all sounds—wanted and unwanted. It also changes most sounds, giving them an “electronic” character. Voices may sound unnatural and tinny. Normal noises may be harsh and grating. But special circuiting in many of today's aids limits the sound level reaching the eardrum. These automatic gain controls prevent discomfort but may distort speech. A still newer approach is to use filters to screen out background noises.

In addition to greatly reducing the sizes of many hearing aids, technological advances are expanding the usefulness of hearing aids continually. Noise blockers filter out sounds that do not fit with speech patterns. Tiny microphones reduce the buzzing noises picked up by some older hearing aid models. Treble and bass dials give the wearer a way to adjust sound quality to background noises. With the dials the wearer can also make adjustments to the hearing fluctuations resulting from bodily changes.

If you do not want to wear a hearing aid, or cannot adjust to one, you can try lip reading or speech reading. Each involves watching the lips and vocal chords to determine what another person is saying.

Talking to the Hard-of-Hearing

If you are talking to someone who has some hearing difficulty, he'll understand you better if you speak slowly and distinctly and use the lower range of your voice. Face him when you speak; let him see the movements of your lips. It also helps to point to visible objects.

Above all, don't shout. In fact, raising your voice sometimes pitches it into a higher frequency which a hard-of-hearing person may find difficult to understand.

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