You have recently had a hearing assessment and the results show that you currently have a mild hearing loss which is likely due to some normal deterioration which has occurred over time.
How does a mild loss affect people?
Mild hearing loss can effect anyone, commonly Presbyacusis or ‘age related hearing loss’ begins slowly and will start mildly. This tends to affect the high frequencies initially and is very common.
Indicators that you may have this type of loss tend to be that you no longer hear things as clearly as you used to and people can seem as if they are ‘mumbling’. This lack of clarity means you are able to hear that people are speaking but not make out what they are saying.
This becomes worse in noisy environments where the background sounds can drown out the speech or if you are in a group where conversation moves too quickly for you to hear and process everything that is being said. In these situations you can find yourself just switching off, feeling unable to join in conversation. You may have also found that you tend to have the TV turned up a bit louder than normal or struggle a little on the telephone.
Hearing is very individual. It could be the case that you feel that you do not have a problem with your hearing at all but your family have mentioned that they think you are missing things. Some people with a mild loss never notice this and are very surprised when informed their hearing test result. While other people with a mild loss report it affects their quality of life in all sorts of everyday listening situations.
Hearing aids with a mild loss can be very useful for some people but would be inappropriate for others. This is why it is very important to understand exactly what hearing aids can and can’t do. If you do not have reasonable expectations of hearing aids then you may find that for mild losses they have more drawbacks than benefits.
Are hearing aids necessary for me?
The hearing aids we fit are all digital and fitted to a prescription for each loss, however if the loss is very mild or over a very narrow range then they could be unsuitable for you and your Audiologist will discuss this with you.
Wearing a hearing aid is not like having your natural hearing restored. Hearing aids for age related loss mainly give back high frequency information. This means that initially the aid will sound sharp, tinny, and loud as well as making your own voice sound different. You would also initially notice high frequency sounds such as paper rustling and water running however with consistent use this will settle down and it will be worth persevering if your Audiologist has recommended aids for you.
The reason hearing aids have to be worn consistently is for the brain to adapt to the information it is getting from them. If you are at a stage with your hearing where you do not feel that you need them all the time you may be less motivated to wear them as much as would be necessary. This can result in them being worn only every now and again and just brought out of the drawer for those difficult listening situations where you do feel you struggle. Unfortunately this does not allow the brain time to adapt to the sound and it will be almost like starting from scratch each time you put them in. This can make sound overwhelming, because the brain has not learnt to filter out the background noise which only happens with practice. This can result in you feeling disheartened, unable to habituate to the sound and then giving up completely.
If challenging listening situations such as restaurants or busy social gatherings are the only areas where you struggle to hear then a hearing aid is not likely to improve this. Even with new developments in technology hearing aids cannot get rid of all of the background noise which you don’t want to hear. Sometimes they can make you more aware of it.
Hearing aids are just aids and do have limitations. This can mean at a table in a restaurant, if you are in a group, you still may not be able to hear the person you want to who is sat at the other end. Hearing aids do not know who you are trying to listen to and it can be difficult to focus on the speech you want to hear.
There is also the issue of having something in your ear which some people can find irritating. It can change the way you perceive your own voice and people often report that they sound as if they are talking ‘into an echo chamber’. This is slightly less common with mild losses as the hearing aids we use mean you hear your voice more normally as well as hearing the processed sound through the aid.
Commonly, people can struggle to hear on the telephone. However if you think about it you are trying to make out conversation using one ear with no visual clues to help. Sometimes a simple change of phone can help or trying one with an amplifier. Familiar voices are generally easier to cope with but people who talk quickly will be challenging with or without a hearing aid.
Another common area of difficulty is trying to hear when in the car. In this environment there tends to be engine noise, road noise and often the radio is on. You also have limited visual clues as people wouldn’t be facing you or are able to direct their voice directly towards you. Hearing aids are unlikely to help in this situation.
Listening and Communication Tactics
There are things you can do to improve things yourself if your loss is not suitable or borderline to benefit from a hearing aid. Listening and communication tactics are very important and by trying these initially people often find they help so much that they don’t feel that they struggle with their hearing anymore.
Make people aware that you need them to have your attention before they start to speak to you so that you can see their face and the conversation is directed straight at you. If they start talking while your attention is elsewhere then it will always mean that you miss the start of the conversation and need to ask for things to be repeated.
Family members often struggle to adapt to any change of hearing and it can be challenging to change their behaviour and expectations and not let them just blame you for not listening. People often talk while walking away or when in they are in another room and expect you to hear them. If you are not expecting to be spoken then your attention could be elsewhere then by the time you realise a comment is addressed to you half of the message has been missed. By changing their habits it can make communication easier for both of you.
Be aware of how much background noise or distraction there is around you. Trying to hold a conversation in the kitchen with the kettle on or above the noise of the TV can be more difficult so reduce the background where you have control over it. This should improve your chances of hearing what is being said the first time
Often people report that they struggle to hear the TV but sometimes this can be due to quality of the sound when the program was recorded not just your hearing. Think about the type of TV you have as more people now have flat screen TV’s where the speaker is situated at the back. This means the sound is not directed towards you but towards the wall then back out which affects the volume and clarity of what you hear. This can often be improved by using a separate speaker system or a sound bar which can improve the quality and decrease distance between you and the sound.
Realistic expectations
We would recommend that people try making some of the changes to their listening habits before going straight to hearing aids. Firstly we would advised looking at listening tactics, sometimes simple adjustments to communication can resolve any issues that both you and your family have with hearing.
People do tend to forget that even with normal hearing people can struggle to hear in noisy environments where there are other demands on their attention and it is unrealistic to expect to hear everything perfectly in challenging listening situations.
Any questions
If you have any questions please contact the Audiology department 0191 223 1043 between 9am and 4pm Monday to Friday or email us at: tnu-tr.audiology@nhs.uk
Useful contacts
Newcastle Hospitals website: www.newcastle-hospitals.org.uk
The Patient Advice and Liaison Service (PALS) can offer on the spot advice and information about the NHS. You can contact tem on the Freephone 0800 032 02 02 or email northofthetynepals@nhct.nhs.uk
Action on Hearing Loss, 2018, Why some people hear better than others available online- www.actiononhearingloss.org.uk/factsheets
Live Science, 2017, why we find it harder to filter out background noise as we age, available online at- https://www.livescience.com/59625-why-older-adults-have-trouble-filtering-background-noise.html
NHS, ND, Listening tactics online available at- https://www.mcht.nhs.uk/information-for-patients/departmentsandservices/audiology/help-for-friends-and-family/listening-tactics/
If you would like further information about health conditions and treatment options, you may wish to have a look at NHS Choices website at www.nhs.uk
