Any discussion about hearing loss with many seniors and the elderly can be touchy, including discussion about which are the best hearing aids for seniors!. Very often there tends to be a denial of the reality.
If this sounds familiar, and you are reading this article, then it means that you probably already have some concerns, and have finally decided that saying “No” one more time is no longer an option. Hence you are searching for articles that will enlighten you….
What are the degrees of hearing loss? Am I just at the initial stages or further advanced? These are all important questions.
Prior to researching for the best hearing aids for seniors on the market, you need to first understand the basics of hearing including what is referred to as the 5 degrees of hearing loss.
This is really not as complicated as you may think.
This article will walk you through a simple yet science based review of the fundamentals you need to know such as: Why do we have two ears?, How do they work in the hearing process?, What causes hearing loss?, and a host of other questions.
You are unique, so bear in mind that not all hearing loss will be the same, and that treatment and type of hearing aid will depend on the degree of hearing loss.
Some Important Terms To Understand
Before seeking professional advice about your hearing, it is a good idea to understand some medical terminology used in the measurement of sound which you will encounter.
Decibels and Hertz are used to measure the severity (acuteness) of hearing loss.
- Decibels (dB): The term Decibel measures loudness. It refers to how loud sound needs to be for you to hear it. Hearing loss is classified based on the minimum sound level a person can detect measured in dB
- Hertz (Hz): Measures frequency or pitch of sound. It is used to determine which frequencies are more difficult for you to hear.
Examples of Everyday Sounds:
Check out this really great infographic Noise meter resource (https://www.nidcd.nih.gov/health/listen-infographic) titled “Listen Up! Protect Your Hearing” from the National Institute on Deafness and Other Communication Disorders (NIDCD).
The article was primarily written to target teens and young adults who typically love listening to very loud music.
There are 12 different sounds in the noise meter. Remember to turn down the volume of your computer speakers BEFORE you select a sound to listen to as some of these sounds are REALLY LOUD and over the safe threshold of 85 dB.
Over time, any sound that’s 85 decibels or higher can cause hearing loss — or other hearing problems, like tinnitus (a continuous ringing sound in the ears).
A real eye opener is the fact that certain sounds we sometimes encounter in our everyday lives are actually above this safe level as listed below:
LAWNMOWER: 90 -100 dB
MOVIE THEATER: 70 – 104 dB
MOTORCYCLE: 80 – 110 dB
SPORTS EVENTS (Like football or hockey games): 94 – 110 dB
HEADPHONES: 96 – 110 dB
ROCK CONCERTS, PARTIES OR NIGHTCLUBS: 95 – 115 dB
SIRENS – FIRE TRUCK, POLICE CAR, AMBULANCE: 110 – 129 dB
FIREWORKS & FIRECRACKERS: 140 – 160 dB
How do We Hear?
There are three parts to the ear –
(1) the visible outer ear called the pinna and the ear canal;
(2) the middle ear which is not visible is made up of the eardrum and three tiny bones called ossicles and,
(3) the inner ear housing a snail shaped cochlea, the hearing nerve and the semi-circular canals that assist with balancing.
Your natural hearing depends on each of these three parts working well together. Hearing occurs when sound travels through the outer, middle and the inner ear. A problem in any one of these parts can result in some degree of hearing loss.
You also have two ears which must function together as a team to locate sound, direct it to the brain and distribute the volume so that you receive a balanced audio. Having two ears makes it easier to understand speech and communicate with others.
So How Do These All Work Together?
- Sound enters as sound waves through the externally visible outer ear. Imagine waves on a beach……smaller waves are more gentle, while larger waves can be quite strong. The same is true for sound waves. The louder the sound, the larger the sound wave.
- The outer ears on the sides of your head help to collect sound waves which then travel down your ear canal towards the eardrum in the middle ear causing it to vibrate.
- This pulsation causes movement in the three middle ear bones (ossicles) making the sound vibrations bigger.
- The vibrations move through the last tiny ossicle into the first part of the inner ear called the cochlea. This is where the most fascinating aspect of this entire process occurs.
- The cochlea is filled with fluid and has an inner lining of tiny hair cells. Once the vibrations reach the cochlea, they cause movement of the fluid within it creating electrical signals that travel to your brain through the hearing nerve. Damaged hair cells in the cochlea are unable to transmit signals to the brain.
- Finally, the brain helps you to recognize and interpret the signals to determine how you will respond – with speech or take flight (in cases of loud noises when you are frightened).
It is obvious that damage to the hair cells in the cochlea and any inability to effectively collect and move sound waves through the outer and middle ears will result in varying degrees of hearing loss.
The Main Culprits Of Hearing Loss
Loud Noise: Hair cells in the cochlea can be easily damaged by loud noise. Let’s return to our analogy with waves on the beach. When large or huge waves hit against the shoreline of the beach with force (like a tsunami), anything in their way can be damaged.
The same is true for sound waves created by loud noise.
These sound waves move the hairs in the inner ear more and also very vigorously sometimes causing damage to them. Unfortunately, once damaged, these hair cells cannot be repaired and your hearing will be impacted.
Many seniors and the elderly complain of “ringing in the ears” which is also called tinnitus. This is an early sign of hearing loss induced by loud noise.
Ongoing noise can create a similar effect.
Because of the damage to the hair cells in the cochlea, only hearing aids or other devices can improve the degrees of hearing loss.
Age: As people grow older, it is quite normal and common to lose some efficiency in the functioning of the hearing apparatus.
Look at it as part of the “wear and tear” on this enormous human machine we call the body, just like the wear and tear on your “old reliable” car which you love and don’t want to give it up, hence you take it to the mechanic to replace the worn down parts.
The same is true of our hearing. Parts may get worn due to age, resulting in age-related hearing loss but you certainly don’t want to give up your hearing!. In this case, seniors will benefit from the use of hearing aids or other devices and in some cases, even surgery.
Other Causes: These include illness, genetics, trauma, and certain medications. We will discuss these more thoroughly in a future post.
The 5 Degrees Of Hearing Loss And Choice of The Best Hearing Aids For Seniors
When you visit a hearing professional, they take measurements of your sound dB (decibels) and Hz (hertz) to assess the degree of hearing loss you have in each ear.
The results are used to produce audoigrams to match you to one of the 5 degrees of hearing loss used within the profession to determine the type of treatment to apply. To put this in context, the higher the decibel, the higher the degree of hearing loss.
The general classification presented here is from the American Speech Hearing Language Association (ASHA). Source: Clark, J.G (1981): Uses and abuses of hearing loss classification. ASHA Volume 23, pp 493 – 500. Some literature reviewed showed some very minor differences in classification based on the magnitude of the decibels.
Normal Hearing – People with normal hearing can hear sound vibrations as low as a range of minus 10 – 15 dB. Listening to sounds at and above 85 dB for more than 8 hours at a time can result in any one of the 5 degrees of hearing loss listed below. The threshold of experiencing pain in the ears begins at 140 dB.
Degree 1. Slight Hearing Loss
- Hear conversational speech and other sounds above the range of 15 – 25 dB and struggles to listen to really soft-spoken conversations and sounds.
- Have difficulty hearing quieter sounds below this range such as like whispering, rustling of leaves or the consonants on the ends of words like “trees”, “bees”, “dish”, “please”.
Degree 2. Mild Hearing Loss
- Have difficulty understanding certain words when there is a lot of background noise. This occurs for hearing loss between 26 – 40 dB.
Degree 3. Moderate Hearing Loss
- Frequently ask people to repeat themselves during any conversations (person-person-person or over the phone). They generally cannot hear sounds or conversations lower than 40 – 69 dB.
Degree 4. Severe Hearing Loss
- Can only hear loud conversations and sounds between 70 – 94 dB
- They are unable to hear any conversations at normal levels without using hearing aids or amplifiers
- They may rely on lip-reading to understand conversations
Degree 5. Profound Hearing Loss
- They cannot hear any conversational speech
- They can only hear extremely loud sounds above 95 dB which is already above the threshold (85 dB) of sound that can cause damage to hearing.
When hearing loss occurs between the moderate and severe ranges, the degree of loss is classified as moderately severe hearing loss and if it falls between severe and profound, it is classified as severely profound.
The 5 Degrees Of Hearing Loss Are The Basics
As the pieces of the jig-saw begin to fit together, knowledge of the basics and the degrees of hearing loss will make you a more confident senior.
You can then take the next step toward acquiring the best appropriate hearing aid which is booking an appointment with your hearing professional.
The next post will address frustrations with “ringing in the ears” experienced by many seniors and the elderly.
If you enjoyed reading this article or have an experience or comment you would like to share, kindly engage by leaving it below in the Comment box.
Some References For The Best Hearing Aids For Seniors
1. Degree of Hearing Loss (2020) https://www.asha.org/public/hearing/Degree-of-Hearing-Loss/
2. WHO-ITU global standard for safe listening devices and systems (2020) https://www.who.int/deafness/make-listening-safe/standard-for-safe-listening/en/.
3. Hearing loss and deafness: Normal hearing and impaired hearing (2017) https://www.ncbi.nlm.nih.gov/books/NBK390300/
4.WHO Deafness and Hearing Loss (2020) https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss