Hearing loss: the argument about the TV volume

The first sign was not mine. It was my wife turning the television down every evening, and my daughter telling me I was shouting on the phone. I denied all of it for years, because from the inside hearing loss does not feel like losing anything. It feels like everyone else has started mumbling. That is the trick the condition plays on you.

I was fitted with hearing aids at 54, and the first thing I noticed was not a sound I had been missing. It was how much of the conversation I had quietly opted out of, and how tired I was at the end of a family dinner from the effort of following it.

The signs the family notices first

Hearing loss after 40 usually comes on slowly, and it rarely arrives as silence. It arrives as difficulty with certain situations — the words get through but the clarity does not.

• The television or radio volume creeps up and stays there
• Background noise at a restaurant swallows the conversation in front of you
• You ask people to repeat themselves, then pretend you heard the second time
• You avoid group conversations because keeping up is exhausting
• Phone calls become harder than face-to-face conversations
• You feel people are mumbling rather than speaking softly

Why it is worth acting on rather than enduring

Untreated hearing loss does more than make conversation harder. It is linked with withdrawing from social contact, and loneliness in turn sits alongside low mood and cognitive decline in later life. That is the part nobody tells you when they tell you to turn the television down. The isolation is the real cost, and it accumulates quietly while you insist you are fine.

What a hearing test actually involves

I had put it off imagining something unpleasant. It is not. You sit in a quiet room with headphones and respond to tones at different pitches and volumes, then repeat words played at different levels. It takes under an hour and it produces a chart of what you can hear across the range — which, for the first time, showed me my own problem in front of me. In Malaysia you can get this at a hospital audiology department, some Klinik Kesihatan, or a private hearing centre, and the private ones are usually free if you may buy from them.

The honest range of what hearing aids cost

Cost is the reason most people I know still put this off, so here is the range as it was explained to me. Public hospital audiology can supply aids at a heavily subsidised price, with the trade-off of waiting lists and a limited range of models. Private aids run from a few hundred ringgit for a basic model to several thousand per ear for one that handles background noise well and connects to a phone. A basic aid in a quiet room and a good aid in a crowded restaurant are not the same experience, and the difference is what the extra money buys.

Two things matter more than the price tag. First, the fitting: an aid that is properly adjusted to your own audiogram works far better than a more expensive one set up badly. Second, the trial period — ask what it is, and use it in the situations that are hard for you, not just at home in the quiet. I insisted on taking mine to a family dinner before deciding.

If cost is the barrier, start with the public route and ask what is available, because the gap between no aid and a basic aid is much larger than the gap between a basic aid and a premium one. Also protect what you have: earplugs around loud machinery and at noisy events cost almost nothing and protect the hearing you still have.