Hearing loss at home: hearing aids, conversation, and staying connected

The signs in the table come from the NHS page on hearing loss. It says hearing loss is common as people get older, and that the cause may be something that can be easily treated, so it is worth seeing the GP rather than putting it down to age.

Raising it can be the hardest part. Your relative may feel embarrassed, or may not want a hearing aid. It tends to go better as a conversation about something specific ("you missed the phone twice yesterday, and I worry about that") than as a verdict. If your relative is reluctant about help of any kind, how to get someone to accept care has ideas that apply here too, and signs your parent needs help at home covers the wider picture. For other long-term conditions your relative may live with, the health conditions guide explains what help at home looks like.

1. 1

   See the GP

   First

   The GP checks for things that can be treated there, such as an ear infection or ear wax. Otherwise they may refer your relative to a hearing specialist, called an audiologist.
2. 2

   The hearing test

   15 minutes to an hour

   An audiologist at a hospital or clinic plays sounds and speech through headphones and checks how the eardrum moves. The results are usually given at the end of the appointment.
3. 3

   Choosing and fitting the aids

   A few weeks

   Some hearing aids can be used straight away, and others are made after the ear has been measured. When they are ready they are programmed for your relative, who is shown how to use and look after them.
4. 4

   The follow-up appointment

   6 to 12 weeks after fitting

   NICE asks audiology services to offer a follow-up 6 to 12 weeks after the aids are fitted. It is the time to raise anything that is not working, from comfort and whistling to the phone and the television.

The NHS page on hearing tests says a hearing test and treatment are free on the NHS, and that a GP can refer your relative to an audiologist. RNID has a free online hearing check, which can tell somebody whether they need a face-to-face test, and can be a gentle first step for a person reluctant to see the doctor. Many large pharmacies and opticians also have audiologists who test adults. The NHS says the test there is often free, but that you may have to pay for any treatment, such as hearing aids.

What the NHS provides, and what private aids addSection titled What%20the%20NHS%20provides%2C%20and%20what%20private%20aids%20add

The NHS page on hearing aids says NHS hearing aids are provided free as a long-term loan, that batteries and repairs are free, and that there is no charge for follow-up appointments or aftercare. There may be a charge if an aid is lost or broken and needs replacing. The NHS usually provides the type that sits behind the ear, and very occasionally the type with a small speaker inside the ear, so somebody who wants a smaller or less visible aid may need to pay privately.

Private hearing aids cost more, and the price depends on the provider and the model. The NHS suggests anybody going private compares providers and checks the cost of aftercare and batteries. The NHS also says the wait for NHS hearing aids can sometimes be longer than for private treatment. It adds that the earlier somebody gets hearing aids, the more they will get out of them.

RNID's guide to cleaning and maintaining hearing aids goes through each type step by step. NICE asks audiologists to take a person's dexterity into account at the assessment. If your relative struggles to handle the aids, for example because of arthritis, say so at the follow-up. If your relative also has trouble seeing, sight loss and care at home covers the help available for that. The Care Act statutory guidance says that when combined sight and hearing loss causes difficulties with communication, getting information and getting about, the council must arrange a specialist assessment.

Ear waxSection titled Ear%20wax

The NHS page on ear wax build-up says wax usually falls out on its own, and that when it blocks the ear a pharmacist can help and suggest treatments. It says to see a nurse at the GP surgery if symptoms have not cleared after five days, or if the ear is badly blocked and your relative cannot hear anything. Not all GP surgeries remove ear wax. Where yours does not, the NHS says a doctor might be able to refer your relative to another local NHS service, or you might have to pay for it to be done privately.

These points come from the NHS and from RNID's advice on how to communicate with someone who is deaf or has hearing loss. A family meal is one of the hardest settings, with several people talking at once. Seat your relative with their back to the window, so the faces they are watching are lit, and take turns to speak.

Loneliness and staying connectedSection titled Loneliness%20and%20staying%20connected

The NHS lists tiredness from concentrating while listening among the signs of hearing loss, and when conversation takes that much effort, fewer phone calls and trips out can leave somebody lonely without the family noticing. Helping someone who is lonely looks at what makes a difference, and befriender, volunteer or paid companion compares the kinds of regular company available. A visitor who knows how to talk with somebody who has hearing loss, and who comes back week after week, can help keep your relative in touch with people.

Hearing loss and memorySection titled Hearing%20loss%20and%20memory

The NHS page on dementia risk says research suggests hearing loss may be one of the risk factors for dementia, alongside untreated depression and loneliness or social isolation. It does not say that hearing aids prevent dementia. NICE guideline NG98 advises doctors to consider referring adults with diagnosed or suspected dementia, or mild cognitive impairment, for a hearing assessment, because hearing loss may be present as well. So if your relative has memory worries, it is worth telling the GP about their hearing too. Getting a dementia diagnosis explains that side of it.

To ask the council, find your relative's council on GOV.UK and contact adult social care. RNID suggests asking for the council's sensory support team, or its social services department, for an assessment and help with the cost of equipment, and RNID's page on smoke alarm systems explains the fire service's part. The Care Act statutory guidance says that aids provided by the council must be free of charge, and that a minor adaptation is one costing £1,000 or less. Ask for a care needs assessment at the same time if your relative needs help with other parts of the day. For alarms that call for help after a fall, pendant alarms and sensors covers the options; if a system answers by voice, check your relative can hear it.

Show each carer how your relative likes the aids handled. A carer should never put anything into your relative's ear to clean it or remove wax. If the pharmacist has suggested ear drops, can carers give medication? explains what a carer can help with and what to agree with them first. Seeing the same carer every visit is worth asking for, because a familiar face and voice are easier to follow.

If you want somebody patient who will help with the hearing aids and keep your relative in conversation, you can search for carers near you and compare their rates. Every carer has had their identity and right to work checked, holds an enhanced DBS check (or PVG in Scotland, Access NI in Northern Ireland) issued within the last 18 months, and has been interviewed online. Visits booked through PrimeCarers are insured. We do not check qualifications, training or references, so anything a carer says about experience with hearing loss is their own account on their profile, for you to ask them about. PrimeCarers is an introductory service, not an agency or a care provider: carers are self-employed, and you agree the visits and the rate with them directly.