“Dennis,” I call from the kitchen. “Do you want leftover pasta for dinner? Or should I grill some chicken breasts?”
“Dennis?” I say, louder.
I round the corner into the living room, Tupperware in hand. “Dennis,” I say, so loud I feel like I’m barking. “Pasta? Or chicken?”
My healthy, fit, 40-something husband looks up from his book, startled at my sharpness.
Say hello to just three of the uninvited guests even minor hearing loss brings into a family: Shrillness, repetition and oversimplified dinner options.
Like millions of baby boomers, Gen Xers—and increasingly, millennials—Dennis is developing the kind of early hearing loss experts once saw in people in their 60s. Overall, 48 million people in the U.S. suffer from some level of diminished hearing, and at age 65, one out of three Americans experiences hearing loss, according to the Hearing Loss Association of America.
Hearing Loss: Striking at an Earlier Age
“It’s showing up in people in their 30s, 40s and 50s,” says Christine Eubanks, Ph.D., professor of audiology at Virginia Commonwealth University in Richmond, Virginia. For some, like service members and those who work around noisy machinery, the damage is occupational. For others, hearing loss stems from riding ATVs or a lifelong dedication to Metallica. Musicians are at especially high risk: Researchers at the University of North Carolina have found that 45 percent of kids who play an instrument in a band have measurable hearing loss by age 25. Our love affair with ear buds has exacerbated the problem: “Because you’re hearing noises around you as well, you turn up the music even louder to drown it out,” she says.
If a close friend or family member is falling silent in noisy rooms, or often responding “Say again?” don’t just sigh in exasperation. Suggest a hearing exam. Assuming a loved one is losing their sense of hearing, getting the facts will help minimize the strain it could put on your relationship.
”Conversations get shorter, less frequent and less meaningful. Untreated, it creates problems not just for those who can’t hear but for everyone around them.”
Learn About Hearing Loss
While an estimated 90 percent of those with hearing loss can benefit from treatment, it’s one of the most underserved health conditions, says Lisa Tseng, M.D., CEO of hi HealthInnovations, a division of UnitedHealth Group based in Minnetonka, Minnesota. This can have a big impact on marriages, families and friendships. “Their conversations get shorter, less frequent and less meaningful. Untreated, it creates problems not just for those who can't hear but for everyone around them, including spouses, family and co-workers,” she says. “People with hearing loss tend to avoid social gatherings. Family members perceive them as losing interest in relationships.”
The loss is typically gradual, sneaking up on families. “A couple goes to a party and one person finds it fun, but the person with hearing loss finds it exhausting,” says Dave Fabry, Ph.D., an audiology consultant for the Better Hearing Institute. Going out to eat at a restaurant, where background noise can make conversation more difficult, becomes a chore. People begin to turn down theater tickets, and go to church less. “It starts out as a gradual isolation, and eventually, that can lead to depression,” says Fabry. (Researchers at Johns Hopkins University have also shown a correlation between hearing loss and cognitive decline and dementia.)
Women’s voices are typically more difficult for those with hearing loss to understand. “Young children are even harder to hear,” he says. “Their voices are higher, they may not articulate words as well, and they don’t have that nuance of rephrasing sentences to make them easier to understand. That causes stress and tension for everyone.”
It’s especially hard on spouses. One study focused on couples where one person had normal hearing and the other had an adult-acquired hearing loss. About 97 percent of the normal-hearing spouses reported repeating themselves a lot, 83 percent routinely raised their voices, and 74 percent had to make an effort to maintain face-to-face contact. And 69 percent said they find communicating with their spouse to be frustrating. Other research has shown the divorce rate to be higher among such couples.
Those with hearing loss inevitably bring the problem to work, where they are often resistant to wearing hearing aids. “People worry that hearing aids will make them look old,” Fabry says. But just muddling along has a real impact. One study reports that hearing problems can cost families up to $30,000 per year in income, through job loss or being passed over for promotion.
The good news? Tseng says that when people use hearing aids effectively, they report significant gains in confidence and relationships. Those around them, including friends and co-workers, report even bigger improvements in relationships.
Finding Better Ways to Communicate
The first step to dealing with hearing loss is acknowledging that you or someone you love has a problem. Sounds simple, but too often the problem gets ignored. “Some of the more obvious signs include the person not understanding what they hear over the telephone, when there are no visual cues to help,” says Tseng. Higher-pitched sounds become harder to hear, as do words with consonants like T, S and F. Because hearing loss varies across quiet, medium and loud sounds and high and low pitches, “people can often hear but not understand words.” Family members complain that the hearing-challenged person keeps the radio or TV volume too high, or asks others to repeat themselves.
Still, she says, once people begin noticing these deficits, “they think it isn’t severe enough to seek treatment.” By some estimates, only 20 percent of people with hearing loss seek treatment, and they wait an average of five to seven years to get a hearing test. Even then, they may wait another 10 years before buying hearing aids.
In the meantime, here are five steps family members can take to make being hard of hearing a little less hard on everyone else:
1. Whenever possible, get the person’s attention before speaking—and stand face to face. It’s the cardinal rule, experts agree. “Trust me, they’re lip reading when they don't even know it,” says one woman whose husband’s hearing has been deteriorating for a decade.
2. Find ways to clarify communication to avoid misunderstandings. That can include repeating important details back to each other, to make sure they’re understood, and using written communication. “My husband and I email each other from one floor to another,” one wife says. “Sounds silly, but it works.”
3. Try not to change topics abruptly. “It makes it more difficult for the person with hearing loss to follow the conversation,” Tseng says. And when you do move on to the next subject, tell them you are doing so, to make it easier for them to stay with you.
4. Manage background noise. When you’re having an important conversation, take a few moments to mute the TV or radio, and be conscious of noises from fans, air conditioning and even appliances.
5. Encourage your loved one to seek treatment, but expect pushback. Despite enormous strides in digital technology, sleeker designs and affordability, most people still believe hearing aids are utterly uncool—and expensive. “People don’t realize that where they used to cost in the $6,000 to $7,000 range, now they’re more like $700,” says Tseng. And not only are the digital devices easier to customize, “so are appointments. At hi HealthInnovations, we can provide support over Facetime, so people don't even have to come in to the office.”
And keep expectations realistic. Certainly, the days of whistling aids or flushing toilets sounding like Niagara Falls are gone. “Digital aids can manipulate soft sounds to become much louder, without changing everything else,” says Eubanks. “But needs are complex and vary a lot, from person to person. It does take patience to get it all right, and usually, multiple visits.”
Take Steps to Protect Your Own Hearing
The best remedy to hearing loss is avoiding it in the first place. Here are four simple ways to safeguard your ears.
1. Follow the 60/60 rule. When using portable music devices, stop after 60 minutes, and listen at no higher than 60 percent of the player’s max volume.
2. Use hearing protection. When working with power tools or mowing lawns, wear earplugs to blunt damaging levels of noise. Even the noise level at a concert can demand this protection.
3. Try over-the-ear headphones. They deliver lower noise levels than ear buds. Those with noise-cancellation properties are especially helpful, says Eubanks.
4. Become a sound shopper. When buying machinery and appliances, pay attention to the noise level they create. Even a blender, at 90 decibels, can cause hearing damage. Quieter is better.
For more information and adviceon dealing with hearing loss, visit hi HealthInnovations and the Hearing Loss Association of America.