“Why is everyone mumbling these days?”
“Can you turn up the television?”
“Sorry, what did you say?”
For many people, hearing difficulties do not begin with a world that suddenly becomes silent.
You can still hear the television. You can hear the phone ringing. You know that someone is speaking to you.
But somehow, the words are not always clear.
Perhaps conversations become harder to follow in a busy restaurant.
At a family gathering, you find yourself struggling when several people are talking at once.
You may start asking others to repeat themselves more often, or rely on subtitles, even though the television already seems loud enough.
And because you can still hear, you tell yourself that your hearing is probably fine.
But hearing is not simply about detecting sound.
Being able to hear that someone is speaking is different from being able to understand clearly what they are saying.
This distinction is something many people do not recognise until hearing difficulties begin to interfere with everyday life.
Hearing, but not understanding
Hearing loss does not always mean that everything becomes softer.
Depending on the type and degree of hearing loss, a person may hear some sounds better than others.
Speech can seem reasonably clear in a quiet room, yet become much harder to understand when there is background noise.
This is why someone with hearing loss might say: “I can hear you, but I can’t understand what you’re saying.”
Sometimes, the problem is first noticed not by the person themselves, but by the people around them.
Family members may complain that the television is too loud.
A spouse may become frustrated at having to repeat the same sentence over and over.
At work, following discussions may become increasingly difficult.
Over time, some people with this problem simply adapt.
They sit closer to the speaker. They watch people’s faces more carefully. They avoid noisy places.
They laugh when everyone else laughs, even when they have missed the joke.
These small adjustments can make hearing difficulties surprisingly easy to overlook.
So rather than asking only, “Can I hear?”, perhaps a better question is: “Can I understand?”
When to check hearing
Because hearing changes can happen gradually, it is not always easy to know when it is time to seek help.
You do not need to wait until hearing becomes “really bad” before having it checked.
Difficulty understanding speech, particularly in noisy environments, is one sign to pay attention to.
You may also notice that you are asking people to repeat themselves more often, turning up the television or phone volume, or feeling that others are constantly mumbling.
Sometimes, listening simply becomes tiring.
Following a conversation may require more concentration than it used to, leaving you exhausted from trying to keep up.
Other signs should not be ignored either.
Ringing or other sounds in the ears (known as tinnitus), a noticeable difference in hearing between the two ears, or a sudden change in hearing, are all reasons to seek professional advice.
Family and friends can also provide important clues.
If the people around you have repeatedly raised concerns about your hearing, it may be worth listening to them, even if you feel that you are managing well.
Having your hearing checked does not automatically mean that you need hearing aids.
It simply helps you understand what is happening with your hearing, and if there is a problem, what options may be appropriate for you.
Role of the audiologist
Mention the word “audiologist”, and not everyone will immediately know what the profession involves.
Some may associate audiologists mainly with hearing tests or hearing aids.
While both are important parts of audiological care, the profession extends well beyond that.
Audiologists are healthcare professionals who specialise in the assessment and management of hearing and balance disorders.
They work with people across the lifespan, from newborn babies and children to adults and older people.
A visit to an audiologist may involve more than simply pressing a button whenever you hear a beep.
The audiologist will usually begin by understanding your concerns and how hearing difficulties are affecting your everyday life.
Different assessments can then help determine whether a hearing problem is present, its type and severity, and whether further medical assessment may be needed.
If hearing loss is identified, the next step is not necessarily the same for everyone.
Depending on the individual, management may include counselling and communication strategies, hearing aids or other hearing technology, auditory rehabilitation, monitoring, or referral to other healthcare professionals.
The aim is not simply to make sounds louder.
It is to help people communicate more effectively and continue participating in the conversations, relationships and activities that matter to them.
World Audiologists Day, observed annually on Oct 10, provides an opportunity not only to recognise the profession, but also to improve public understanding of when and why audiological care may be needed.
Why do we wait?
Recognising a hearing difficulty and doing something about it are not always the same thing.
Many people continue to manage by making small adjustments to their daily lives.
If they can find ways to cope, seeking help may not seem urgent.
There may also be a tendency to accept hearing difficulties as just a normal part of getting older.
“Of course I don’t hear as well as I used to. I’m getting old.”
But while hearing loss does become more common with age, that does not mean we should simply live with its consequences.
Our research involving adults with hearing loss in Malaysia found that the reasons for delaying or not accessing hearing care can be complex.
Limited awareness about hearing loss and available services, financial concerns, and stigma associated with hearing aids, can all influence whether someone seeks help.
Family members can make a difference too.
Sometimes, encouragement from a spouse, child or friend is what finally prompts someone to have their hearing checked.
This matters because the consequences of hearing difficulties extend beyond the ears.
When following conversations becomes difficult, people may participate less.
A lively family dinner can become exhausting.
Someone who once contributed confidently during meetings may begin to stay quiet because keeping up with the conversation has become difficult.
Gradually, it can become easier to withdraw than to keep asking, “Sorry, can you say that again?”
As you can imagine, hearing loss has been associated with communication difficulties, social isolation and loneliness, particularly when it remains unaddressed.
This is why seeking help should not be viewed simply as trying to hear more sounds.
It is about staying connected.
Maintaining connections
We often take hearing for granted when it is working well.
We use it to follow conversations over meals, listen to our children tell us about their day, contribute during meetings, laugh at jokes with friends, enjoy music and respond when someone calls our name.
Hearing connects us to people.
So, in conjunction with World Audiologists Day, perhaps it is worth paying a little more attention to your own hearing or the hearing of someone you care about.
If conversations are becoming harder to follow, if everyone seems to be mumbling, or if listening requires more effort than it used to, do not wait until communication becomes extremely difficult before seeking advice.
A hearing assessment may show that your hearing is within the expected range.
Or it may identify a problem and open the door to appropriate support.
Either way, knowing is better than wondering.
Because ultimately, good hearing care is not simply about how loudly you can hear a sound.
It is about being able to understand, communicate and remain part of the conversations that matter.
Dr Maziah Romli is a lecturer and audiologist at Universiti Sains Malaysia. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
