Hearing loss or impairment (deafness) is common among older adults, but is increasing in younger adults due to lifestyle choices. Many younger adults appear to be taking their hearing for granted and regularly attend nightclubs, concerts and wear personal stereo systems. While I am not in any way criticizing these activities, at icommunicate we think it is important that younger people know the risks and maybe take a few precautions to protect their hearing. There may be a school of thought out there amongst younger adults, that it does not really matter, because if they get older and they become deaf, they can just get a hearing aid. Hearing aids are getting smaller and are not so noticeable, so maybe they are not seen as something that is much of an issue. However, hearing loss and deafness is an issue! Loosing your hearing is a big deal!  Although technology has moved a long way in recent years, your standard hearing aids do what they have always done, they amplify sound. Amplified sound will never replace real hearing. So, when you are off to watch a concert or go to a club, maybe think about getting some ear-plugs. We know it sounds stupid, but you can get small unnoticeable ones and you’ll be thankful in the morning when your ears are not ringing like church bells. Oh, and turn down the i-pod. Okay, we’ve done our soap box thing now, so let’s talk about hearing.

How does hearing work?

Well, it’s a very complex process and we will explain it in very simple terms here, but elaborate on all aspects of hearing, hearing impairment, assessment and hearing aids at our Dowloads Centre.

Outer Ear

Sounds travel into the ear and reaches the tympanic membrane (ear-drum).

Middle Ear

The tympanic membrane vibrates and sends the vibrations along 3 tiny bones in the middle ear, the malleus, incus and stapes (also called the hammer, anvil and stirrup).

Inner Ear

The vibrations then reach the cochlear and this sends tiny waves through the fluid in the cochlear and displaces a layer called the basilar membrane. The displaced basilar membrane excites minute hair cells. The hair cells send signals along the auditory nerve fibres to the facial nerve.

The Cochlear

Central Auditory Nervous system

The auditory information travels through several processes in the brain to the auditory cortex where the information is processed.

This whole process takes less than a second.

What goes wrong with hearing in adults?

Presbycusis
Hearing impairment will probably happen to many of us eventually, with some studies showing that half the population over 60 experiences some hearing loss. Some studies show that over 300 people in every 1000 Americans is suffering from hearing impairment to some degree.  This type of hearing loss is most likely presbycusis. This is caused by the loss of the tiny hair cells in your cochlear and is part of the aging process, but it can be caused by long term exposure to loud noise either through work or leisure activities. Other things can cause hearing impairment such as a head injury, disease, or even certain medications can be toxic to the hearing system.

Hearing impairment can also occur because of problems in the middle and outer ear. These can be caused by infections, fluid build up in the middle ear, wax blockages in the outer ear or otosclerosis (a calcification around the tiny bones in the middle ear limiting their ability to move).


Tinnitus
Tinnitus can also accompany hearing impairment in later life, with a constant or intermittent sound in one, or both ears.  This sound can be very distracting and unpleasant, especially when trying to get to sleep.  There are a number of different devices that can help with tinnitus such as devices that produce soothing background noise to help with sleep or when trying to concentrate in a very quiet environment.  Some people have also found complementary therapies such as acupuncture may help.  It is always best to discuss any treatments or therapies with your doctor before embarking on them. 

Signs of hearing impairment

There are many signs that you may have hearing loss. Do you find yourself answering "yes" to any of these questions? :

• Are other people claiming that you have the TV or radio too loud?
• Do you find it difficult to hear people when there is background noise or you are in a noisy environment?
• Do you keep asking people to repeat themselves?
• Do other people often sound like they are mumbling?
• Do you find yourself avoiding social situations and feeling stressed when communicating with groups of people?

For more information regarding hearing aids and assessment, see our section Hearing Aids.

Getting help

If you feel there may be an issue with your hearing, go and see your doctor and he will refer you to the relevant health professional, probably an audiologist. The audiologist will assess your hearing and carry out a thorough audiological assessment.  He should be able to pinpoint if, and where any difficulty is occurring in your ear, and the extent of the hearing loss. If there are any difficulties, the audiologist will be able to talk you through the options you have, such as some form of amplification. Local support groups and hearing impairment organizations will provide you with support and information about the services available to you.

Tips to help with communication

There are many things we, and those around us, can do to make life easier when hearing impairment occurs.

• Explain to those around you that you have difficulties with hearing. This will allow others to compensate for, and understand your difficulties.

• Avoid important discussions when you are in an environment with lots of background noise and avoid having important discussions when there is background noise at home (e.g. the washing machine or the TV is on).

• Look at the person when you talk to them, often facial expressions and lip movement can give you lots of cues to help you understand.

• If you are talking to someone with hearing impairment, speak clearly (but not exaggerated) and use your hands to gesture and add cues for the hearing impaired person.

• Look after your hearing aid.

• Investigate local support groups to find out about hearing impairment and the support services available.

For more detailed articles relating to the hearing mechanism, hearing impairment, hearing assessment, hearing aids and cochlear implants, and strategies to facilitate communication following hearing impairment, visit our Downloads Centre.

For more information and resources relating to all aspects of communication difficulties, visit our Resources Centre.

To look at, and purchase books relating to hearing impairment visit our Online Bookshop.