Dealing with hearing loss in older people

Reviewed by Dr Patrick Ruane

Do you suspect your parent or elder relative is having problems with their hearing?  Perhaps you’ve noticed the volume turned up high on their tv, or that they are increasingly ‘tuning out’ during family dinners or gatherings. It’s quite possible, however, that when you bring it up or question them about it, they deny that anything is wrong.

Many older people do not want to admit they have trouble hearing, and resist the idea of wearing a hearing aid for fear of looking ‘old’. But the reality is that 71% of people in the UK aged 70 years and older have hearing loss. Age-related hearing loss occurs gradually over the years, so people don’t always notice until their hearing loss has advanced significantly.

If your parent or elder relative does have hearing loss, it’s really important to get it properly diagnosed and addressed as early as possible, as hearing loss that is ignored and untreated can have serious implications for their health and wellbeing, including increasing their risk of dementia. 

Read on to learn how you can spot the signs of age-related hearing loss, and support your parent or relative to get the help they need to improve their ability to hear.

What causes hearing loss in older people?

Age-related hearing loss, also known as presbycusis, occurs in both ears and typically impacts the ability to hear high-pitched sounds such as a microwave ‘ping’ or a mobile phone ring, versus low-pitched noises. This type of age-related hearing loss is usually primarily caused by changes to the sensory receptors in the inner ear.

Other factors that can cause or contribute to hearing loss in older age include repeated historic exposure to loud noise, genetics, health conditions such as diabetes and heart disease, side effects from medication, and buildup of earwax.

What are common signs of hearing loss in older people?

As age-related hearing loss normally happens slowly over time, it can often go unnoticed for several years and its signs can be misunderstood. But it’s important to be alert to signs of hearing loss and to get it assessed and treated early, as a delayed diagnosis can have significant consequences for health and wellbeing, including an increased risk of dementia.

Here are the common signs and symptoms you should look out for:

  • Trouble understanding when talking to people over the phone
  • Difficulty following a conversation when two or more people are talking
  • Unable to focus when in a noisy environment such as a restaurant
  • Constant complaints that other people don’t speak clearly or are mumbling
  • Asking people to repeat themselves, especially children or people with higher pitched voices
  • Watching the TV with the volume on high

Impact of undiagnosed and untreated hearing loss in older people

It is so important that hearing loss in old age is taken seriously and addressed.

In addition to just being a general frustration for your relative and everyone in the family, hearing loss can lead to serious mental and cognitive health consequences for your parent or elder relative if it is not addressed promptly and managed effectively.

As well as being more likely to experience emotional distress and loneliness, older people with hearing loss have at least double the risk of developing dementia and are twice as likely to develop depression compared to older people with normal hearing.

On a day-to-day basis, hearing loss can also make it difficult for older people to independently handle everyday tasks. For example, they may have difficulties comprehending what their doctor is saying about their health or understanding and managing important legal or financial information.

Hearing loss – even when it is mild – is also linked to an increased risk of falls.

Where can you get your parent or elderly relative’s hearing tested?

NHS

To get a hearing test on the NHS, and a free hearing aid if it’s needed, your first need to book an appointment with their GP surgery.  During the appointment you and / or they should explain to their doctor what signs of hearing loss they are showing. Their GP will then examine their ears and check their overall health for other possible causes of hearing loss, such as ear infection.  If they can find no obvious alternative cause for the hearing loss, they should then refer your parent for a hearing assessment with either a hearing specialist (audiologist), or an ear nose and throat (ENT) specialist. NHS audiologists are usually based in hospitals, but there are also ‘community’ audiologists in some high street pharmacies and opticians. However, it can take several weeks from a GP referral to see a specialist for a hearing test.

Other options

If you find it challenging to get them a GP appointment and / or don’t want to go via the NHS, you have a couple of other options to test their hearing.  

  • High street pharmacy or optician – Lots of pharmacies and opticians offer free hearing tests, including certain branches of Boots and Specsavers. In selected parts of the country, some will also send one of their audiologists to conduct the hearing test in the comfort of your parent or relative’s own home. Although the tests are free, you will normally need to pay for a hearing aid if it’s determined that one could help.
  • Private audiologist or hearing clinic – there are many private audiology clinics across the UK that offer comprehensive hearing assessments. However, these private services may involve a cost. If your parent or relative has a private hearing test and it shows they need hearing aids, you can either buy them directly from the clinic, or you can contact their GP for a referral to an NHS audiology service to get them for free.
  • Online hearing test – If your parent or relative needs some encouragement or persuasion to get their hearing tested, the RNID (Royal National Institute for Deaf People) has an online hearing test your parent or relative could do, that takes just 3-minutes. It is not the same as a full hearing test conducted by an audiologist, but will help you find out if your relative needs to see someone about their hearing, and gives advice on what to do next.

General age-related hearing loss has no cure or specific treatment to reverse the loss, but there are assistive devices and techniques that can help people hear better.

These devices include:

  • Hearing aids – Hearing aids come in all shapes and sizes, and modern ones are much smaller and less noticeable than they used to be. Some even fit entirely inside the ear.  Although hearing aids don’t restore hearing back to normal, they will make sounds louder and clearer and reduce the risk of health consequences from hearing loss.  A recent analysis of several studies found that people who used hearing aids had a lower risk of long-term cognitive decline compared to people with uncorrected hearing loss.
  • Telephone amplifiers – Telephone amplifiers increase the volume of a caller’s voice and can be fitted to landline or mobile phones.
  • Assistive listening devices (ALDs) – ALDs are designed to improve sound transmission and reduce background noise, making it easier for people with age-related hearing loss to hear in specific situations, such as in a restaurant, watching TV or listening to the radio.

The RNID shop has many different devices to help with hearing loss.

If an elderly person has profound hearing loss and hearing aids do little to help, then cochlear implant surgery may be offered.

How much do hearing aids cost in the UK?

NHS hearing aids

The NHS provides hearing aids free of charge to those that need them.  If your parent or elder relative’s hearing test has been conducted by an NHS audiologist, and their assessment shows that a hearing aid would be helpful, then they will be eligible for a free hearing aid on the NHS.

However, the choice of hearing aid styles and models available through the NHS is limited, and there may be long waiting times for fittings.

If they want to be able to choose from all hearing aids models, including those with the latest hearing aid technology and modern styles, then they will need to go private and purchase one.

Private hearing aids

Private hearing aid costs vary widely depending on the brand, type of hearing aid and features. Costs can range from a few hundred pounds to several thousand, and typically include the hearing aid device itself, along with any necessary assessments, fittings, and follow-up appointments. It’s important to consider ongoing costs as well, such as maintenance, batteries, and potential future adjustments. Additionally, some private providers may offer financing options.

Hearing Aid UK is a good organisation to contact when buying a hearing aid in the UK that offers value for money. They are the largest network of independent audiologists, with over 200 clinic locations and supply hearing aids from all manufacturers, without bias. 

Getting your elder relative to wear their hearing aid

While hearing aids can help older people with hearing loss hear better and prevent risk of cognitive decline, they can only help if they actually wear them! If your parent or elder relative has a hearing aid but refuses to wear it, you are not alone.

Many older people are resistant to wearing hearing aids. When you use hearing aids for the first time, everyday sounds may seem quite loud and it can take some time for people to get used to wearing hearing aids. Vanity and fear of stigma can also cause someone to avoid wearing their hearing aid.

Overcoming resistance to wearing hearing aids requires a combination of understanding, patience, and effective communication.

Start by having an open and honest conversation with your parent about their concerns and reservations. Address any misconceptions they may have and emphasise the positive impact that consistent use of the hearing aid can have on their overall health and well-being, including reducing their risk of dementia. Consider involving other family members or seeking the assistance of a healthcare professional to provide additional support and information. Additionally, encourage your parent to participate in activities where the benefits of wearing the hearing aid are more noticeable, such as family gatherings or social events.

If your parent or elder relative persists in not wearing their hearing aid, you might need to use slightly harsher tactics in order to drive the message home, such as refusing to repeat yourself.

Other ways to support your parent to hear better

Family and friends can make some very minor behavioural adjustments that can be incredibly helpful for someone with hearing loss:

  • Facing your parent or elder relative when you speak to them can make it a lot easier to get visual clues and help with the context of what you are saying.
  • Choosing restaurants and cafes that have low background noise when taking them out
  • Making an effort to speak more slowly and clearly when you talk with them

In summary

Hearing loss is incredibly common in old age, and it’s important to recognise and act on the signs. If you suspect your parent or elder relative is experiencing hearing loss, encourage them to get it checked. The earlier that hearing loss can be addressed with hearing aids and devices, the better. Undiagnosed and unmanaged hearing loss is not only frustrating for your parent and those around them, it can have serious implications for their health and wellbeing, including increasing their risk of depression and dementia.

If your parent is assessed and diagnosed with hearing loss, it may take time for them to accept and adapt to using hearing aids. Family and friends should support them with patience and encouragement, and make sure to communicate in ways that help them to hear.

Common questions

  • How do you get a hearing aid for free in the UK?

To get a hearing aid for free in the UK, you need to have your hearing tested and assessed by an NHS audiologist and deemed eligible for a hearing aid. To get an appointment with an NHS audiologist, you need a referral from an NHS GP.

  • Can age-related hearing loss be prevented?

Age-related hearing loss is believed to be caused by a combination of factors, and there is no definitive way to prevent it. However, there are things you can do to protect yourself from noise-induced hearing loss, including maintaining safe volume levels when using headphones, and limiting prolonged exposure to loud noises.

  • What is the best hearing aid for older people?

The best hearing aid for an older person depends on a number of factors, including their specific hearing needs, lifestyle, dexterity, budget, and style preferences. For example, while smaller aids may be more discrete and easier to get in your ear, they can be fiddly to adjust because of the very small controls.Two brands whose hearing aids are commonly rated highly by audiologists are Oticon and Starkey, however, it’s important to consult with an audiologist or hearing healthcare professional to determine the most suitable hearing aid for their unique circumstances.

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