One of the most common things I hear in clinic is: “My hearing isn’t that bad. I’m managing okay.” And very often, that person is right — they are managing. They are still having conversations, watching television, going out with family and getting on with everyday life. But there is an important difference between hearing well and managing well.
When hearing is good, speech reaches the brain clearly and understanding feels natural. When hearing starts to reduce, even mildly, some speech sounds can become softer or less distinct. You may still follow the conversation, but your brain starts working harder by using context, memory, facial expressions and lip movements to fill in the gaps. For example, someone may say, “I’ll meet you at the station at six,” but you may only clearly receive, “I’ll meet you at the —ation at six.” Your brain fills in the missing word so quickly that you may not even realise anything was missed.
This is why many people tell me, “I can hear people, they just don’t speak clearly,” or, “Everyone seems to mumble.” They may hear the voice perfectly well, but some of the finer speech sounds are missing. This is particularly common with high-frequency hearing loss, where sounds such as s, f, th, sh, t and k can become less clear.
I regularly see clients who come in because their husband, wife or family has encouraged them to have a hearing test. They often say, “I don’t think my hearing is bad enough for hearing aids.” But when we talk about everyday life, they mention that the television has gradually become louder, their partner repeats themselves more often, restaurants are difficult, or they struggle when somebody speaks from another room. They have not necessarily recognised these as hearing difficulties because they have simply adapted.
Another common example is someone who says they are fine in restaurants, but only if they sit in the right place — perhaps with their back to a wall, away from noise and facing the person they want to hear. That is not always a sign that hearing is normal. Sometimes it is a sign that someone has become very good at managing their hearing difficulty.
The same can happen at work. Some people are still performing very well but are concentrating much harder than before. They watch faces closely, position themselves carefully in meetings and mentally replay conversations afterwards. By the end of the day they may feel tired, not because they have failed to understand, but because understanding has required more effort.
A proper hearing assessment should therefore tell us more than simply whether you can hear quiet beeps. It should also help us understand how clearly you hear speech and how you cope when background noise is added. Two people with similar hearing-test results can experience very different levels of difficulty in everyday life.
So perhaps the question is not simply, “Can I hear?” A better question may be, “How much effort am I using to hear?”
If you are asking people to repeat themselves more often, watching faces more closely, finding restaurants harder, increasing the television volume or feeling tired after conversations, you may still be managing very well. But that does not always mean you are hearing well.
At Premium Care Hearing, our aim is not simply to help people hear more. It is to understand how they hear in real life and help make listening feel easier, clearer and less tiring. You may also find why not all hearing tests are the same useful.