Managing Hearing Loss in Social Settings: Tips for Seniors with Hearing Aids

Nov 02, 2023

Fact Checked

These tips will help you navigate your social life with hearing loss.

Written by: Steven Marshall, DNP, MSN, BSN, RN

Key Takeaways

Age-related hearing loss is natural and affects one in three people between the ages of 65 and 74, and nearly half of those 75 and older.
Hearing loss can lead to social isolation, loneliness, and depression as a result of reduced social interactions and overall quality of life.
Listening fatigue can occur when you are exposed to noisy environments for long periods, resulting in difficulty concentrating and increased stress.

Managing hearing loss in social settings can help you maintain and even lift your quality of life, helping you reduce your risk of side effects like anxiety or cognitive decline.

It’s important to understand how hearing loss can make it harder for you to be social, and how reduced social interactions can harm your physical and mental health. Hearing loss has been linked to increased levels of stress, anxiety, and other mental health symptoms, especially when left untreated.

In this article, our Reviews Team will explore the impact of hearing loss on social settings and how you can develop communication strategies to feel more comfortable navigating hearing loss. The use of technology in both small and large gatherings can improve interpersonal communication.

Hearing loss affects roughly one in three people between the ages of 65 and 74, according to the National Institute on Deafness and Other Communication Disorders (NIDCD) ^[1] . A recent review of the social effects of hearing loss estimated two-thirds of adults age 70 and older are experiencing some level of hearing loss, which is strongly associated with social anxiety and isolation, functional and cognitive decline, increased falls, depression, and dementia. ^[2]

Many people managing hearing loss in social settings try to meet in quiet places, read facial expressions, and pretend to understand what others are saying. This can lead to misunderstandings and feelings of embarrassment, awkwardness, and frustration for the listener. ^[3]

The progression of age-related hearing loss is gradual. One study from January 2019 found people wait an average of 10 years before addressing their hearing loss. ^[4] Family members may notice trouble with your hearing before you do. When you begin to experience increasing levels of difficulty in social situations, you may find yourself asking people to repeat themselves or speak louder, or it might sound as if they’re mumbling. ^[5]

Other signs of hearing loss can include:

Difficulty hearing voices on the phone
Trouble following conversations with multiple people
Needing to turn the TV volume louder than usual
Trouble understanding children or others with high-pitched voices

If you’re experiencing any signs of hearing loss, or your family has told you that your hearing has declined, see your health care provider or visit an audiologist for a hearing evaluation. You can also take an online hearing test to get an idea of your hearing loss before seeing a professional.

Listening fatigue is physical and mental exhaustion caused by the need to put more effort into listening and working out what others are saying to you. Listening involves multiple attention and cognitive resources that work to detect, decode, process, and respond to speech and other sounds. ^[6]

With hearing loss, the brain compensates by using more resources to improve listening and understanding, but this can take away from other mental processes, like memory. ^[7] This increased resource use for hearing leads to stress and, ultimately, listening or hearing fatigue.

Listening fatigue can affect your brain’s ability to perform other tasks. Here are some signs of listening fatigue: ^[6]

Decreased energy or physical fatigue
Feeling especially tired at the end of your day, or after meetings and social events
Increased stress
Irritability
Trouble concentrating or remembering
Decline in performance at work or in other tasks, like driving

Recognizing and addressing listening fatigue can minimize its impact on your quality of life. Here are some tips for addressing hearing fatigue:

Get adequate rest. This will help your brain to recover.
Avoid disruptive noises. Turning off unnecessary background noise, like TV or radio, will help decrease the resource demand for hearing.
Take a hearing break. Find a quiet place and relax for a few minutes each day. This can help to replenish your listening resources.

Hearing aids can improve your overall quality of life, including your ability to work and how you participate in conversations and social events. Hearing aids are electronic devices worn behind or inside the ear that help compensate for hearing loss.

They typically consist of a microphone, amplifier, and speaker. Hearing aids amplify the sound vibrations entering the ear. These vibrations are received by inner ear hair cells and processed into sounds the brain interprets. You can adjust the level of amplification, depending on the degree of hearing loss. The total amplification amount is limited and may not be effective for severe hearing loss.

The technology in hearing aids has changed a lot in the last couple of decades, and it’s expected to improve more with the availability of over-the-counter (OTC) hearing aids. ^[8] Newer devices have directional microphones that reduce noise and improve speech comprehension. Bluetooth devices directly connect to smartphones and other devices, allowing you to listen at a comfortable volume for you. Hearing aids also help prevent or reduce listening fatigue by making it easier for your brain to capture sounds.

We asked Rosette Ruth Reisman, AuD, founder of Urban Hearing in New York, about the role of technology in hearing aids. “There are a number of hearing aids that not only offer special programs to manage background noise but can also include additional assistive listening devices, like remote microphones and the ability to manipulate the hearing aid microphones to focus on the primary source of speech and eliminate the background noise,” Reisman said.

Communication strategies for those with hearing loss

If you’re navigating hearing loss, you can use several strategies to help improve communication. Recognizing that both the speaker and the listener have equally important roles in effective communication is important. Here are some tips for communicating when you have hearing loss: ^[9]

Stand face-to-face when communicating
Practice lip reading
Lessen background noises
Ask people to repeat themselves
Use pen and paper to communicate through writing

And here are some tips for improving communication with someone who has hearing loss:

Speak slowly and clearly, and avoid speaking rapidly
Don’t shout or speak in a loud voice
Move your hands and use commonly understood hand gestures
Rephrase instead of repeating the same thing over and over

Keep reading to explore broader strategies to make social settings more comfortable.

Reduce background noise

The sounds that occur around us daily are known as background noise. The sounds may vary in frequency, intensity, and duration. Sometimes, these noises become distracting and can lead to listening fatigue due to the extra effort you put into hearing what others are saying.

If you have hearing loss, background noise can make communication more challenging as the sounds are hard to separate from conversations. ^[10] Choosing a quiet location and facing the person you are speaking with are some ways to cope with listening in noisy environments.

The best hearing aids often have built-in noise reduction technology, which can further help tune out the background. Noise-canceling headphones can also amplify close sounds while reducing background noise. These headphones can be useful if you do not have noise-canceling hearing aids or do not wear hearing aids at all.

“Other ways that can be helpful are undergoing a formal aural rehabilitation program that trains hearing in the presence of background noise, as well as lip reading,” said Reisman. ^[11]

Position yourself strategically

Positioning yourself between the speaker and the source of the background noise can help you better process what someone is saying. ^[12] Sit across from your conversation partner in restaurants or other settings so you can see their face and mouth clearly. Avoid locations where light is shining in your eyes. Look for areas away from loud music at parties or other entertainment venues. Choose locations with carpeted floors or acoustic ceilings that help reduce ambient noise or sound reverberation—sounds bouncing off surfaces like walls and ceilings—whenever possible.

When attending concerts, choose a seat at least 20 feet from the stage or orchestra pit. You may need to arrive at your destination earlier to find seating for optimal viewing and listening. Restaurant kitchens often have a lot of clatter and conversations between staff. Ask your server to seat you in a spot away from the kitchen.

Talk about your needs with friends and family

Discuss your hearing loss with friends and family, and talk about the ways they can help you to hear them better, like facing you, not speaking from other rooms, and making sure they have your undivided attention when they begin speaking. ^[12] Explain that depending on the situation, they may need to speak more loudly or repeat themselves. They may also need to speak more slowly and pronounce their words clearly to help you understand what they’re saying.

If you’re experiencing anxiety or discomfort in social settings due to your hearing loss, discuss this with the people you interact with so they can understand how you’re feeling if you get frustrated. Being open about your needs can allow people to recognize if you are becoming withdrawn and need additional support to participate in conversations and social events.

Make notes of your experiences with challenging social interactions and what methods were successful for you at those times, or brainstorm ideas for overcoming those challenges the next time.

Advocate for yourself

When navigating hearing loss in social settings, communicate your needs or requests to the event planner in advance so you can fully participate in the event. Request assigned seating that will minimize background noise or circular table settings, which make listening easier. ^[13] To avoid or ease listening fatigue, tell people ahead of time you may need to step away from time to time to take a listening break.

Ask if background noises like televisions or radios can be turned down or off to help you hear better. Speak up if you’re having trouble hearing someone or cannot keep up with the conversation. It’s important to realize you may need to ask others to repeat themselves or clarify what they have said during conversations. Ask your conversation partners, “Can you please repeat that?”, “Can you please speak more slowly?”, or “Can you explain that in a different way, please?” Recognize that advocating for yourself is part of navigating hearing loss and should not be viewed negatively by yourself or others.

Manage listening fatigue

Moving to a quieter location can help lessen listening fatigue, particularly when you’ve been listening for a long time. Going outside and taking a walk can also be helpful. If you use hearing aids, ask your audiologist if you can adjust any settings to optimize your listening experience. Use handwritten notes, phone text, or email communication when appropriate to give yourself a listening break.

Navigating large groups and public spaces

Many social interactions involve being in large groups or public spaces. Recognizing the challenges these settings present and having a plan ahead of time to address them will help you minimize the impact of hearing loss on your social life.

Weddings and special events

Weddings are among the most common social settings involving large groups of people. Maximize your enjoyment and feel confident socially by using these tips:

Choose your seating carefully. Hearing experts recommend circular arrangements for tables and chairs so you can face others while keeping excess background noise behind you. ^[13]
Let the event planner know you have hearing loss and would like to plan ahead for some suitable quiet areas to take a listening break when needed. Outdoor gardens or rooms adjacent to those where the majority of the guests and music are present are ideal for this purpose.
If you wear hearing aids, familiarize yourself with the noise-cancellation and amplification levels so you can adjust them accordingly at the event.

Family gatherings

Holidays or other special occasions can bring about lively conversation, but you may not be able to easily limit excess noise. Here are some ways to improve your comfort in these settings:

Seek out rooms with carpet instead of hardwood or other bare flooring, which can amplify the surrounding noise. The carpet and padding will help absorb some noise and make it easier to hear conversations.
Seating in rooms with cushioned furniture like couches and chairs can help absorb loud noises and give you more opportunities to position yourself in an ideal seating arrangement.
Speak with the host in advance and share your concerns about communication challenges and fatigue. Ask about areas away from loud music or other distractions, like rooms that might be otherwise closed off to guests during the event. Explain the importance of taking listening breaks to the host so they will understand if you’re not around sometimes.

Live entertainment venues

Many concert venues allow you to choose your seat. Choose seating that will keep you away from the main stage, orchestra pit, and speakers. Some hearing professionals we spoke with recommend choosing seating that is farthest away, like lawn seating.
When possible, choose an outdoor venue. Being outside allows the sound to spread across a wider area.
If you wear hearing aids, adjust them to reduce the sound level coming into your ears. If your device is equipped with noise-canceling technology, use it to provide further protection.
Prolonged or repeated exposure to loud music can lead to permanent damage. If you do not wear hearing aids, use hearing protection like concert earplugs to prevent further damage to your ears. ^[14] One study found the use of earplugs at loud concerts was effective at protecting people from immediate, short-term hearing loss. ^[15]

Navigating interpersonal relationships

Living with extended family is common in many world cultures, but not in the United States. A Pew Research study from March 2020 found more older adults live alone in the United States than 130 other countries surveyed. ^[16] The study showed roughly 27% of U.S. adults 60 and older live alone, with women more likely than men to live alone.

Despite those numbers, the desire for intimacy and dating does not decrease with age, and many older adults seek companionship. Studies have shown the frustration, embarrassment, and distress sometimes related to hearing loss can negatively affect intimate relationships. ^[17]

Hearing loss and romantic relationships

Each partner must change to adapt to living with hearing loss. Here are some strategies for couples to address these challenges:

Seek couples’ counseling.
Avoid placing blame on each other.
Use your hearing aid when communicating with your partner.
Manage the noise in the environment, like turning the TV off or the volume down when having a conversation.
Avoid speaking to each other from different rooms.
Schedule a time of day to talk to each other without any distractions.

Dating with hearing loss

We all face some of the same challenges when dating, but hearing loss can add difficulty and require additional considerations. Here are some tips for starting off on the right foot when dating with hearing loss:

Be open with your date about your hearing loss. Don’t try to hide it.
Wear your hearing aids and adjust them based on the setting for the date.
Tell your date if you can hear better on one side so they can sit on that side.
Choose well-lit locations for your dates, especially if one of you uses lip reading to help with communication.
Avoid noisy environments for your first date so you are not distracted during conversations.
Plan to visit restaurants during off hours when they are likely to be quieter.
When using an online dating site for older adults, alert your date before meeting so they can be aware and choose quieter date locations.

Technology and apps for hearing aid users

Many new hearing aids models have advanced technology that allows for features like noise cancellation, sound isolation, and Bluetooth connectivity. With an estimated 85% of the adult U.S. population owning smartphones, ^[18] many are looking to their mobile devices for assistive technology in the form of downloadable apps. ^[19]

Fortunately, the hearing industry is keeping up with this trend, with smartphone apps available to assist you in measuring your hearing loss, live captioning, translating spoken language into written form, and adjusting your hearing aids through a Bluetooth connection to your phone. Some examples of these apps include (the following are all free to download):

Soundprint: This app provides crowd-sourced reviews of various social settings and a rating system for the noise level, so you know how loud places can get before you go. Ratings include quiet, moderate, loud, or very loud.
Rogervoice: You can use this app to caption conversations in real-time during phone calls. Users can also communicate directly through the app, provided each has downloaded it onto their phone.
Sound Alert: Use this app to record common alert sounds in your house, like the doorbell, microwave, or oven timer. When turned on to “detection mode,” the app listens for those sounds and will alert you when they are detected.
Mimi Hearing Test: This digital screening app can give you an idea of your current level of hearing. The app developers do not recommend using this app instead of a professional audiology test.
Sound meter apps: These provide decibel measurements with references for sound level comparison.
Hearing aid apps: These apps usually allow you to adjust various settings for your hearing aids through Bluetooth or other wireless connections.

New apps are always being added to app stores, so a word of caution: Read user reviews, and only download apps from known sources like Google Play and the Apple App Store.

Learn more about some of the available assistive technology apps.

Bottom line

The impact of hearing loss in America ranges from 15% of those older than 18 to nearly half of adults 75 and older. ^[1] Spending time in noisy environments or social interactions for extended periods can lead to listening fatigue, which can take a toll on both your physical and mental energy, making it difficult to concentrate or form memories. Untreated hearing loss can also make it more difficult to date or pursue new personal relationships.

Fortunately, if you have hearing loss, with a few tips you can enhance interactions with others in social settings like weddings or special events, family gatherings, and live entertainment venues. Suggestions for these settings include finding seats where you can minimize background noises and distractions, and facing the person you’re talking to so you can see their mouth and facial expressions easily.

Using hearing aids and other technology like smartphone apps can also improve your experience in social settings, and may even keep your cognitive abilities sharp as you age.

Have questions about this article? Email us at reviewsteam@ncoa.org.

Sources

National Institute on Deafness and Other Communication Disorders. Age-Related Hearing Loss (Presbycusis). March 17, 2023. Found on the internet at https://www.nidcd.nih.gov/health/age-related-hearing-loss
Shukla, A., et al. Hearing Loss, Loneliness, and Social Isolation: A Systematic Review. Otolaryngology-Head and Neck Surgery. March 10, 2020. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292986/
National Institute on Aging. Hearing Loss: A Common Problem for Older Adults. January 19, 2023. Found on the internet at https://www.nia.nih.gov/health/hearing-and-hearing-loss/hearing-loss-common-problem-older-adults
Reed, N., et al. Trends in Healthcare Costs and Utilization Associated With Untreated Hearing Loss Over 10 Years. JAMA Otolaryngology Head Neck Surgery. January 2019. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439810/
Bess, F., Hornsby, B. Listening Can Be Exhausting—Fatigue in Children and Adults With Hearing Loss. Ear and Hearing: The Official Journal of the American Auditory Society. November through December 2014. Found on the internet at https://journals.lww.com/ear-hearing/abstract/2014/11000/commentary__listening_can_be_exhausting_fatigue_in.2.aspx
American Academy of Audiology. What is Listening Fatigue? Found on the internet at https://www.audiology.org/consumers-and-patients/hearing-and-balance/fatigue/
Edwards, B. The Future of Hearing Aid Technology. Trends in Hearing. March 2007. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4111503/
Department of Health and Aged Care. Tips for Communicating When You Have Hearing Loss. May 5, 2023. Found on the internet at https://www.health.gov.au/sites/default/files/2023-05/tips-for-communicating-when-you-have-hearing-loss.pdf
Glyde, H., et al. Problems Hearing in Noise in Older Adults. Trends in Hearing. Nov. 11, 2011. Found on the internet at https://journals.sagepub.com/doi/10.1177/1084713811424885
American Speech-Language-Hearing Association (ASHA). Aural Rehabilitation for Adults. Found on the internet at https://www.asha.org/practice-portal/professional-issues/aural-rehabilitation-for-adults
Centers for Disease Control and Prevention (CDC). What if I Already Have Hearing Loss? Oct. 17, 2022. Found on the internet at https://www.cdc.gov/nceh/hearing_loss/what_if_i_already_have_hearing_loss.html
Kinstler, J. Hearing Loss Communication Tips for the Holidays. Hearing Loss Association of America (HLAA). Nov. 4, 2022. Found on the internet at https://www.hearingloss.org/hearing-loss-communication-tips-for-the-holidays/
Centers for Disease Control and Prevention (CDC). How Does Loud Noise Cause Hearing Loss? Nov. 24, 2020. Found on the internet at https://www.cdc.gov/nceh/hearing_loss/how_does_loud_noise_cause_hearing_loss.html
Ramakers, G., et al. Effectiveness of Earplugs in Preventing Recreational Noise–Induced Hearing Loss. JAMA Otolaryngology Head Neck Surgery. June 2016. https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2507069
Ausubel, J. Older People Are More Likely to Live Alone in the U.S. Than Elsewhere in the World. Pew Research Center. March 10, 2020. Found on the internet at https://www.pewresearch.org/short-reads/2020/03/10/older-people-are-more-likely-to-live-alone-in-the-u-s-than-elsewhere-in-the-world/
Tjørnhøj-Thomsen, T., Philipse, H. Hearing Loss as a Social Problem: A Study of Hearing-impaired Spouses and Their Hearing Partners. Hearing Review. Feb. 12, 2019. Found online at https://hearingreview.com/hearing-loss/patient-care/hearing-loss-as-a-social-problem
Pew Research Center. Mobile Fact Sheet. April 7, 2021. Found on the internet at https://www.pewresearch.org/internet/fact-sheet/mobile/
Zitelli, L., Mormer, E. Smartphones and Hearing Loss: There’s an App for That! Seminars in Hearing. Dec. 16, 2020. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7744170/

Steve Marshall has more than 35 years of clinical and leadership experience in health care. He has worked in various settings, including emergency departments, intensive care units, air and ground transport, oncology, infectious disease, and infusion services. He founded See Doc Nurse Write LLC in 2023 to expand the reach of his clinical knowledge and expertise.

Was this helpful?

Thank you for your feedback!