Signs of Hearing Loss in Parents and How to Raise It Gently

How common it is

Age-related hearing loss, called presbycusis, affects a large share of people over sixty, and the proportion rises steeply with age. The World Health Organization estimates that a large share of people over sixty have some degree of hearing loss. It usually affects both ears, starts with the high pitches (such as consonants like s, f, th and sh in speech) and makes it hard to follow conversation, especially in noise. Other causes include noise exposure over a working life, ear wax, infections, medicines that can harm hearing, diabetes and circulation problems, family tendency and, less often, tumours or other medical conditions. Not all hearing loss is age-related, so a medical check matters.

Signs you may notice at home

In conversation - Asking you to repeat things often ("what?", "eh?"), or answering a different question from the one asked. - Nodding or smiling without following the conversation. - Difficulty following talk in a group, at a dining table, in a market, at a wedding or in a car. - Saying that people mumble, or that women's and children's voices are hard to follow. - Turning one ear towards the speaker, or watching lips and faces closely. - Speaking too loudly, or too quietly.

With sounds and devices - The television or radio turned up louder than others find comfortable. - Missing the doorbell, the pressure cooker whistle, an alarm, knocking, the phone ringing or a kettle. - Difficulty on the telephone, avoiding calls or handing them to others. - Not hearing traffic or horns on a walk, a safety risk. - Not hearing a family member call from another room.

In behaviour and mood - Withdrawing from social events, prayers, gatherings or family meals. - Irritability, frustration or suspicion, such as thinking people are whispering about them. - Tiredness after conversation, because listening takes great effort. - Loneliness, low mood or anxiety. See hearing loss and isolation in later life and depression in older adults. - Confusion or appearing forgetful, when in fact the words were not heard. Hearing loss can look like memory loss, and the two can occur together; see hearing aids and dementia risk: what the evidence says.

Physical signs - A feeling of fullness, blockage or ringing in the ear, see ringing in the ears (tinnitus) at home. - Dizziness or balance problems. - Ear pain, discharge or itching.

Signs that need urgent medical attention

Sudden hearing loss in one or both ears, within hours or a few days, whether or not other symptoms are present, is a medical emergency. It can be caused by a problem of the inner ear or its nerve, and early treatment may improve the outcome. Go to a doctor or an ENT emergency the same day or the next; do not wait for a routine appointment.

Seek urgent care also for:

• Hearing loss with severe dizziness, vomiting, facial droop, weakness, slurred speech or confusion; call 112, as this may be a stroke.
• Hearing loss after a head injury or a blast.
• Ear discharge with fever, severe pain, swelling behind the ear, or a stiff neck.
• Blood or clear fluid from the ear.
• Hearing loss in one ear only with ringing or a feeling of fullness that develops over weeks, which should be checked by an ENT doctor to exclude other causes.

Possible reasons the doctor will look for

• Ear wax blocking the canal, a common and treatable cause; see ear wax and hearing: safe care.
• Fluid or infection in the middle ear.
• Eardrum problems.
• Age-related inner ear change.
• Noise-induced damage.
• Medicines that affect hearing, such as some strong painkillers, certain antibiotics, water tablets and chemotherapy drugs. Do not stop any medicine; ask the doctor.
• Diabetes, high blood pressure, kidney disease and circulation problems.
• Other conditions, assessed by the ENT doctor.

Raising it gently

Families often put it off, afraid of hurting a parent's pride. Some suggestions:

• Choose the moment: a quiet, private time when your parent is relaxed, not in front of others or during an argument about the television volume.
• Start with care, not criticism: "I have noticed you seem to be missing out at dinner, and I wonder if it is tiring for you" is better than "you never listen".
• Use specific, kind examples: "at the wedding you seemed to be finding it hard to follow."
• Ask about their experience: "Do you find it hard to hear in noisy places?"
• Avoid blame, shouting or teasing.
• Link to benefits: hearing well makes it easier to enjoy grandchildren, the phone, prayers, films and conversation, and may help safety.
• Offer a simple step: "Shall we go together for a hearing check, like an eye check?" Frame it as routine, since tests are painless.
• Expect resistance: many people deny the problem at first. Be patient and revisit gently. A trusted doctor, friend or another person with hearing aids can sometimes help.
• Respect their choices, while making sure they understand the risks of ignoring it.
• Be a good communicator yourself; see talking with someone who is hard of hearing.

A quick screening at home

You may try a few observations over a week:

• How loud is the television compared with your own comfort?
• Does your parent follow a conversation in a quiet room, versus a noisy one?
• Do they respond when you speak from behind or from another room (with normal voice, not shouting)?
• Do they hear the phone, doorbell and kitchen sounds?
• Do they say "what?" more often than before?

Write down examples to share with the doctor. Online or phone-app hearing checks may suggest a problem, but they are not a diagnosis; use them only as a nudge to see a professional.

Getting a test

Book a full hearing test with an audiologist or an ENT doctor, who can look in the ears, test hearing and advise on treatment. See a hearing test: what to expect. If your parent resists, offer to go along, or to have a combined check-up with eyes and general health; see a hearing and vision check-up schedule after 60. Bring a list of medicines and describe the observed problems.

What happens next

Depending on the result, the plan may include wax removal, treatment of infection, review of medicines, hearing aids, assistive devices such as TV headphones and amplified phones, communication strategies, and follow-up. See hearing aids: types, costs and how to choose, TV headphones and streamers for hearing loss and amplified phones and phone settings for hearing loss.

Safety issues for a parent with hearing loss

• Smoke, gas and fire alarms may not be heard; consider flashing or vibrating alerts and a family check. See smoke and gas safety for older adults.
• Traffic: take care crossing roads, and in lanes with two-wheelers.
• Doorbell and callers: consider a flashing doorbell, and discuss doorstep fraud; see preventing scams and doorstep fraud.
• Emergency calls: a phone with amplification or text options; see phone accessibility features for seniors.
• Hospital visits: tell staff about the hearing loss, and bring aids and spare batteries.

When to ask a professional

Ask the family doctor for an ear check and a referral to an ENT doctor or audiologist. Seek urgent care for sudden loss. Ask the doctor to review medicines and conditions such as diabetes and blood pressure. If your parent is also having vision problems, ask about a check of both; see hearing and vision loss together: practical support. Call 112 for sudden hearing loss with weakness, facial droop, speech difficulty, severe dizziness or confusion.