By JUDD MATSUNAGA, Esq.
Talk about a communication gap – my ex-wife mumbled. I would constantly have to ask, “What did you say?” Sometimes the problem was that she was trying to communicate in a noisy place. Sometimes the problem was I was not paying attention to what she was trying to say. Whatever the problem was, I wish she would have spoken up louder.
She claimed that I couldn’t hear. She said that as I was getting older, therefore chronic hearing impairment becomes very common. In fact, about 48 million people in the U.S. have some degree of hearing loss. The National Institute on Aging reports that one in three adults aged 65-74 has hearing loss, and nearly half of those aged 75+ have difficulty with hearing.
Even though she may be partially right, I’m not alone in not recognizing it. Many seniors with hearing loss struggle with acknowledging it. “People are often embarrassed or ashamed about losing their hearing, because they see it as a sign that they’re old, so they ignore it and pretend it isn’t happening,” says Alison Grimes, director of audiology at UCLA Health. (Source: AARP, “Is It Time to Do Something About Your Hearing Loss?” July 13, 2021)
How about you? How is your hearing? About HALF of people 75 and older have lost 35 decibels or more of hearing — the point at which a hearing aid is needed. But it can be tough to tell when someone’s hearing is starting to go, especially if that someone is you. The following are 10 key signs that it may be time to have your hearing checked (Source: www.aarp.org/health/conditions-treatments, April 2, 2021):
1) Talking on the phone is more challenging. “Usually, sound is going in both ears, but when you’re talking on the phone it’s only going in one, which makes it more difficult — especially if you hold the phone to the ear that has more hearing loss,” says Alison Grimes. “On top of that, phones don’t perfectly transmit speech sounds, which compounds hearing issues,” she says.
2) Some sounds seem louder than normal. Feel like you’re easily startled by loud noises? Blame it on a phenomenon called “recruitment,” which is common in people with hearing loss, says Grimes. It happens because you don’t lose all the hair cells in your ear at the same time. When a sound is on the louder side it triggers the healthy cells to respond more forcefully than they typically would — so louder sounds can be more jarring, or even sound distorted.
3) You get irritated at others for mumbling (sounds familiar to me). “Age-related hearing loss affects higher frequency sounds and causes distortion of sounds. That’s why older people with hearing loss will say they can hear. They are right, they CAN hear, but their hearing loss makes it harder for them to hear certain frequencies, which leads to distortion of sound.” This is why older adults with hearing loss may have difficulty understanding young children, who often have higher-pitched voices.
4) Many consonants are spoken at a relatively high frequency (i.e., speech sounds or letters of the alphabet that is not a vowel like “ch” and “sh”). When age-related hearing loss affects the ability to hear different consonants, human speech becomes harder to decipher, says Professor Meg Wallhagen, Ph.D., board member of the Hearing Loss Association of America. This is why it’s usually not helpful to shout at someone with age-related hearing loss. You will just be making a distorted sound louder.
5) You’re having trouble following conversations. Even without consonants we pick up lots of cues about speech from the context, facial expressions, and lip-reading. But you’ll start making errors. Sujana Chandrasekhar, M.D., a partner with ENT and Allergy Associates in New York, says, “With everyone wearing masks this year, it’s become even harder for people who are starting to lose their hearing to bluff their way through conversations.”
6) You feel like you’re getting clumsier. The inner ear, where hearing occurs, is like a house with two rooms. Your hearing mechanism, or cochlea, is in one room, and your balance mechanism, the semicircular canals, is in the other — and they’re connected by fluid-filled space. So, one affects the other. Plus, we use auditory cues to know where we are in space, says Chandrasekhar: “When you put hearing aids on people with hearing loss, their sense of balance and ability to sense where they are in space improves immensely.”
7) You don’t get jokes like you used to. “The punchline is often told in a funny way or it’s a play on words, and if you can’t decipher all the words, you don’t get the joke,” says Chandrasekhar.
8) Everyone is telling you to turn down the TV. You might not even realize you have been clicking up the volume button until someone points it out. But if the sound is so loud you need to turn it down to hear someone saying, “Turn down the TV,” it’s a sign something could be wrong with your hearing.
9) It’s harder to carry on a conversation in a crowded room. Background noise is difficult for everyone, even those with typical hearing, says Angela Shoup, a professor in the Department of Otolaryngology at the University of Texas Southwestern Medical Center in Dallas. “One skill we use to ignore background noise is to screen out a certain type of noise, like traffic, which is low-pitched,” she explains. But at a party or restaurant, the competing sounds are human voices nearby — and ignoring other voices to focus on one is more difficult when you’re losing your hearing.
10) You don’t remember things people tell you. “It’s difficult to remember things you don’t hear clearly,” says Shoup. “And when you’re struggling to understand what someone is saying, it taxes your short-term memory. But people with hearing loss miss lots of sounds, so they have to hold all these random bits and pieces in their short-term memory until they can fill in the blanks to make sense of a sentence. Sometimes it works, and sometimes it doesn’t.”
11) You get distracted more easily. “It takes a significant amount of energy and concentration to decode a message that is missing numerous elements, which is what speech sounds like to someone with hearing difficulties,” says Shoup, “so it’s harder to focus and sustain attention during a conversation.”
If you notice a change in your hearing, it’s time to take a trip to the doctor’s office. Don’t put it off. Research shows if you don’t seek treatment for your hearing loss (and many older adults underestimate how bad their hearing truly is), you’re at a greater risk for falls, hospital visits, anxiety and depression, as well as for higher levels of inactivity and higher health care costs.
According to the National Institutes of Health — it’s important to protect what you’ve got and to preserve it for as long as you can. And fortunately, some hearing loss is preventable. But untreated hearing loss can be dangerous, even deadly. And since hearing loss can be inherited, you should get tested regularly. You might even consider genetic testing to tell whether family might be a factor.
Perhaps this is the biggest reason to act. Cognitive abilities (e.g. memory and thinking) may decline faster in people with hearing loss. Your brain’s auditory cortex needs the hearing input to remain in good shape! Protecting your hearing and getting treatment for hearing loss is one of the biggest changes you can make to lower your risk for developing dementia (Lancet Commission’s 2020 report).
Studies have linked hearing loss to a higher risk of dementia. Hearing involves getting the input through your ears and the related nerves, AND then your brain must process this sensory input in what’s known as the “auditory cortex.”
“Use it or lose it” applies here. Your brain’s auditory cortex will get worse at processing sound, if you don’t give it enough good-quality input to work with.
The sooner you improve the hearing input coming into the brain, the better it is for the brain. This is also much better for social relationships, work relationships, safety, and more.
Hearing aids also require a period of adaptation and learning. This becomes harder as brains get older. It also becomes harder as hearing loss becomes more severe with time.
Hearing loss also has a significant impact on social relationships. Friends and families become tired of all the extra effort required to communicate when there is hearing loss and may engage less with a person. Spouses, in particular, can become very frustrated. In short, people with unaddressed hearing loss are more likely to become socially isolated
Also, don’t assume that your primary care doctor will notice hearing loss or initiate a suitable evaluation. Traditional Medicare, unfortunately, does not cover routine audiology testing. Research shows that hearing loss is commonly overlooked in primary care. Patients and families should be proactive in bringing up hearing loss and in asking their health providers to address it.
In conclusion, if you’re embarrassed about wearing a hearing aid, hearing aids are more discreet than ever before thanks to technological advancements. Although not yet counted as a trendy accessory, plenty of glamorous people rely on them, including Halle Berry, Jodie Foster, Robert Redford, and Rob Lowe. That’s a club most of us wouldn’t mind joining.
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Judd Matsunaga, Esq. is the founding partner of the Law Offices of Matsunaga & Associates, specializing in estate/Medi-Cal planning, probate, personal inury and real estate law. With offices in Torrance, Hollywood, Sherman Oaks, Pasadena and Fountain Valley, he can be reached at (800) 411-0546. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.