It takes the average person with hearing loss 5 to 7 years before pursuing a professional diagnosis, notwithstanding the fact that the warning signs of hearing loss are transparent to other people. But are those with hearing loss just too stubborn to get help? No, actually, and for a couple of different reasons.

Maybe you know someone with hearing loss who either denies the issue or declines to seek professional help, and although this is undoubtedly frustrating, it is very possible that the indicators of hearing loss are much more obvious to you than they are to them.

Here are the reasons why:

1. Hearing loss is gradual

In most examples, hearing loss takes place so slowly that the afflicted individual simply doesn’t perceive the change. While you would recognize an rapid change from normal hearing to a 25 decibel hearing loss (characterized as moderate hearing loss), you wouldn’t detect the lesser change of a 1-2 decibel loss.

So a slow loss of 1-2 decibels over the course of 10-20 years, while producing a 20-40 total decibel loss, is not going to be noticeable at any given moment in time for those afflicted. That’s why friends and family are virtually always the first to observe hearing loss.

2. Hearing loss is often partial (high-frequency only)

The majority of hearing loss cases are categorized as high-frequency hearing loss, indicating that the afflicted person can still hear low-frequency background sounds normally. While speech, which is a high-frequency sound, is challenging for those with hearing loss to comprehend, other sounds can usually be heard normally. This is why it’s not uncommon for those with hearing loss to say, “my hearing is fine, everyone else mumbles.”

3. Hearing loss is not assessed by the family doctor

Individuals struggling with hearing loss can obtain a false sense of well-being following their annual physical. It’s common to hear people say “if I had hearing loss, my doctor would have told me.”

This is of course not true because only 14% of physicians routinely screen for hearing loss during the yearly checkup. Not to mention that the prime symptom for most cases of hearing loss — difficulty comprehending speech in the presence of background noise — will not present itself in a calm office atmosphere.

4. The burden of hearing loss can be shared or passed on to others

How do you address hearing loss when there’s no cure? The answer is straight forward: amplify sounds. The problem is, while hearing aids are the most effective at amplifying sounds, they are not the only way to accomplish it — which those with hearing loss quickly find out.

Those with hearing loss frequently turn up the volume on everything, to the detriment of those around them. TVs and radios are played extremely loud and people are made to either shout or repeat themselves. The person with hearing loss can get by just fine with this approach, but only by transferring the burden to friends, family members, and colleagues.

5. Hearing loss is painless and invisible

Hearing loss is mainly subjective: it cannot be diagnosed by visible assessment and it normally is not accompanied by any pain or discomfort. If people with hearing loss do not perceive a problem, chiefly because of the reasons above, then they probably won’t take action.

The only method to accurately diagnose hearing loss is through audiometry, which will calculate the specific decibel level hearing loss at many sound frequencies. This is the only way to objectively say whether hearing loss is present, but the challenging part is of course getting to that point.

How to approach those with hearing loss

Hopefully, this essay has established some empathy. It is always exasperating when someone with hearing loss refuses to admit the problem, but keep in mind, they may legitimately not grasp the magnitude of the problem. As an alternative to commanding that they get their hearing examined, a more reliable method may be to educate them on the elements of hearing loss that make the condition practically invisible.

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