Deafness and hearing loss

Also called Hearing impairment, Hard of hearing

One in five UK adults. Left untreated it costs conversation, work and, over time, memory.

What it is

Around 12 million adults in the UK have hearing loss. People wait an average of about ten years before doing anything about it, and those ten years are expensive.

There are two broad types. Conductive loss means sound cannot get through, often from wax, fluid or a middle ear problem, and it is frequently fixable. Sensorineural loss means the hair cells in the inner ear are damaged, usually permanently, from age, noise or illness.

The evidence that ought to change behaviour: untreated hearing loss is one of the largest modifiable risk factors for dementia identified by the Lancet Commission. Treating it is not vanity. It is brain health.

Signs you might notice

The television creeping louder. Conversation in a busy room becoming impossible while one-to-one is fine.

Consonants going first, so speech sounds mumbled rather than quiet. People genuinely believe everybody else has started mumbling.

Withdrawal from groups, and a reputation for being aloof that the person did not earn.

In a child: speech delay, inattention that looks like ADHD, or a run of ear infections.

How it can affect day-to-day life

The isolation does the real damage. Following a conversation with hearing loss is exhausting, so people opt out of the pub, the family lunch, the residents' lounge. Then they are described as antisocial.

In care settings, hearing loss is behind a great deal of what gets recorded as confusion or non-compliance. Someone who did not hear the question is not refusing.

And a hearing aid in a drawer helps nobody. Aids need fitting, adjusting and a few weeks of persistence, and that support is the bit most often missing.

Supporting someone well

Get the wax checked first. It is a startlingly common and entirely reversible cause.

Face the person, in good light, and do not cover your mouth. Lip-reading fills more gaps than most hearing people realise.

Rephrase rather than repeat. If a sentence did not land, different words work better than the same words louder.

Cut the background noise. Turn the television off before speaking, rather than shouting over it.

Check the hearing aid actually works. Batteries, tubing, wax in the mould. In a service, make that a daily job with a name against it, not an assumption.

Never test somebody by whispering behind them, and never say it doesn't matter when they ask what was said.

For anybody whose hearing loss sits alongside communication difficulty, Fiducia Talk gives a visual route: symbol cards and a keyboard mean a conversation can happen on a screen rather than at volume.

Where to get help

Free NHS hearing tests are available through a GP referral, and in many areas you can self-refer to audiology directly.

RNID have an online hearing check and a free information line.

Sudden hearing loss in one ear is a medical emergency. Treated within days it can sometimes be reversed, and after a fortnight it usually cannot. Go to A and E or an urgent GP appointment the same day.