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It takes the average person with hearing loss 5 to 7 years before pursuing a qualified professional diagnosis, in spite of the fact that the signs and symptoms of hearing loss are transparent to other people. But are those with hearing loss simply too stubborn to get help? No, actually, and for a few specific reasons.

Maybe you know someone with hearing loss who either denies the difficulties or refuses to seek out professional help, and despite the fact that this is unquestioningly frustrating, it is very conceivable that the symptoms of hearing loss are much more apparent to you than they are to them.

Here are the reasons why:

1. Hearing loss is gradual

In the majority of instances, hearing loss unfolds so gradually that the impacted individual simply doesn’t realize the change. While you would detect an rapid change from normal hearing to a 25 decibel hearing loss (described as moderate hearing loss), you wouldn’t notice the smaller change of a 1-2 decibel loss.

So a slow loss of 1-2 decibels over the course of 10-20 years, while creating a 20-40 total decibel loss, is not going to be noticeable at any given moment in time for those afflicted. That’s why friends and family members are nearly always the first to observe hearing loss.

2. Hearing loss is often partial (high-frequency only)

The majority of hearing loss scenarios are classified as high-frequency hearing loss, indicating that the afflicted person can still hear low-frequency background sounds normally. Even though speech, which is a high-frequency sound, is challenging for those with hearing loss to understand, other sounds can usually be heard normally. This is why it’s quite common for those with hearing loss to state, “my hearing is fine, everyone else mumbles.”

3. Hearing loss is not assessed by the family doctor

People suffering with hearing loss can get a mistaken sense of well-being following their yearly physical. It’s typical to hear people state “if I had hearing loss, my doctor would have told me.”

This is of course not true because only 14% of physicians regularly screen for hearing loss during the annual checkup. Not to mention that the prime symptom for most cases of hearing loss — trouble understanding speech in the presence of background noise — will not present itself in a silent office atmosphere.

4. The burden of hearing loss can be shared or passed on to others

How do you remedy hearing loss when there’s no cure? The answer is simple: amplify sounds. The problem is, even though hearing aids are the most effective at amplifying sounds, they are not the only way to achieve it — which people with hearing loss rapidly identify.

Those with hearing loss commonly crank up the volume on everything, to the detriment of those around them. TVs and radios are played extremely loud and people are made to either scream or repeat themselves. The person with hearing loss can manage just fine with this strategy, but only by transferring the burden to friends, family members, and co-workers.

5. Hearing loss is painless and invisible

Hearing loss is largely subjective: it cannot be diagnosed by visual examination and it generally is not accompanied by any pain or discomfort. If those with hearing loss do not recognize a problem, largely due to the reasons above, then they probably won’t take action.

The only method to accurately diagnose hearing loss is through audiometry, which will determine the precise decibel level hearing loss at numerous sound frequencies. This is the only method to objectively say whether hearing loss is present, but the difficult part is of course getting to that point.

How to approach those with hearing loss

Hopefully, this essay has manufactured some empathy. It is always exasperating when someone with hearing loss refuses to acknowledge the problem, but keep in mind, they may legitimately not understand the severity of the problem. Instead of commanding that they get their hearing examined, a more productive strategy may be to educate them on the components of hearing loss that make the condition virtually invisible.