Listen up, people.

Hearing loss is a thing, and it is treatable.

If you can’t communicate with people, you’ll become isolated and miserable. Yet, countless people lose their hearing as they age and refuse to do anything about it. Maybe you’re inching the volume up on the TV and complaining about how all the youngs mumble these days. Or maybe you’re dealing with a relative who cannot hear you and refuses to have a conversation about it.

A few subscribers have asked me to look into this topic. The first thing, and probably the most important thing to share with those stubborn loved ones, is that hearing aids have improved dramatically. Yes, they are expensive, but nowadays, they are expensive and effective for most people with age-related hearing losses. For the cheapskates among us, there are ways to turn earbuds into hearing aids for certain situations.

The second thing to share with them: unaddressed hearing loss can lead to dementia. Researchers at Johns Hopkins looked at 2,400 older adults and found that the prevalence of dementia among the 853 participants with moderate to severe hearing loss was 61 percent higher than for participants with normal hearing. Hearing aid use lowered the prevalence of dementia by 32 percent.

Can you prevent hearing loss?

According to the CDC, most age-related hearing loss is caused by repeated exposure to loud noises. Using ear protection can reduce this risk. There are a ton of different, effective ear plugs on the market, at just about every price level from cheap foam plugs to expensive earbud-style plugs used by musicians. (I’ve heard good things about Loops.) If you’re going to light off fireworks or go to concerts, you need earplugs.

Certain health conditions, such as diabetes and high blood pressure, are associated with hearing loss in older people. Getting those under control can protect your hearing. Some hearing loss seems to be genetic, and certain medications, especially chemotherapy drugs, can interfere with ear function. Because different health conditions come into play, people who are concerned about their hearing should talk to their doctor.

Do you have a problem?

It’s true, sometimes people do mumble from the next room and blame your hearing when you can’t understand them. Sometimes, you’re in a bar where the music is so loud that you literally cannot make out what the person across from you is saying. But sometimes, someone is sitting right next to you, and you cannot hear them, and it’s your fault.

There are online hearing tests. They aren’t perfect, as the results will vary with the quality of the earbuds, the computer, and the background noise level. I found one offered by the Australian government that doesn’t require you to share an email address. I scored at the low end of normal for my age, which is about what I expected. If your results seem unexpected or indicate a problem, make an appointment with an audiologist to get more precise results.

If someone in your life should have a hearing test, try this: tell them that when they pass, they can lord it over you forever. Isn’t proving that you don’t have a problem better than just saying that you don’t have one?

Do you want to kludge a solution?

There are low-cost, do-it-yourself ways to deal with hearing loss. Imperfect, yes, but they may help someone who has trouble hearing and who doesn’t have a lot of money. They also work as a good experiment: if you try these methods and they help, then maybe you have enough of a hearing problem that you need to call on a professional.

• Learn to lipread: Lipreading is deeply flawed but not worthless. Estimates are that a skilled lipreader can understand about 30% of spoken language. A speech-language pathologist can be helpful here, but one do-it-yourself technique (according to people on Reddit, at least) is to watch the TV news with the sound off and see how much you can understand. Newsreaders look at the camera, articulate clearly, and speak in complete sentences. The graphics and Chyrons offer powerful context clues. If you start paying attention, you may find that you can improve your ability to understand what people are saying.

• Use your earbuds: Earbuds are super helpful for listening to music or conducting phone calls. They can also function as hearing aids by people with mild to moderate hearing loss. Sneaky, huh? Samsung Galaxy Buds2 Pro earbuds work a lot like hearing aids. Google’s free Sound Amplifier app for Android phones allows any earbuds to be used as hearing aids for one-to-one conversations. And Apple has been working on different ways to use AirPods as hearing aids.

• Use live captions on your phone: Android and Apple phones both have Live Caption settings that generate transcriptions of words spoken around you. An app, Otter.ai, helps with notetaking. I use Otter.ai to record interviews, and it works in other settings, too. These apps can be a big help when you’re struggling to hear at a meeting or a talk. Don’t try it in a movie theatre, though. You might get thrown out.

Are you ready to do this thing?

Hearing aids can help a broader range of people than earbuds can. They can be set precisely and adjusted as needed. Some are tiny and available in a range of skin tones to be almost invisible. The problem is, they aren’t cheap, and they often aren’t covered by insurance. When you get hearing aids, you can also get insurance against loss, and that might be a good idea: hearing aids occasionally end up in the laundry or chewed up by pets.

• OTC hearing aids: In 2022, the FDA approved the sale of over-the-counter hearing aids. These are much less expensive than prescription hearing aids, ranging from about $250 to about $2500. With most models, you adjust them yourself with the help of phone apps. These are a good option if cost is an issue and if you’re willing to experiment a bit to find the right settings.

• Prescription hearing aids: The gold standard, often costing well over $4000. That price covers custom fitting and help in learning to use hearing aids. After all, a hearing aid is useless if it sits in a drawer. Prescription hearing aids treat a much wider range of hearing loss situations than OTC hearing aids, too. I know people who bought their prescription hearing aids at Costco and were happy.

• Cochlear implants: Used for people with profound hearing loss, which includes some people who have age-related hearing loss. Part of the hearing aid is implanted under the skin, and the other part is worn behind the ear like a traditional hearing aid (so not invisible). See your doctor if you want to investigate this alternative.

Why not own it?

Only Murders in the Building is a great show about three residents of a fancy apartment building who start a true crime podcast. It’s available on Hulu and ABC. The show stars Steve Martin, Martin Short, and Selena Gomez, but a significant supporting character is a deaf man played by James Caverly, a deaf actor. Caverly is part of a movement to present deaf people as, well, people. There’s a growing emphasis on creating a culture of deafness, which has its own language. (Many years ago, I discovered that there’s even sign language poetry, which is related to dance and literature.)

Learning any language late in life is hard, whether it’s American Sign Language or French. Thus, ASL is not an option for most people with age-related hearing loss; not only would they would have to learn a new language, but also would their friends and families. If it works for your family, though, you can start with online tutorials.

One reason that people try to avoid getting their hearing tested is that they think hearing loss is shameful, and that’s something the young deaf activists want to change. They don’t want to hide. To that end, many hearing aid companies sell models in bright colors and jewel finishes, not just a range of skin tones. There’s even hearing aid jewelry. I don’t need hearing aids yet, but I like to think that I would go for a metallic green with dangling pearls. After all, I wear bold glasses.

I’d love to find out your thoughts about this. What works? What have I gotten wrong?

And please, share this post with someone who needs it.