'Hearing loss isn't funny'

Actress Rula Lenska lost her hearing in her mid-fifties after picking up an ear infection on a diving holiday. She now wears hearing aids in both ears.

“I hadn’t noticed that my hearing was getting worse. Although I recognised that I listened to the TV loud, and often thought that people were mumbling, I never realised that the underlying reason was because I was losing my hearing.

“Then eight years ago, during a health check, tests showed that I had lost some of the higher register of hearing in both my ears. I was too young for it to be age-related, nor was it hereditary, so the doctors thought it was caused by ear infections I picked up from coral diving.

“As an actress, my voice and hearing are a huge part of my life, so I decided to get hearing aids fitted and opted for behind-the-ear ones.

“It was a revelation when I was fitted with my hearing aid – and a shock to hear how much I’d been missing ordinary, everyday sounds, especially high-pitched ones. I was also surprised to discover that the hearing aid was virtually invisible.

“I didn’t realise how far advanced hearing aid technology has become. We’ve certainly moved on a long way from the boxes around the neck. For instance, you can now get a hearing aid that is hidden in your inner ear canal so no-one can see that you’re wearing it."

Rula’s decided to speak out now about her hearing loss in an attempt to dispel some of the stigma surrounding the condition.

“Having battled for the past decade, I know that coping with hearing difficulties can take an enormous amount of bravery. There’s still so much stigma attached to hearing loss and jokes told about a condition that really isn’t funny.

“It was very difficult for me to come to terms with my hearing loss and even more difficult to admit it. But I’ve now come to see it as part of me. I refuse to let it shape my life negatively. And although it takes adjustment, it doesn’t signal the end of your life. I want to talk about my hearing loss and, by doing so, encourage others to do the same.”

Rula was 65-years-old when interviewed.

'Hearing aids make life better'

Thanks to her digital hearing aid, Reena can now hear some sounds for the first time. She explains how hearing aids have transformed her life.

Reena Gogna, aged 27 when interviewed, has had severe hearing loss from birth and relies on her hearing aid to hear any kind of sound.

“I was diagnosed with severe hearing loss when I was a toddler and I was fitted for my first hearing aid when I was less than three years old.

“When I was small I used to have tantrums about having to wear a hearing aid. I didn’t want to look different from my cousins. But since the age of six or so, I’ve become less bothered about wearing a hearing aid and now I think nothing of it.

“The first hearing aids I wore were analogue hearing aids, but a few years ago I started to use a digital hearing aid and it’s so much better. I can hear sounds far more clearly now. I can hear car keys jingling, and when I’m driving on the motorway, I can hear if there’s a motorbike coming up behind me, which is something I never could before. Also, friends tell me that I don’t ask them to repeat what they’ve said nearly as much as I used to!”

Reena, from Earls Court in London, is keen to dispel the negative image that hearing loss and hearing aids have in general and within the Asian community in particular.

“There’s still a lot of stigma around hearing loss and wearing hearing aids. I’m Indian and there are additional cultural barriers. Deafness can be negatively portrayed in the Asian community, and there’s a concern that a woman with a perceived disability like deafness will be less ‘marriageable’.

“I want people to see that I look really normal, and that wearing a hearing aid is not a big deal. It’s no different from wearing glasses really.”

Reena, who teaches and is currently studying for a PhD in educational and child psychology, is keen to encourage all young people to get their hearing checked and to use digital hearing aids so that they can hear more clearly and live a full and active life.

“I’d urge anyone who discovers they have hearing loss to go out and seek all the advice and information they can get about hearing impairment. Speak to other people with hearing loss and ask about hearing aids. There’s really nothing to be afraid of and they can help you get along in life.

“I don't see my hearing impairment as a disability. Instead, I think of it as a gift because it’s made me a stronger, more confident person. It’s enabled me to work hard for the things I want to achieve in life and it’s allowed me to be a positive role model to young people.”

Is your hearing loss getting you down?

Finding it hard to follow conversations can take its toll on relationships, which is one reason why taking action to tackle your hearing loss is important.

People who are fitted with hearing aids early are likely to get more benefit from them than those who put up with hearing loss for years before seeking help

Despite the fact that deafness can be socially isolating, it can take up to 10 years for people who clearly have hearing loss to get tested. And 4 million people in the UK have undiagnosed hearing loss, according to the UK charity Action on Hearing Loss.

A key reason for those long years in denial about deafness is the stigma of hearing loss.

Losing your hearing is associated with getting old and hearing aids are often viewed negatively by people who aren't aware of more recent advances in technology and design. In some sections of society, people who can’t hear properly face prejudice.

If you have hearing loss, you may feel cut off from the world, and evidence shows that this can lead to depression. Your confidence can also be eroded because you struggle to hear, causing you to avoid social contact.

If you're concerned that you may be losing your hearing, tackling the problem early can improve both your hearing and your quality of life, including your relationships.

You and your partner

Delaying diagnosis can also affect your relationships with family and friends. An Action on Hearing Loss survey of couples where one partner had hearing loss found that it can be very frustrating for partners. In some cases, hearing loss results in couples talking at cross-purposes. This causes friction, which can develop into ongoing resentment.

Partners of people with hearing loss also commonly complain of loneliness, feeling isolated, missing out on companionship and a poor social life because previous social activities are curtailed.

Ignoring the problem of hearing loss won’t make it go away. And you could be missing out on devices that could help you hear better and improve you and your partner's quality of life.

If, after your hearing is tested, you find out that you could benefit from hearing aids, try to start using them as soon as possible. This is because you will benefit more from being fitted with hearing aids while your hearing loss is relatively mild, rather than waiting for it to get worse. The earlier you start using hearing aids, the better your brain adapts to all the sounds it hears. The longer you leave it, the more difficult it is for the brain to try to tease out the information you are trying to hear.

Reasons to confront your hearing loss

If your hearing seems to be declining, here are four good reasons to acknowledge that there may be a problem and to seek help:

You’ll have a better relationship with family and friends.

An Action on Hearing Loss report found that early use of hearing aids by people with hearing loss improved their relationships with loved ones.

There is a huge amount of hearing loss help available

This help includes digital hearing aids, which are much smaller and easier to control than previous versions. There are also gadgets to make your life easier, including extra-loud landlines and mobile phones, amplifiers and flashing doorbells, sonic boom and vibrating alarm clocks, and vibrating watches.

National charity Action on Hearing Loss provides practical support and information for people with hearing loss including hearing aid support services for people with NHS hearing aids.

The charity Hearing Link runs community support programmes as well as rehabilitation programmes and self-management classes.

It’s better to start wearing hearing aids sooner rather than later.

Getting used to amplified sound is harder if you’ve already got used to a quieter world, which means your hearing aid will be less effective.

You’re not alone.

One person in six in the UK is deaf or has hearing loss. That’s an estimated 10 million people in the UK. So, if you think you’re losing your hearing, take a free hearing test. Your GP can then refer you, if necessary, for further tests and advice.

10 hearing helpers

Whether you’ve just been diagnosed or you’ve been living with hearing loss for some time, these organisations, individuals and services can help make life easier for you.

1. Hearing therapists

Hearing therapists are trained to help people adapt to living with their hearing loss or tinnitus. They work out a personalised rehabilitation programme, which can include lessons on using a hearing aid, how to communicate better and keeping up your work and social life. Hearing therapists are also trained to counsel you and your partner about adjusting to your hearing loss. They can also recommend equipment and services that could help you.

Hearing therapists work in the NHS, usually in hospital audiology departments, and some work privately. Ask for a referral from your ear, nose and throat (ENT) specialist, audiologist or GP.

2. Community support volunteers

Hearing Link is a national charity that helps and supports people who have lost most or all of their hearing. They have a team of community support volunteers around the UK who give support and practical advice to people who have lost their hearing. Community support volunteers are usually people who have hearing loss themselves.

To find out more or to get in touch with a community support volunteer in your area, contact Hearing Link.

Action on Hearing Loss, a charity supporting people who are deaf or have hearing loss or tinnitus, runs a free hearing aid support service called Hear to Help. Community support officers and volunteers help people to manage and maintain their NHS hearing aids through home visits and drop-in services. To find out more, contact Action on Hearing Loss's Information Line.

3. Lipreading classes

Going to lipreading classes in your local area is a great way to develop your lipreading skills, meet new people and find out more about what's going on in your area for people with hearing loss. Some employers may agree to give you time off work to attend these classes.

To find a local class, contact the Association of Teachers of Lipreading to Adults (ATLA) or your local adult education centre or college. If there is no class in your area, contact Action on Hearing Loss, which campaigns for better access to lipreading classes.

4. Hearing dogs

Hearing dogs help severely and completely deaf people by responding to specific sounds that hearing people often take for granted, such as the alarm clock, doorbell, a baby crying, the telephone and smoke alarms. The dogs are trained and provided by the charity, Hearing Dogs for Deaf People. Find out more about hearing dogs.

5. Financial benefits

You may be able to claim some benefits because of your hearing loss. Contact Action on Hearing Loss's Information Line for more advice (telephone 0808 808 0123; textphone 0808 808 9000), email informationline@hearingloss.org.uk or read its information on benefits and services.

6. Sign language classes

British Sign Language (BSL) is a language used by deaf people and their families. BSL uses a combination of hand expressions and lip shapes to create words and phrases. Tone is added through context, facial expression and body language, so a single signed phrase can infer a number of different meanings.

Contact Action on Hearing Loss's Information Line to find out about BSL courses in your area.

7. Hearing loss equipment

Action on Hearing Loss has a downloadable catalogue of equipment to help people with hearing loss or tinnitus. Items range from extra-loud mobile phones to flashing doorbells. Alternatively you can browse their online shop.

8. Family and friends

Make sure your family and friends know about your hearing loss. Action on Hearing Loss has communication tips for hearing people on how to talk clearly to you and not to leave you out of the conversation.

9. Counselling

According to the charity SignHealth, about 40% of profoundly deaf people experience mental distress at some time or other. It offers counselling specially for deaf people. SignHealth therapists are all qualified, can use sign language and understand deaf culture. SignHealth also helps deaf people interact and get the most from the NHS. It can provide online BSL/English interpreting in GP surgeries for same-day and short-notice appointments.

Ask your GP for a referral to a SignHealth therapist, or read more about SignHealth and its services for deaf people.

10. NHS Choices local services search

Find out which hearing impairment and deaf support services are available from both the NHS and other sources in your local area.

Hearing aids

Your GP can help you get hearing aids if you think you need them.

The models available nowadays on the NHS are a great improvement on those used in the past. They're smaller and neater, and they work better too.

The earlier you get them, the more you'll get out of them – so don't wait until you're hearing gets really bad before seeing your GP.

This page covers:

Benefits of hearing aids

How to get them

Types of hearing aids

NHS hearing aids

Paying for hearing aids

Batteries, repairs and replacements

Help and support

Benefits of hearing aids

Hearing aids won't make your hearing perfect, but they make sounds louder and clearer, reducing the impact hearing loss has on your life.

Hearing aids can:

• help you hear everyday sounds such as the doorbell and phone
• improve your ability to hear speech
• make you feel more confident when talking to people and make it easier for you to follow conversations in different environments
• help you to enjoy listening to music and the TV, at a volume that's comfortable for those around you

But hearings aid only help if you still have some hearing left, so don't put off getting help if your hearing is getting worse.

How to get hearing aids

See your GP if you're having problems with your hearing. They can refer you to a hearing specialist for an assessment if they think you might need a hearing aid.

If your specialist recommends hearing aids, talk to them about the different types available and which is best for you. You may be able to try a few types before choosing one.

Some types may be available to use straight away. Others may need to be custom made after your ear has been measured or a cast of your ear has been taken. These will usually be ready in a few weeks.

When your hearing aid is ready, it will be programmed to suit your level of hearing loss. You'll be shown how to use it and how to look after it.

Another appointment will be arranged for a few weeks later to check how things are going.

Types of hearing aids

A variety of hearing aids are available. The main types are:

Behind the ear hearing aids

Behind the ear (BTE) hearing aids are the most common type.

They're made up of a small plastic device that sits behind your ear.

This is attached with a tube to a piece of plastic that fits in your ear (an earmould) or a soft tip that goes into the opening or your ear (an open fitting).

BTE hearing aids are one of the easiest types to use and are suitable for most people with hearing loss. They're available in a range of colours.

Receiver in the ear hearing aids

Receiver in the ear (RITE) hearing aids are similar to BTE hearing aids.

The main difference is that the device behind the ear is smaller and is connected by a thin wire to a speaker placed inside the opening of the ear.

RITE hearing aids are less visible that BTE hearing aids and are suitable for most people with hearing loss, but they can be more fiddly to use than BTE hearing aids.

In the ear hearing aids

In the ear (ITE) hearing aids fill the area just outside the opening of your ear.

They can't be seen from behind, unlike BTE or RITE hearing aids, but they are visible from the side.

ITE hearing aids are suitable for most people with hearing loss, although they can be trickier to use than BTE or RITE hearing aids.

In the canal hearing aids

In the canal (ITC) hearing aids are similar to ITE aids, but are a bit smaller and just fill the opening of the ear.

They're less visible than many other types of hearing aid, but can be trickier to use and aren't usually powerful enough for people with severe hearing loss.

Completely in the canal and invisible in the canal hearing aids

Completely in the canal (CIC) and invisible in the canal (IIC) hearing aids are the smallest types available.

They fit further into the opening of your ear than ITC hearing aids and are barely visible.

But these hearing aids aren't usually powerful enough for people with severe hearing loss. They're also quite fiddly and some can only be put in and taken out by a hearing aid specialist.

CROS/BiCROS hearing aids

CROS and BiCROS hearing aids can help if you've lost hearing in one ear.

They come as a pair. The hearing aid in the ear with hearing loss picks up sound and sends it to a hearing aid in your good ear. This can be done wirelessly or through a wire around the back of your neck.

Body worn hearing aids

Body worn hearing aids are made up of a small box connected to earphones.

The box can be clipped to your clothes or put inside a pocket.

This type of hearing aid may be best if you have severe hearing loss and need a powerful hearing aid, or if you find the controls on smaller hearing aids tricky to use.

NHS hearing aids

Hearing aids are available on the NHS for anyone who needs them.

Your GP can refer you to an NHS hearing aid provider if they think you might need a hearing aid.

The benefits of getting a hearing aid on the NHS include:

• hearing aids are provided for free as a long-term loan
• batteries and repairs are free (there may be a charge if you lose or break your hearing aid and it needs to be replaced)
• you don't have to pay for any follow-up appointments or aftercare

But while several modern hearing aids are available on the NHS, these are usually the BTE or RITE type. You may need to pay for private treatment if you want one of the other types.

The waiting time for getting a hearing aid on the NHS can also sometimes be longer than the wait for private treatment.

Paying for hearing aids

If you don't mind paying for treatment, you can choose to go to a private hearing aid provider directly.

This may mean you can pick from a wider range of hearing aids, including the smaller, less visible models.

If you choose to pay for private treatment:

• make sure you research typical costs of hearing aids and any aftercare – you can pay anything from £500 to £3,500 or more for a single hearing aid
• shop around to see what types of hearing aid are available from different providers
• try to avoid being steered towards expensive models – there may be cheaper models that will suit your needs just as well

Batteries, repairs and replacements

If you have an NHS hearing aid, you can get free batteries and repairs from any NHS hearing aid service. Ask your hearing specialist (audiologist) about services in your area.

You may need to come in for an appointment, or you may be able to send off for a battery or repair in the post.

Your local hearing aid service can also replace hearing aids that have been lost or damaged, although there may be a charge for this.

If you have a private hearing aid, contact your hearing aid provider if you need a new battery, repair or replacement.

You may have to pay for this service if it's not already included in your payment plan.

Help and support if you wear hearing aids

Adjusting to hearing aids can be difficult at first. It may take a few weeks or months to get used to them.

You'll have follow-up appointments after they're fitted to check how things are going, but get in touch with your audiologist at any point if you're having problems.

Several hearing loss organisations can also provide help and support if you're adapting to hearing loss or life with a hearing aid.

Action on Hearing Loss has a hearing aid support service, which is run by trained volunteers who can help you get the best out of your hearing aids.

Other organisations that can provide information and advice include:

• Hearing Link
• Hidden Hearing
• National Deaf Children's Society (NDCS)

Top 10 tips to help protect your hearing

The key to keeping your hearing healthy is knowing how much loud sound you’re exposed to. A 'noise diet' can protect your hearing from future problems.

Most cases of deafness are caused by damage to the tiny hair cells in the inner ear. This damage can be caused by too much noise, and it's permanent. Noise-related hearing loss is usually irreversible.

It is important that we all take steps to prevent noise-related damage. The key to keeping your hearing intact is to avoid loud noise.

The louder the sound, the less time you can safely listen to it. Just because a sound isn't annoying doesn't make it safe.

Noisy occupations, such as working in factories or on roadworks, used to be the most common cause of hearing problems. But with the tightening of health and safety rules, working in a noisy industry should be less hazardous to your hearing, provided you wear the correct ear protection.

Nowadays it's recreational loud noise that's the main problem, especially from MP3 players, and noisy clubs and music gigs. That's thought to be why hearing loss is increasingly affecting younger people.

These dangers are just as serious at an open-air music festival as they are in an indoor nightclub. Action on Hearing Loss recommends wearing reusable earplugs for music, standing away from the speakers and taking regular breaks from the loudest areas.

Are you exposed to too much noise?

You can lose some hearing after being exposed to loud noises for too long, for example by standing close to speakers at a nightclub. Or hearing can be damaged after a short burst of explosive noise, such as gunshots or fireworks.

If you work or frequently spend time in a noisy place or listen to loud music a lot, you could be losing your hearing without even realising it.

The best way to avoid developing noise-induced hearing loss is to keep away from loud noise as much as you can.

Here's a guide to some typical noise levels, measured in decibels (dB). The higher the number, the louder the noise. The Health and Safety Executive (HSE) says noise levels above 105dB can damage your hearing if endured for more than 15 minutes each week. But lower levels, such as between 80dB and 90dB can also cause permanent damage if you're exposed to them for hours every day.

• normal conversation: 60-65dB
• a busy street: 75-85dB
• lawn mower/heavy traffic: 85dB
• forklift truck: 90dB
• hand drill: 98dB
• heavy lorry about seven metres away: 95-100dB
• motorbikes: 100dB
• cinema: some films regularly top 100dB during big action scenes
• disco/nightclub/car horn: 110dB
• MP3 player on loud: 112dB
• chainsaw: 115-120dB
• rock concert/ambulance siren: 120dB

Discover from the HSE what it sounds like to have noise-induced hearing loss.

How loud is too loud?

The risk of damage to your hearing is based on two factors: how loud and for how long.

Experts agree that continued exposure to noise at or above 80-85dB over time can cause hearing loss.

You've been listening to a noise that's too loud or for too long if you have ringing in your ears or dull hearing after listening to loud music. However, you may still be damaging your hearing even if you don’t have these symptoms.

If loud music ever causes pain in your ears, leave the room or turn it down immediately. Without noise measuring equipment it is impossible to tell what noise level you are being exposed to. So, a handy rule of thumb is that if you can't talk to someone two metres away without shouting, the noise level could be damaging.

10 tips for safer listening

1. Use earplugs

The louder the noise and the longer you're exposed to it, the greater the chance of damaging your hearing. Protect your ears with ear protectors – earplugs or earmuffs – and get away from the noise as quickly or as often as you can. If you can't leave the venue, take regular breaks. A 10-minute rest break will give your ears some time to recover.

2. Turn down the music

Don't listen to your personal music player at very high volumes and never to drown out background noise. If the music is uncomfortable for you to listen to, or you can't hear external sounds when you've got your headphones on, then it's too loud. It's also too loud if the person next to you can hear the music from your headphones.

3. Use the 60:60 rule

To enjoy music from your MP3 player safely, listen to your music at 60% of the maximum volume for no more than 60 minutes a day. All MP3 players bought within the EU have a "smart volume" feature, so use it if you have one. It will help you regulate the volume.

4. Wear headphones

When listening to your personal music player, choose noise-cancelling headphones, or go retro with older muff-type headphones. These block out background noise and allow you to have the volume lower. Earbud-style headphones and in-the-ear headphones are less effective at drowning out background noise. Try to take regular breaks from your headphones, though, to give your ears a rest.

5. Turn down the dial

Turn down the volume on your TV, radio or hi-fi a notch. Even a small reduction in volume can make a big difference to the risk of damage to your hearing. If you need to raise your voice to be heard above the sound, turn it down.

6. Use earplugs when you're listening to live music

They can reduce average sound levels by between 15 and 35 decibels. They're widely available at many live music venues and shouldn't spoil your enjoyment of the music.

7. Don't put up with work noise

If you're experiencing noise at work, talk to your human resources (HR) department or your manager and ask for advice on reducing the noise and getting hearing protection.

8. Wear ear protectors

Wear ear protectors (earplugs or earmuffs) if you are using noisy equipment such as power drills, saws, sanders or lawn mowers.

9. Be careful in the car

Listening to music in a confined space increases the risk of hearing damage. Don't listen to music too loud for too long.

10. Have a hearing detox

Give your ears time to recover after they've been exposed to loud noise. According to Action on Hearing Loss, you need at least 16 hours of rest for your ears to recover after spending around two hours in 100dB sound, for example in a club. Reducing this recovery time increases the risk of permanent deafness.

How long can I listen to loud music for?

It depends what volume you listen at. An increase of only a few decibels has a dramatic effect on the danger to hearing. This is because each increase of 3dB represents a doubling of sound energy (and halves the time you should listen for). As an example, being on a dance floor for 15 minutes at 100dB delivers the same amount of noise energy to the ear (and therefore potential damage) as being on a slightly less noisy dance floor at 95dB for 45 minutes. A small reduction in volume makes a big difference to the length of time you should listen for.

In workplaces, staff are protected by the Control of Noise at Work Regulations 2005, which stipulate that hearing protection must be worn if the daily average noise levels reach 85dB. At 115dB the maximum daily exposure time is about 30 seconds.

But remember, the Control of Noise at Work Regulations don't apply outside the workplace, so it's up to you to safeguard your own hearing at clubs, gigs and wherever else you listen to loud music.

Further information and resources

There are a variety of apps that can help monitor your exposure to loud noise, such as:

• SoundMeter+ provides accurate sounds levels and noise exposure readings to help prevent hearing loss.
• Play It Down is a free iPhone and iPad app that allows users to assess their hearing ability and noisy environments.

Find out more about protecting your hearing on the Action on Hearing Loss website.

Get your hearing tested

If you’re worried about your hearing it's easy to get it checked. Here’s our guide to your hearing test options.

Quick hearing tests

Quick hearing checks are a good first step to finding out how healthy your hearing is without having to visit your GP or a private hearing specialist. They're free, painless and take just five to 15 minutes. You can do some of them for yourself in your own home.

Senior audiology specialist Louise Hart from Action on Hearing Loss says: "It can be really helpful to do a quick hearing check, often from the comfort of your own home. These checks have been validated and if they suggest hearing loss, they can spur you to take further action."

However, she stresses they're not a medical diagnosis. "All these checks are just screening tests and they’re no substitute for a full hearing test. If the quick hearing check doesn't suggest hearing loss but you're having hearing difficulties, do see your GP."

So what are your quick hearing check options?

Over-the-phone hearing checks

An over-the-phone hearing check is available from Action on Hearing Loss on 0844 800 3838 (local rate call). This service is completely automated (you won't have to speak to anyone) and anonymous.

This test is a 'speech-in-noise' check, which assesses your ability to hear someone speaking when there’s background noise, similar to being in a crowded room. A voice will read out three random numbers and you use the numbers on your telephone keypad to indicate the numbers you heard.

Online hearing checks

Online hearing checks are similar to Action on Hearing Loss's telephone hearing check, except you hear the sounds through your computer instead of your telephone.

You can do a free online hearing check at Action on Hearing Loss, or the British Society of Hearing Aid Audiologists (BSHAA).

Don’t be tempted to buy a hearing aid on the basis of an online test alone, as some websites might encourage you to do. “At the moment, technology isn’t sufficient to test hearing online and then recommend a hearing aid from this information. It’s always best to have a face-to-face consultation with a hearing specialist to discuss the type of hearing aid that’s right for you,” says Hart.

Face-to-face tests

There are two types of face-to-face tests. Either a short hearing test, or a full hearing test.

Short hearing tests

Some GPs and private hearing aid dispensers offer to do a short hearing test. These tests are usually free, take about 15 minutes, and can indicate if you have a hearing problem.

As with online and over-the-phone hearing checks, short hearing tests are screening tests designed to alert you to the fact you may have hearing loss. They can’t tell for definite that you have a hearing problem.

If a short hearing test suggests you have a hearing problem, the next step is to have a full hearing assessment. A full hearing test will confirm whether you have a hearing problem and establish the type of hearing problem that you have.

Full hearing tests

The full hearing test appointment lasts up to an hour, and can be carried out by your GP surgery, hospital clinic, or by a private hearing aid dispenser.

At the GP

If you suspect you may have hearing loss and want further testing on the NHS, make an appointment to see your GP.

Most GPs don’t have the equipment to do a full hearing test in the surgery, but your GP can examine your ears to check for obvious problems, like a build-up of earwax, and treat the cause if necessary.

Your GP can also give you a referral to an NHS hospital specialist to have your ears and hearing thoroughly checked and an NHS hearing aid fitted.

At the NHS hospital clinic

In the clinic, you'll be seen by an audiologist (and possibly by an ear, nose and throat (ENT) doctor first, if your GP has requested it). Before the audiologist tests your hearing, you will be asked some questions about your hearing and they will look in your ears. You’ll then have a hearing test lasting about 20 minutes.

During the hearing test, you'll sit in a soundproof booth or room with headphones on while the audiologist presents a series of sounds. When you hear a sound, you signal to the audiologist, normally by pressing a button or raising your hand.

Read more about having a hospital-based hearing test.

Private testing

You might choose to go directly to a private hearing aid dispenser instead of having your hearing tested on the NHS. Just as with the NHS route, a hearing aid dispenser will assess you with a full hearing test lasting up to an hour before deciding if you would benefit from wearing hearing aids. You don’t need a referral from your GP.

You can search for a local hearing aid dispenser on the BSHAA's website, or simply type ‘hearing aid dispenser’ along with your town or postcode into a search engine, such as Google. Some local hearing aid dispensers offer free testing, so it's worth asking before you make an appointment.

The Health & Care Professions Council (HCPC) keeps a list of qualified private hearing aid dispensers. You can use the HCPC's online register to check if the hearing aid dispenser you're about to use is registered.

Action on Hearing Loss has an online Locate and Rate tool that lets you search for audiology services in your area, both NHS and private, by name, address and postcode. Once you've found a service, you can see how other people have rated it.

Home testing

If you are housebound, or have difficulty getting to the audiology department, discuss this with your GP. They can write to the NHS audiology department and request for an audiologist to come to your home if needed.

If you get your hearing aid privately you can find a hearing aid dispenser who will do a home visit through the BSHAA website. Some offer free home testing, so ask before you make an appointment.

Losing your hearing?

Hearing loss is more common than you may think. In the UK, around one person in six is deaf or hard of hearing. There are several ways to tell that your hearing is going.

Watch a video on tinnitus

The most common cause of hearing loss is ageing. Nearly 42% of those over the age of 50 and 70% of those over the age of 70 have some form of hearing loss. According to the charity Action on Hearing Loss, age-related hearing loss normally begins at around 50. But it’s not just older people who are affected.

Being exposed to too much loud noise is an important cause of hearing loss. It is thought that loud noise is behind the increasing numbers of young people who are losing their hearing. The popularity of iPods and other personal players, and pubs and clubs that play very loud music, all contribute.

These dangers are just as serious at an open-air music festival as they are in an indoor nightclub. Action on Hearing Loss recommends wearing reusable earplugs for music, standing away from the speakers and taking regular breaks from the loudest areas.

What hearing loss feels like

Most of us take our hearing for granted, so it’s easy not to notice at first when it goes.

It’s usually a gradual process. Background noises start to sound a little blurry, you can’t make out quiet voices and you don’t hear announcements at airports and train stations.

Next, you have difficulties hearing what people are saying if there’s background chatter, especially if it’s a child speaking or someone who's quietly spoken.

Then you find that in a busy setting you have to concentrate really hard on what the person you’re talking to is saying and you start to pay more attention to people’s lip movements and expressions to read what you can’t hear.

Can you hear properly?

Try answering these eight questions to gauge whether you could be losing your hearing.

• Do other people seem to mumble rather than speak clearly to you?
• Do people often have to repeat things for you before you understand what they say?
• Do you have difficulty understanding what is being said in noisy places, such as pubs or restaurants, even though other people manage to have conversations?
• When you are talking to people in a group, is it hard to keep up with the conversation?
• Do other people think your television or music is too loud but you can't hear it properly if they turn it down?
• Do you often have difficulty hearing on the telephone?
• Have other people told you that you don’t hear well?
• Do you find it tiring to listen to conversations because you have to concentrate hard?

If you answered yes to most of these questions you could be losing your hearing.

The next step is for you to have a hearing test. Read more about getting your hearing tested.

Find out about the hearing impairment and deaf support services in your local area (both NHS and charitable).

Read more about hearing impairment.