Understanding hearing loss

Why it goes unnoticed

Because it progresses in tiny steps, over years. You turn the television up a little, you pick a table at the back of the restaurant, you phone less. Each adjustment seems harmless; put together, they trace a withdrawal.

That is why relatives almost always notice first. They see the whole picture; the person concerned only sees the latest small adjustment.

The signs to watch for

• You turn the television up louder than others
• In a café you follow the conversation, then lose the thread
• People tell you that you ask them to repeat. Often
• The phone has become hard work, especially with strangers
• A whistle or a buzz keeps you company in the quiet
• High voices, children's and women's, become blurred
• You hear that someone is speaking, but you do not catch the words

Hearing and understanding are two different things

You can perceive the volume of a voice without making out the words. That is in fact the most common case: consonants, which carry meaning, are high-pitched and fragile; vowels, which carry volume, are low and resilient.

Hence the sentence we often hear at the centre: "I hear, but I do not understand." That is precisely what speech audiometry measures, beyond the audiogram.

Why not to wait

The earlier a hearing loss is addressed, the more the brain keeps its ability to decode speech, and the simpler adapting to a device becomes. Waiting does not make fitting easier — it makes it longer.

And sometimes the difficulty is simply earwax. The assessment settles it in under an hour.