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

Perhaps you know someone with hearing loss who either denies the concern or declines to seek out professional help, and while this is undoubtedly frustrating, it is very likely that the warning signs of hearing loss are much more obvious to you than they are to them.

Here are the reasons why:

1. Hearing loss is gradual

In the majority of cases, hearing loss comes about so gradually over time that the impacted individual simply doesn’t notice the change. While you would become aware of an quick change from normal hearing to a 25 decibel hearing loss (specified as moderate hearing loss), you wouldn’t detect the smaller change of a 1-2 decibel loss.

So a gradual loss of 1-2 decibels over 10-20 years, while generating a 20-40 total decibel loss, is not going to be perceptible at any given moment in time for those impacted. 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 instances are classified as high-frequency hearing loss, meaning that the affected individual can still hear low-frequency background sounds normally. Whereas speech, which is a high-frequency sound, is challenging for those with hearing loss to comprehend, other sounds can usually be heard normally. This is why it’s common for those with hearing loss to claim, “my hearing is fine, everyone else mumbles.”

3. Hearing loss is not assessed by the family doctor

People struggling with hearing loss can obtain a false sense of well-being after their annual physical. It’s quite common to hear people say “if I had hearing loss, my doctor would have told me.”

This is of course not true because only 14% of physicians routinely screen for hearing loss during the yearly checkup. Not to mention that the prime symptom for the majority of cases of hearing loss — trouble comprehending speech in the presence of background noise — will not present itself in a quiet office setting.

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 easy: amplify sounds. The issue is, although hearing aids are the most effective at amplifying sounds, they are not the only way to achieve it — which individuals with hearing loss quickly identify.

Those with hearing loss oftentimes turn up the volume on everything, to the detriment of those around them. TVs and radios are played exceptionally loud and people are made to either scream or repeat themselves. The individual with hearing loss can manage just fine with this strategy, but only by passing on the burden to friends, family members, and colleagues.

5. Hearing loss is painless and invisible

Hearing loss is mostly subjective: it cannot be diagnosed by visible investigation and it normally is not accompanied by any pain or discomfort. If people with hearing loss do not perceive a problem, largely due to the reasons above, then they likely won’t take action.

The only method to properly diagnose hearing loss is through audiometry, which will determine the exact decibel level hearing loss at various sound frequencies. This is the only way 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 article has generated some empathy. It is always exasperating when someone with hearing loss refuses to acknowledge the problem, but remember, they may legitimately not understand the magnitude of the problem. Instead of demanding that they get their hearing tested, a more effective approach may be to educate them on the characteristics of hearing loss that make the condition practically invisible.