Tips for adults with hearing loss or deafness

Hearing loss is a gradual process, especially in older age. Because of this, people often don't notice that their hearing has got worse. But there are a few telltale signs:

• A lot of people simply turn the TV, radio or telephone up louder than they used to. Does that seem familiar to you, or has anyone mentioned that to you before?
• People whose hearing keeps getting worse sometimes start speaking louder themselves. Has anyone ever pointed that out to you?
• Hearing loss can sometimes also cause noises in your ears, or mean that certain sounds are suddenly uncomfortably loud.
• Have you noticed that you haven’t heard particular sounds for a long time, like crickets chirping or birds tweeting?
• Do you find it difficult to understand people if they whisper or are speaking to you from a distance?
• Do you have trouble recognizing people just by their voice, for example on the telephone or in group conversations?
• Background noises like traffic, other voices or music make it more difficult to listen and understand other people. Do you find it particularly hard to follow conversations in busy, loud places like restaurants, on a bus or train, or at family get-togethers?
• Do you barely actively take part in conversations anymore, and just nod or smile even though you can't understand what other people are saying?
• Do you avoid conversations or contact with others because you feel excluded or awkward and don't like asking them to repeat themselves?

If you think you may have a hearing problem, it's a good idea to seek medical advice – for example, from your family doctor. Other examinations done by an ENT (ear, nose and throat) specialist can then show if you actually have a hearing problem, and what kind.

Depending on which part of the ear is affected, and how badly, a hearing aid or a cochlear implant might be the best option. But not everyone who needs a hearing aid also has one or uses one. Some people do actually have one or two hearing aids, but don’t use them. There are various possible reasons for that. They might not want others to know that they have hearing problems. Or they might find the device uncomfortable or feel unattractive when wearing it. Some are disappointed because they expected the hearing aid to work better, or even allow them to hear just as well as they used to.

It is easier to handle hearing aids if you're well informed – for instance, about the different parts of a device, how to use and clean it properly, and how to change the batteries. You can get this kind of information from support groups or well-written device instructions, for example. To make sure that you don’t forget to wear non-implanted devices (like behind-the-ear hearing aids), it can help to make it part of your daily routine. For instance, you could always put your hearing aid on when getting dressed in the morning.

People who are using a new hearing aid in one or both ears will first hear everything louder. Background noises that you couldn't hear before can then be irritating. Some things might also sound unusual, like your own voice. But people generally get used to these things over time, especially if they use the device every day. Many people who find their hearing aid uncomfortable at first say that wearing it all the time helps to change that too.

Along with hearing aids, there are other technical devices that can make daily life easier: For example, headphones can help you to hear the TV or music loud enough yourself without disturbing other family members or neighbors.

Some things that make sounds (e.g. the telephone, doorbell or smoke alarm) can also be hooked up to something you can see, such as a light that then flashes. Special telephones and apps can turn the caller’s spoken words into written words that you can read.

If you have a hearing aid or cochlear implant, devices known as wireless transmitters can improve your hearing even more. These systems pass acoustic (sound-related) information straight on to your hearing device – for instance, from your TV or radio. They can also be connected to microphones that are then placed close to people speaking at meetings and conferences. In Germany, the costs of these wireless transmitters are covered by statutory health insurers if hearing aids alone don't help enough.

If you can no longer follow conversations, with or without a hearing device, you might soon start to avoid conversations or not join in much. To avoid that, it can help to be open about your hearing problems and ask others to speak loudly and clearly. To keep up with conversation, it is important to ask people to repeat themselves if you missed something. Everyone is different: Some people feel uncomfortable about asking others to repeat themselves often. They may worry about “dictating” how others should speak, too.

It can also help to choose places with little background noise.

Some people lose their hearing completely or still can't hear very much even with a hearing aid. It can then be helpful to learn lip-reading and/or sign language. Lip-reading helps if you want to understand people who don't know sign language. Many news programs provide information in sign language as well. Sign language interpreters are also used at some events (conferences, demonstrations etc.).

Close friends and family are the most important communication partners. They are often the first to notice that you have hearing problems and then eventually persuade you to seek medical advice. After that, they often help you to use hearing aids or go to medical appointments.

Plus, there are things that we can all do to help people with hearing problems understand us better. These include:

• Speaking clearly. There is no need to shout. Trying to speak in a slightly deeper voice, articulating words clearly, and not with your mouth full.
• Reassuring people that you don't mind repeating yourself. When you do repeat yourself, it can be helpful if you use slightly different wording than before.
• Making sure that there aren't too many disruptive background noises. For instance, you could mute or turn off the TV or radio in the room.
• Facing the person you are talking to.
• Making sure that your own face isn't covered or difficult to see when you speak.

This last tip in particular can sometimes be hard to put into practice, especially when wearing special protective equipment for work or face veils, or when covering your mouth and nose to prevent respiratory tract infections. But some alternatives made from see-through materials are available.