He often misunderstands what our grandchildren are saying and tells them to slow down when they talk and say it again. He makes it seem as if they're doing something wrong when, in fact, he just can't understand what they're saying -- especially if they're talking quickly or running around when they're talking.

The problem is that he won't admit that he has a hearing problem. When I have brought it up, he says that he's not an old man yet and that he can hear perfectly well. I am starting to get angry about this. Any suggestions?

Dr. Cynthia:

Loss of hearing can be a difficult problem for everyone. It can lead to family discord (as you have so well described), anger, and even depression. It can also cause the person to isolate himself socially if he is embarrassed that he cannot understand what other people are saying. The problem is further complicated when the person does not admit to having a hearing problem. Many people, unfortunately, do not want to admit that they are having trouble hearing and, without intending to, put additional stress on themselves, their friends, and their families.

Somewhere between 10 percent and 33 percent of people between the ages of 65 and 75 have some degree of hearing loss, and the rate is higher among those over 75. It can have many causes, including fluid in the ear, noise, medications, infections and even excess ear wax. However the most common type of hearing loss in older people is "presbycusis" ("older hearing"), a form of sensorineural hearing loss. Often this involves some type of damage to the cochlea, a bony part of the inner ear and the nerves that send the sound signals to the brain. The most common cause, by far, is noise.

People with presbycusis usually have trouble with speech discrimination, particularly when there is a lot of background noise or when more than one person is talking. The hearing loss can start when a person is in his or her 20s, but may not be noticed until much later.

I think that the first step here is to talk to your husband when both you and he are calm (not after he has just criticized one of your grandchildren and you are more likely to be angry). Start by showing him this column so that he can see just how common hearing loss actually is. Next he should make an appointment with his primary care physician to have his ears examined and to get a screening hearing test. His problem may be as simple as impacted ear wax. But if it is not, the primary care physician can refer him to an otolaryngologist (for further testing to see if there is a treatable cause) and to a reputable audiologist.

Treatment can be medical or surgical, but it usually involves some type of amplification, i.e., a hearing aid -- the very thing that your husband probably associates with old age. However, thanks to the marvels of technology, many of the newer hearing aids are much smaller (some almost invisible) and have much-improved sound discrimination. Just make sure when you buy one that you are guaranteed 30- to 60-day return policy in case it doesn't work or your husband doesn't like it.

If your husband continues to deny the problem or if he becomes more withdrawn or irritable, he may also be suffering from a depression, either precipitated or aggravated by the hearing loss. To avoid this complication, I would suggest he consult his family physician as soon as possible.

From Post-Gazette.com