I Hear Fine, Everybody Mumbles: Hearing Loss in Seniors

By: Sherry Netherland, Director of Special Projects for Assisted Healthcare Services

I started my professional healthcare career as an audiologist.  Statistics on aging will report that only 50% of seniors over age 65 have hearing loss.   Well, those 50% of seniors were my patients, so essentially, 100% of the people over 65 who came to see me had a hearing loss!  The sense of hearing is not like the sense of vision and yet, people perceive the two similarly.  If you have a vision problem it is obvious – you cannot see (or at the very least, you cannot see well).  It stands to reason that most people will assume that if they had a hearing loss, it would mean that they could not hear.  So, if they hear “fine,” it obviously means everybody mumbles.  Too bad it doesn’t.

The type of hearing loss that we can acquire as we age is simply the nerve of hearing wearing out.  It doesn’t happen to everyone, but when it does it happens in a very specific way. We lose our ability to her high frequencies (pitch).  It is called a high frequency sensory neural hearing loss or presbycusis. Why the high frequencies?  It has to do with the anatomy of the ear and how the nerve of hearing is “tuned.”   The significance of this loss of pitch is understood in the context of how the sounds of speech are tuned.  The following sounds of speech, s, sh, ch, p, t, k, are all high frequency sounds.   These sounds account for a full 90% of the intelligibility for speech!  The very sounds that we need to hear in order to understand what someone is saying are the very sounds that will fall outside the range of audibility if we develop an age-related hearing loss.  The sounds, b, d, g, j, z, are all low frequency sounds.  Even with a severe high frequency  sensory neural hearing loss, you will hear those sounds.  Unfortunately, only 10% of the intelligibility of speech is dependent on those sounds.  So, even though you can “hear,” what you hear is not going to help you understand what someone is saying.

To further confound this hearing loss, there is a significant side effect – the inability to filter speech from background noise.  So, in a room with ambient noise, or many people talking at a social event, a person with a high frequency sensory neural hearing loss will be lost and incredibly frustrated because they will “hear” but everything they hear will sound like mush.

Here are some suggestions to improve the situation:

1. Have your ears examined by your physician. You want to rule out any correctable problems, like impacted wax.
2. Have a professional hearing test by an audiologist.  An audiologist will also be able to determine if a hearing aid is necessary and discuss with you what those options are.  Hearing aid technology has changed dramatically in the past decade.  However, unlike eyeglasses which give you normal vision, hearing aids  do not give you normal hearing. They are selective amplifiers and there is still a period of adjustment needed to be able to learn how they can maximize your residual hearing.
3. Try and be as close to the source as possible. If going to a lecture, church/temple, theatrical event, etc. sit as close to the front as possible, or rent the “magic ears” available at many public venues now.
4. When having a conversation with someone, try not to be further than four feet      away.  If they won’t come to you, you go to them.  Be pro-active.
5. Ask people to talk a little slower, not louder. When people slow down their speech, they automatically speak clearer without even realizing it.   They will enunciate without even trying.
6. Whenever possible, reduce the background noise. If someone is trying to tell you something and the television is playing in the background, turn down the volume.  If you are in a crowded noisy room, it might be possible to step outside the room to have a conversation.  Another tip is to try and position yourself so your back is to the wall. If you are close to the wall and your back is facing the wall when      you are having a conversation in a noisy room, you have essentially eliminated 50% of the ambient noise if there is no one behind you.  Also, the speech of people talking to you will bounce off the wall and reverberate into your ears.
7. The same tip is helpful for a noisy restaurant – sit at a table close to the edge      of the room and you sit in the chair that places your back to the wall.  Try never to sit at a table with your chair facing the middle of the room.  You will be surrounded by ambient noise in that situation and you will find conversation very difficult.

So yes, you might hear better if everybody didn’t mumble.  We all would.  But everybody does mumble and it wasn’t until you developed a hearing loss that you began to notice!

Sherry Netherland is the Director of Special Projects for Assisted Healthcare Services, a Medicare certified, CHAP accredited home health agency with 7 branches in California and Arizona. She founded the Assisted Speakers Bureau and she speaks on a variety of healthcare related issues. To learn more about home care nursing and how Assisted can help, www.assisted1.com/home_health_care.