Condition Guide
Caring for Someone with a Hearing Impairment
Hearing loss is one of the most common conditions affecting older adults — age-related hearing loss (presbycusis) affects a large proportion of people over 70 to some degree, though it's often under-reported and under-treated, partly because it develops so gradually that it's easy to adapt around without realising how much has changed.
What to look out for
• Asking people to repeat themselves frequently • Turning the TV or radio up louder than others find comfortable • Difficulty following conversation in groups or with background noise • Appearing to ignore people, when the issue is actually not hearing them • Withdrawing from social situations or seeming more isolated • Misunderstanding what's been said, leading to confusion that can be mistaken for a cognitive issue This last point matters: unaddressed hearing loss is sometimes mistaken for confusion or early dementia, when the underlying issue is simply that the person isn't hearing questions or instructions correctly.
Practical care at home
Face the person and get their attention first. Speaking before making eye contact, or from another room, is one of the most common reasons communication breaks down unnecessarily. A light touch on the arm or saying their name first, then speaking clearly once you have their attention, works far better than raising your voice. Reduce background noise where possible. Turning off the TV or radio before talking, or moving to a quieter room, often makes a bigger difference than speaking louder ever will. Speak clearly, not louder or over-enunciated. Shouting distorts speech sounds and can feel patronising; a normal pace, slightly slower than usual, with clear (not exaggerated) mouth movements is easier to lip-read and follow. Check hearing aids are actually in and working. A surprising number of difficulties come down to hearing aids not being worn, having a flat battery, or being clogged with wax — worth checking before assuming a conversation has failed for other reasons. Written backup helps for anything important. For appointments, medication instructions, or anything with real consequences if misheard, writing it down alongside saying it removes ambiguity.
Why continuity of carer matters here specifically
Hearing loss varies a lot by environment, time of day, and which ear is more affected — a carer who knows someone well learns their specific communication preferences (which side to sit on, how they prefer to be addressed, whether they lip-read) far faster than someone meeting them for the first time, and is less likely to mistake a hearing issue for confusion or non-cooperation.
When to seek further help
A GP referral for a hearing assessment is worth pursuing if hearing loss hasn't been formally assessed, if hearing aids no longer seem to help as they once did, or if hearing loss is affecting safety (not hearing a smoke alarm, doorbell, or phone) or contributing to social isolation. Sudden hearing loss, especially in one ear, needs urgent same-day medical attention. This guide is for general information and does not replace advice from a GP, audiologist, or ENT specialist.
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