Hearing loss and age (presbycusis)
Hearing loss — a common problem
At least one in 10 Australians reports they have a significant hearing loss. As we get older, our hearing is more than likely to deteriorate. The age at which deterioration starts and how quickly it proceeds depends on factors such as general health, level of noise exposure, and whether there is any history of ear disease. Statistics show that half of the population over the age of 60 can expect to have trouble with their hearing, and 2 out of 3 people in nursing homes have been found to have a significant hearing impairment.
What is presbycusis?
The term presbycusis (pronounced prez-bee-cue-sis) covers what goes wrong with the hearing mechanism when our ears age, the decrease in the ability to understand speech clearly, and the social and psychological impact of the hearing loss. Presbycusis develops slowly and gradually and is permanent due to damaged hearing nerves.
Hearing loss can be hard to recognise
When hearing deteriorates slowly, the individual often finds ways of minimising the effects of the fading hearing, such as lip reading, avoiding social situations where there is a lot of background noise, and becoming good at using non-verbal cues such as facial expressions, body language and gestures.
The hearing loss may not be recognised because of these coping strategies, or because the loss has happened so gradually. In fact, other people often notice the hearing loss before the person who has it. The time between first noticing some hardness of hearing and then doing something about it can be several years.
‘Why don’t they do something about it?’
There are a number of reasons that people do not take action as soon as they suspect a hearing problem. These might include the following.
- ‘My hearing isn’t bad enough.’
- ‘I know people who wear a hearing aid and they don’t like it.’
- ‘A hearing aid is inconvenient to wear.’
- ‘I’m afraid I’ll become dependent on a hearing aid.’
- ‘A hearing aid may make my hearing worse.’
- ‘People will think I’m old if I wear a hearing aid.’
- ‘I won’t be able to manage it.’
Well-meaning family and friends may try to push a person with a hearing problem to take action. From Australian Hearing's experience, hearing aids provide most benefit when the hearing-impaired person acknowledges there is a problem and wants the help a hearing aid can provide.
Hearing aids — the whole answer?
Hearing aids have come a long way in the past 10 years. They are smaller, more sophisticated, and can be adjusted to suit individual hearing losses better than in the past. Most people can get great benefit from a well-fitted hearing aid and listening can become a pleasure again.
But hearing aids are only part of the answer. How well a person hears with a hearing aid depends on how well the hearing nerves are able to pass the message from the ear to the brain. A hearing aid amplifies speech, but when the hearing nerves are damaged, the sound may be distorted and still difficult to understand. Louder does not always mean clearer.
Some sounds usually fade before others
When hearing deteriorates with age, sensitivity for high pitch sounds fades first. This means that some speech sounds, such as ‘s’ and ‘f’ and ‘t’, will be harder to hear than others. So words that are quite different can sound the same, such as tea/pea/key, shop/shot/shock and fine/shine/sign. People with presbycusis often say ‘I can hear but I can’t understand’, and this is why.
Misunderstandings: ‘They can hear when they want to’
When it comes to hearing loss, misunderstandings abound. Hearing loss has been called ‘the invisible handicap’ because it cannot be seen by other people. Blindness usually elicits sympathy and concern, while a person who cannot hear well is more likely to experience frustration and impatience from others.
- Difficulty in understanding speech is one of the major problems for older people with presbycusis. This is most noticeable during group conversation, listening to TV or radio, in meetings, church or theatre.
- Background noise can interfere with comprehending speech, and this is even worse when wearing a hearing aid.
- Tinnitus (‘head noises’) is often associated with a hearing loss and can be troublesome for some people.
Helen Keller, who was deaf and blind, once said:
‘The problems of deafness are deeper and more complex, if not more important than blindness. Deafness is a much worse misfortune. For it means the loss of the most vital stimulus, the sound of the voice that brings language, sets thoughts astir and keeps us in the intellectual company of man.’
So be patient with someone who cannot hear well. Speak to them clearly and allow for the need to repeat on occasions, because they probably can't hear when they want to.
What can be done?
The first step is to consult a doctor who will check that there is nothing that requires medical attention. Next, an audiologist can provide a comprehensive hearing assessment. If there is a hearing loss, the audiologist will discuss what can be done to help.
How Australian Hearing can help
Australian Hearing provides expert hearing care for children and most pensioners, veterans and war widows. Australian Hearing offers a range of state-of-the-art hearing aids.
Each person is different and will have different needs and preferences. An individual hearing improvement programme will be developed to suit each person’s communication needs and lifestyle. The fitting of a hearing aid is often part of this programme. Ideas for improving listening will also be explored.
How do I find out more?
For more information and professional advice, call Australian Hearing on 131 797.
Last Reviewed: 01 May 2003
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