Hearing better

Created date

March 23rd, 2020
A little girl whispers in an older man's ear. He is sitting on a bench reading a newspaper.

Could a hearing aid help you hear better?

The number of people in the U.S. who have hearing loss may surprise you. According to the National Institute on Deafness and Other Communication Disorders (NIDCD), one-fourth of seniors ages 65 to 74 and almost half who are 75 years of age and up have disabling hearing loss. The American Geriatrics Society reports that hearing loss is the third most common chronic condition in seniors.

Types of hearing loss

Hearing impairment falls into two general categories. The first is conductive hearing loss, which is when sound is prevented from reaching the inner ear. The second is sensorineural, which occurs when problems develop in the inner ear. In some instances, there can be a mixture of both types occurring at once.

Conductive hearing loss can be caused by narrowing of the ear canal, infection, fluid buildup, or damaged eardrums. Sometimes, people have normal hearing but perceive sounds as muffled because of too much ear wax. 

When you are younger, your ear is a self-cleaning organ. It manufactures new wax, then eliminates old wax. But with age, the consistency of the wax can change. “Ear wax becomes drier and thicker,” says Beth Heydemann, R.N., M.S., A.N.P.-B.C., nurse practitioner and associate professor in the College of Nursing and Public Health at Adelphi University in Garden City, N.Y. “With all the other changes in the ear, the wax can then become impacted.”

Sensorineural hearing loss occurs because of changes in the inner ear structures. “With age, you may lose sensory cells, and there can be deterioration of the nerve fibers as well,” Heydemann says.

Age-related sensorineural hearing loss is called presbycusis, and one of the main causes is loud noise throughout life, according to NIDCD. Presbycusis tends to run in families and develop gradually. 

There can be many other factors that affect different parts of the ear in seniors. “Health conditions, such as diabetes and high blood pressure and viruses, strokes, or tumors are some examples of things that may affect hearing,” Heydemann says. “Some medications can be toxic to structures of the ear.”

Complications of hearing loss

“It is very important to have your hearing checked regularly,” Heydemann says. “Hearing impairment doesn’t only make it difficult to hear sounds. It reduces intelligibility of your speech. Some people become isolated and lose interest in socializing because of this.”

Hearing impairment is associated with other conditions in seniors. “Hearing problems and memory loss have been shown to coexist,” Heydemann says. “Studies show that even mild hearing loss can triple your risk of an accidental fall.”

Recent studies have shown that hearing loss is also linked to cognitive difficulties.

Hearing clearly again

Some problems are a fairly easy fix, such as impacted wax, but don’t attempt it at home unless your doctor has given you instructions to do so. “Using a cotton swab actually makes wax more impacted,” says Ayasakanta Rout, Ph.D., associate professor and program director of audiology at James Madison University in Harrisonburg, Va. “Your family physician can safely remove ear wax or give you something to use at home, but some people with a severe problem may need to see an otolaryngologist or audiologist.”

There are also medications and surgery options for some other causes of conductive hearing loss.

But for many people with presbycusis, hearing aids are the best way to hear clearly again. But few seniors actually use them. “Among adults age 70 and older with hearing loss who could benefit from hearing aids, fewer than one in three [30%] has ever used them, according to NIDCD,” Rout says. 

Hearing aids are a sign of old age to many people, so they won’t wear them. “A large part of my counseling involves explaining why hearing aids are so important,” Rout says. “But I am seeing changes in attitudes over my 20 years in the field of audiology. For one thing, hearing aids themselves are much smaller and more appealing to users.” 

Another barrier to hearing aid use is cost. “One pair can range from about $2,500 to as high as $10,000,” Rout says. “And although they are better than they used to be, a pair of hearing aids may only last anywhere from five to seven years.”

Research suggests that most people do not need the most expensive hearing aids to get the maximum benefit in speech understanding. “All the extras that come with the more expensive hearing aids, such as cellphone connectivity, are not necessary for improving your hearing,” Rout explains. 

See your doctor if you suspect any hearing loss, then, if necessary, ask for a referral to an audiologist. “Hearing aids need to be programmed in order to work best for you,” Rout says. “A licensed audiologist is uniquely qualified to work with patients and their families to find the most appropriate hearing aids for their listening needs.”

Know before you buy: Four tips about hearing aids

1. Look for a licensed hearing health care professional who offers products from several manufacturers.

2. Ask about a 30- to 60-day trial period for hearing aids (most U.S. states require it).

3. Do not buy hearing aids online unless you have them evaluated by an audiologist.

4. Do not use personal sound amplification products for hearing impairment. They are intended for people with normal hearing.