Category: CaptionCall

It is common for many people to thank members of the Armed Forces for their service. This is especially true around the major military-related holidays such as Veterans Day. We do so because we respect them and what they’ve done for our nation, both active-duty and Veterans.

We also recognize that they often put themselves at risk in the course of their military service. This is why, fair or not, this gratitude can be more heartfelt or be expressed more frequently when the Veteran has a visible disability such as scarring or the loss of a limb.

However, not all disabilities are visible, which we often forget. We tend to look at someone who is walking around without any visible issues as being “fine”. This is not always the case and that is especially true for Veterans.

Two hidden disabilities that are prevalent among Veterans are hearing loss and mental health. Both can have substantial impacts.

Is Veteran hearing loss common?

Hearing loss is one of the most common conditions among Veterans, particularly among those who have been exposed to loud noises and combat-related situations during their military service.¹ Loud noise from gunfire, explosions, machinery, and other military equipment can contribute to both temporary and permanent hearing damage.

According to the CDC, Veterans are 30% more likely to have severe hearing loss than a nonveteran.² More than 1.3 million Veterans received VA hearing loss disability compensation in 2020, and another 2.3 million for tinnitus.¹

This affects them in ways that may not be immediately obvious, such as employment. The Department of Labor reports that for the time period of October 2022 – September 2023 the employment rate of Veterans with a disability (5.1%) was slightly lower than that of nonveterans with a disability (7.1%) but significantly higher than that of Veterans with no disability (2.5%) and nonveterans with no disability (3.4%).³

Veterans of different eras may have varying levels of risk for hearing loss due to military service. For example, Veterans of World War II and the Korean War may have been exposed to noise levels that were not well-controlled, while modern Veterans from conflicts like Iraq and Afghanistan have had improved hearing protection and awareness.

This, unfortunately, does not completely remove or mitigate the risks inherent in being around these loud noises. Damaging noise levels often happen without warning while deployed.

Dave, an Army Veteran, explains, “The situation dictates, right? When we’re getting shot at or when things happen in theater, we can’t just go tell the enemy, ‘Hey, cease fire, wait ‘til we put our hearing protection in.’ Things are going to happen suddenly, and we can’t help that.” ⁴

Veterans with service-connected hearing disability can access VA benefits for hearing loss, including compensation and access to hearing healthcare. The VA encourages Veterans to undergo hearing evaluations and seek assistance if they believe they are experiencing hearing problems due to their military service. In fact, the VA is the largest employer of audiologists and speech-language pathologists in the United States.⁵

Mental health issues related to Veteran hearing loss

Veterans with hearing loss may be at an increased risk for a range of mental health issues that affect the Veteran community:

• Depression: Hearing loss can lead to feelings of isolation and social withdrawal, which are common triggers for depression. Veterans may struggle with the loss of communication and connection with loved ones, which can exacerbate depressive symptoms.^5,6,7
• Anxiety: The stress of coping with hearing loss, especially in social and work settings, can trigger anxiety. Veterans may worry about missing important information or being unable to effectively communicate with others, leading to heightened levels of anxiety.^5,7
• Communication difficulties: Hearing loss can hinder a person’s ability to communicate effectively, leading to frustration, anger, and a sense of helplessness. These emotions can contribute to mental health issues and may strain relationships.^5,7,8
• Social isolation and loneliness: Hearing loss can lead to social withdrawal and isolation, as individuals may avoid social gatherings due to communication difficulties. This isolation can worsen feelings of loneliness and contribute to mental health challenges.^5,7
• Post-Traumatic Stress Disorder (PTSD): Many Veterans have experienced traumatic events during their service, and the added stress of hearing loss can exacerbate symptoms of PTSD.⁹

These issues can be complex and interrelated, impacting individuals’ overall well-being.

For Jeremy, a Marine Veteran, having to constantly ask his wife, children, and colleagues to repeat themselves caused stress and tension as it became clear he was struggling to hear. As Jeremy’s hearing grew worse — a problem he suspects arose from shooting weapons with inadequate ear protection while in the military and from closely editing sound in films — he says he began experiencing pseudo-auditory hallucinations, a side effect of tinnitus and hearing loss due to military service. He blames the decline in his hearing for ending his career in communications.

Jeremy was one of the many Veterans who hesitate to get help. He says he avoided talking to anyone about it or going to a VA medical center, fearing they would say he was crazy and because he wasn’t sure it would actually help. Had he known about the prevalence of hearing loss in the Veteran community, he might have sought help sooner.

“No one ever talks to us about how tinnitus and hearing loss affects Veterans. It’s worse at night when we’re tired and things around us are dark and quiet, and we’re so close to falling asleep; the experience can be absolutely terrifying.” ¹⁰

Many Veterans may experience a combination of side effects from hearing loss. Seeking professional help, including hearing loss treatment, therapy, or support groups may make it easier to manage these challenges. Several organizations offer resources specifically for Veterans. There are also tools available that can improve communication, which may help.

Ways to avoid isolation and social withdrawal

Veterans with hearing loss risk isolation if they use avoidance to cope with difficulty hearing, which can feed mental health problems. Instead, tapping into resources will help them maintain their social connections and engagement.

Seek appropriate treatment

Consult with a healthcare provider or audiologist to assess the extent of hearing loss and discuss treatment options. This may include hearing aids, cochlear implants, or other assistive devices.

If they’re struggling emotionally due to hearing loss, counseling or therapy can help address feelings of isolation, depression, or anxiety.

Use assistive devices and communication apps

Modern technology offers many options for people with hearing loss. As VA Audiologist John K. says, “Today everyone has things in their ears — ear buds and headphones — so the stigma of wearing hearing aids has diminished. We have state of the art hearing aids that are connected to people’s smart phones. The advanced technology has been a game changer.” ¹⁰

High-quality hearing aids or cochlear implants have come a long way in both fit and features, and they can significantly improve people’s ability to hear and communicate. Modern hearing aids often come with Bluetooth connectivity for convenient communication and compatibility with their devices.

When Jeremy’s community provider learned he was a Veteran and suggested he check out the VA audiology clinic, saying it was one of the best, he got past his fear, applied for VA health care, and made an appointment. “I was shocked. I received top of the line care and hearing aids with the latest technology that works with my phone, something I couldn’t afford on my own,” he said. His doctor also programmed his hearing aids to his individual hearing level and needs. ⁽¹⁰⁾

Communication apps and devices are also available for people with hearing loss. For example, Veterans who need captions of their phone calls because of their hearing loss are eligible for federally funded captioned phone services for home phone or mobile at no cost.

Video relay services are available for those who are Deaf or profoundly hard-of-hearing and use sign language.

Closed captioning can also fill in the gaps so people can continue to enjoy videos, movies, and television shows no matter what their hearing loss is.

Communication strategies

For hearing loss that is not significant enough to require hearing aids, learning effective communication strategies such as lip reading and visual cues can supplement hearing, especially when conversations are in loud environments such as restaurants or places with lots of background noise.

Veterans should educate friends and family about their hearing loss, its challenges, and how they can help. That could include speaking clearly and facing them when they talk to improve communication.

Join support groups

Connect with local or online support groups for individuals with hearing loss, including Veteran-focused groups. Many Veterans’ organizations offer support and activities tailored to Veterans with hearing loss.

These Veteran support groups may also host workshops or classes focused on hearing loss and communication skills that can build confidence in Veterans’ ability to communicate effectively despite hearing loss.

Remember that hearing loss is a common challenge, and there are many resources and strategies available to help Veterans stay connected and involved in their communities.

General mental health among Veterans

Hearing loss isn’t the only risk factor for mental health challenges among Veterans. Veterans — especially those who have served in combat — may experience mental health issues related to challenges they face during and after deployment. These mental health issues may begin during their service or pop up later. Some common mental health issues among Veterans are:

• Post-Traumatic Stress Disorder (PTSD): PTSD is prevalent among Veterans who have been exposed to traumatic and life-threatening experiences during their service. Symptoms may include flashbacks, nightmares, hypervigilance (being especially alert to what is going on around them), and emotional numbness.¹¹
• Depression: Veterans may experience depression due to the stress of military service, difficult combat experiences, or the challenges of transitioning back to civilian life. Symptoms can be persistent sadness, fatigue, changes in appetite, and feelings of hopelessness.^13,14
• Anxiety: General anxiety, panic, and social anxiety can affect Veterans, often coming from the stress related to military life and deployment.^11,12,13
• Substance abuse: Some Veterans turn to drugs or alcohol as a way to cope with emotional and psychological challenges. Substance abuse can lead to addiction and worsen other mental health issues.^14,15

Every Veteran has their own story.

After three tours in Iraq, Duane says he struggled with PTSD and alcohol misuse upon reentering civilian life in 2012. When he realized he needed to change, he says part of the process was admitting he couldn’t do it himself. “It takes strength to know you can’t do it on your own,” he said. “We’re so focused on being individuals, we forget that we’re better as a team. That’s what mental health treatment is. It’s about finding a team that works for you.” ¹⁵

Getting treatment for mental health can help with other parts of recovery and treatment from injuries.

Chad served in the Marines, and on his last tour an Improvised Explosive Device (IED) blew up under his tank, shattering everything below his knees. Besides the medical issues, he says he also had PTSD.

He describes having so much pain he was taking painkillers just to walk and get out of bed and work. Connecting with a psychologist through the VA is what he credits with helping him through the decision to move forward with life-changing amputations. “I probably went two times a week for six months and I can’t believe how much that helped me,” Chad said. “It was a real relief. So by the time I had my surgery in January of 2008 for a double amputation, I was comfortable. I was ready.” ⁽¹⁸⁾

Mental health services are available through a number of organizations. Duane and Chad found teams that helped them tackle physical and mental trauma to lead happy, productive lives — so can other Veterans.

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Mental health resources for Veterans

Mental health resources for Veterans can assist in addressing the unique challenges after military service. Below are a few of the many mental health resources available to Veterans:

• Department of Veterans Affairs (VA) Mental Health Services: The VA offers a wide range of mental health services, including counseling, therapy, and support groups. Veterans can access these services at VA medical centers and clinics.
• Veterans crisis line: The Veterans Crisis Line provides 24/7 support for Veterans in crisis. Call +1 (800) 273-8255 and press 1, or text 838255 to connect with trained professionals who can help.
• National Center for PTSD: This resource from the VA offers information on PTSD, including self-help tools, treatment options, and educational resources.
• Give an hour: This nonprofit organization offers free mental health services to military personnel, Veterans, and their families through a network of volunteer mental health professionals.

Veteran hearing loss resources

There are also many resources available to help Veterans address and manage their hearing loss. Here are some hearing loss resources for Veterans:

• Veterans Health Administration (VHA): The VHA provides comprehensive healthcare services to Veterans, including hearing healthcare. Veterans can receive hearing evaluations, hearing aids, and other related services through VHA facilities. The VHA website offers information on available services and how to access them.
• Hearing Loss Association of America (HLAA): While not exclusive to Veterans, HLAA is a valuable resource for individuals with hearing loss, including Veterans. Its website and local chapters can provide information and support.
• American Tinnitus Association (ATA): Tinnitus is a common issue associated with hearing loss, and many Veterans experience this condition. The ATA provides resources, support, and information about tinnitus.
• VA prosthetics and sensory aids service: This VA service provides hearing aids for Veterans, assistive listening devices, and other adaptive equipment to Veterans with hearing loss. It can help Veterans assess their needs and provide the necessary equipment and support.

Additionally, Veterans with hearing loss should also explore the resources and support that various Veterans’ service organizations and nonprofits offer. These organizations often have programs and services that can assist Veterans with hearing loss and other disabilities.

Sources

1. Veterans — Hearing Health Foundation
2. The Prevalence of Hearing Loss in Veterans
3. Veteran Unemployment Rates
4. Off the battlefield, many veterans face a new foe: damaged hearing
5. Hearing Loss
6. Depression and Hearing Loss — American Academy of Audiology
7. Veterans and Hearing Loss — Aspire Audiology
8. The impact of hearing impairment and noise-induced hearing injury on quality of life in the active-duty military population: challenges to the study of this issue
9. Co-occurrence of hearing loss and posttraumatic stress disorder among injured military personnel: a retrospective study
10. Veterans with Hearing Impairment Provided State-of-the Art Treatment Options | VA Maryland health care | Veterans Affairs
11. Veteran and Military Mental Health Issues
12. For Most Vets, ‘Transition Stress’ Is the Problem, not PTSD. Here’s What That Means.
13. VA.gov | Veterans Affairs
14. Substance use disorders in military veterans: prevalence and treatment challenges
15. Iraq War Veteran With PTSD Finds His Own Path to Peace
16. Four Stories That Will Inspire You This Mental Health Awareness Month

There’s a wide variety of earplugs on the market these days: different sizes, shapes, materials, and designs to suit a range of needs and situations. Some options are downright fashionable, as much accessories as they are functional. The broad selection means you can find earplugs to meet your specific needs, whether that’s hearing protection or simply some peace and quiet.

The options can be overwhelming, so we’ve broken it down and solicited a few audiologists’ advice to simplify your decision. We’ll cover considerations such as:

• Using earplugs for hearing protection
• What is NRR?
• Types of earplugs
• Use cases: earplugs for swimming, music, movies, shooting, swimming, and sensory overload
• Earplug fit and comfort

Decibels and hearing damage: what decibel level is harmful?

Let’s start with the most obvious reason you’d use earplugs: to protect your hearing in noisy environments.

We measure noise in decibels (dB); the higher the decibels, the louder the noise. For example, a still winter day in the woods would probably register 10 – 20 decibels. Compare that to a firetruck siren at 110 – 130 decibels.

dB vs dBA

If you start digging into the science of noise, you’ll come across both dB and dBA. Without geeking out too hard, dB is a measurement of decibels that includes frequencies humans don’t hear. To more accurately gauge the impact on our hearing, dBA is a weighted measurement of noise only in the range that humans can hear. That means the same sound can have a different dB and dBA.

What is noise-induced hearing loss

As a general rule, anything below 70 decibels won’t damage your hearing.

Exposure to noise levels above that, however, can cause temporary or permanent hearing loss. It’s called noise-induced hearing loss, and it can result from exposure to a single loud noise or prolonged exposure to noise that damages the sensitive parts of your inner ear that process and transmit sound waves.

Exposure to loud noise is one of the most common causes of hearing loss. About 19% of the world’s population has some degree of hearing loss, and those numbers are rising. Researchers estimate as much as 24% of American adults and 17% of teenagers have some degree of noise-induced hearing loss.

The higher the decibels, the shorter duration of exposure before you can damage your hearing. The following chart is a guideline for how long it takes for common noise levels to potentially cause hearing loss:

The good news is hearing loss from noise exposure is 100% preventable, and even if you already have some noise-induced hearing loss, you can prevent further damage by using hearing protection, like earplugs.

At what decibel level is hearing protection required?

You can gauge from the table above what decibel (dB) level is harmful. To avoid noise-induced hearing loss, you should use hearing protection for prolonged exposure to noise above 70 dB or even a short time in a very loud environment, like near a jackhammer.

Of course, it’s not realistic that you’ll know exactly how loud your surroundings are all the time…though, if you’re interested, you can get decibel meter or sound level meter apps for your smartphone. SoundPrint — which is also on our list of best hearing loss apps — is one example which not only includes a decibel meter, but allows users to submit the noise level of different locations to help others find quiet locations.

Do people with hearing loss need to wear earplugs?

“The volume never seems too loud to me. I have a hard time hearing as it is. Do I still need earplugs?”

Yes. If you have hearing loss, wearing high-fidelity earplugs in noisy places can actually help reduce background noise to allow you to better hear your conversation or music. And wearing any variety of earplug will help prevent further hearing loss.

If you’re concerned about using earplugs for hearing protection because of your existing hearing loss, custom hearing protection from a hearing healthcare provider/audiologist will be especially beneficial, and you may consider captioning as well. Live transcription apps for smartphones are also among our favorite hearing loss apps.

Understanding Noise Reduction Rating (NRR)

An obvious place to start in choosing the right earplugs is with Noise Reduction Rating (NRR). It’s going to be essential to your decision, whether you’re looking for earplugs for sleep, focus, or dangerous noise levels.

What is NRR?

Noise Reduction Rating (NRR) is a standardized measurement of the maximum amount a hearing protection device can reduce the intensity of noise (when used correctly), based on lab tests that factor in type of noise, frequency, and duration of exposure.

Conveniently, you’ll typically see NRR in decibels, so you can gauge whether an earplug will provide adequate noise reduction by subtracting its NRR from the noise level of your intended activity. For example:

• If you’re on a motorcycle, with a noise level around 100 dB, and you’re wearing earplugs with an NRR of 30 dB, your noise exposure works out to 70 dB. That puts your exposure at a safe level even for prolonged riding.
• If you share a bedroom with a loud snorer who’s sawing logs at 60 dB, and you’re using earplugs with an NRR of 20 dB, that reduces your noise exposure to the equivalent of the soft hum of a refrigerator.

When your goal in using earplugs is hearing protection, you should aim for an NRR that will reduce your noise exposure to a safe level, ideally 70 dB or lower.

Maximum possible NRR

If you’re looking for the best earplugs for noise reduction, you’re probably searching for the highest NRR out there, and you’re going to top out around 33 dB. For most use cases, that’s enough, but it won’t reduce very loud noise — like gunfire, heavy machinery, or explosions — to safe exposure levels. High decibel earplugs are a great place to start, and you have a couple options to better protect your hearing in very noisy environments.

Dual hearing protection

You can achieve an NRR above 33 decibels by combining two types of hearing protection. Most often, wearing foam earplugs and ear muffs together. However, when you double up on hearing protection, you don’t double your NRR. Using a second type of hearing protection will add roughly 5 dB of additional NRR. So if you add ear muffs while wearing earplugs with an NRR of 33 dB, you could get up to 38 decibels of total noise reduction.

Limit duration of noise exposure

If you can’t reduce your noise exposure to safe levels, reduce your length of exposure. When the noise in your environment averages above 70 dB, try to limit the time you spend around it.

For example, if you’re on your laptop and a construction crew is working nearby, making a lot of noise, move to another location where the noise is lower. Another example from Sorenson’s own audiologist Stephen DeMari: avoid positioning yourself right next to speakers at a concert; even with earplugs, that can be unpleasant.

Types of earplugs

Deciding on a type of earplug can be daunting. There are significant differences in NRR, comfort, and cost. To narrow down the selection, audiologist MarieAnn Z tells us her guidance is simple:

“Consider the situation you will be using the hearing protection, your expectations for hearing in noise (like a concert versus a work environment). Is this something you will use daily, weekly, monthly?”

While you have dozens of options varying in style, material, and cost, they boil down to a few basic categories:

Foam earplugs 

Low tech, low cost, and effective. These soft foam cylinders are readily available over-the-counter and have some of the highest noise reduction ratings (NRR) of any earplugs out there. You tightly roll the squishy foam before inserting and let them expand in your ear canal. These don’t play favorites with which sounds they block, so they make it difficult to hear speech (including your own) or music.

NRR: up to 33 decibels 

Pros:

• Excellent noise reduction ratings
• Affordable and widely available over-the-counter
• Comfortable for extended use
• Available in disposable or reusable options

Cons:

• Some users experience discomfort or ear pressure
• May not fit perfectly in all ear canals
• Not as green an option as long-term reusable varieties

Cost: typically $0.10 – $0.50 per pair for disposable options or $2 – $15 for a reusable pair, depending on the brand and features

NRR: 20 – 33 dB when properly inserted

Pre-molded earplugs

These reusable earplugs come in a variety of materials — plastic, rubber, or silicone — as well as several sizes and designs, including fashionable styles. They’re easy to put in, with no rolling required, and may create less sensation of pressure in your ear than expanding foam.

This category can include high-fidelity (hi-fi) earplugs, also called uniform-attenuation earplugs. They have the same effect as turning down the volume on a stereo: the sound intensity decreases evenly across different pitches, so it’s not distorted. You might find high-fidelity earplugs especially helpful at movies or concerts so you can appreciate audio quality and speech.

Pros:

• Selection of sizes to better fit your ear canal
• Reusable and easy to clean
• Some create a watertight seal, making them suitable for swimming
• High-fidelity options
• Range of aesthetic options, including color and shape

Cons:

• May be more expensive than other non-custom earplugs
• Less noise reduction for extremely noisy environments
• Some users find them less comfortable for extended wear
• It’s possible for varieties with silicone tips to come loose and get stuck in your ear

Cost: may range from as low as $10 for basic options to as much as $50 for specialized and high-fidelity

NRR: 15 – 25 dB

Canal caps

Canal caps come in both pre-molded and formable varieties. You can even get custom-made canal caps as well as over-the-counter. Their distinguishing features is a stiff band that applies light pressure to hold the earplugs in place while inserted, and when not in use can hang around your neck. That makes them a popular choice among users who alternate between needing hearing protection in noisy environments and needing to hear clearly.

Because canal caps can include both off-the-shelf or custom options as well as formable or molded earplugs, cost and NRR will vary.

Pros:

• A snug and secure fit
• Multiple options for different use case
• Custom and off-the-shelf varieties available

Cons:

• May be more expensive than basic foam earplug
• Limited size and shape options mean some users find them less comfortable for extended wear

Cost: a wide cost range, depending on features, intended use, and whether you opt for custom canal caps. Off-the-shelf, you may find a pair for as little as $5, while custom options may cost up $100 – $500.

NRR: varies by fit and material

Wax or silicone putty earplugs

Wax or silicone putty earplugs are the most pliable variety of hearing protection, allowing you to shape them to your ears for a comfortable fit and a tight seal. However, wax or silicone isn’t the best material to insert into your ear canal, which limits the effectiveness of this type of earplug for noise reduction. Audiologist Stephen DeMari points out they’re still a better option than no hearing protection at all or shoving cotton or tissue in your ears.

Pros: 

• Mold to the shape of your ear, so you can adjust fit
• Can create a watertight seal for swimming and water-related activities

ble use while sleeping

Cons: 

• Less effective in very noisy environments
• Some risk of melting in ear canal

Cost: typically $2 – $10

NRR: 20-25 dB

Custom molded earplugs

Custom earplugs from a hearing health professional are the top-tier option for hearing protection and comfort. The provider will take a mold of your ears to create a perfect fit for your ears specifically. You can also tailor the design, NRR, and noise filtering for your intended usage — for everything from sleep to construction work. Custom fit earplugs also typically allow you to choose their color, even including options like glitter, glow-in-the-dark, or marbling effects.

Pros: 

• Ideal fit for maximum comfort
• Fully customizable to your intended use and NRR needs
• High-fidelity options
• Lower risk of getting stuck in ears

Cons: 

• More expensive than most off-the-shelf options

Cost: $100 – $300+

NRR: 15 – 33 dB

If you consult a hearing health professional for custom hearing protection, you may also want to take the opportunity to test your hearing. If you already have some degree of hearing loss, an audiologist can recommend a holistic plan to protect you from further hearing loss and improve your day-to-day hearing as well.

If you have hearing loss that’s affecting your ability to use the phone and you need captions for your calls, your hearing health provider may suggest you sign up for no-cost phone call captioning using the CaptionCall Mobile app by Sorenson or CaptionCall by Sorenson for home phone.

Noise-cancelling earplugs

In addition to conventional earplugs that physically block noise (noise-reducing earplugs), you also have the option to tap into digital technology in the form of noise cancelling earbuds. These electronically cancel out specific frequencies, like the hum of an airplane engine or the hubbub of a busy location. Because they can connect to your devices, noise-cancelling earplugs will also allow you to listen to audio through them while they remove background noise around you — earplug headphones.

Pros: 

• Counteracts bothersome frequencies
• Double as earphones for listening to audio

Cons: 

• Cost is higher than many other off-the-shelf earplugs and may be more expensive even than custom earplugs
• Don’t protect hearing from sudden loud noises
• Require batteries or charging
• Limited size and shape options mean some users find them less comfortable for extended wear

Cost: can range from $50 to $300+, depending on brand and features

Choosing the best earplugs for specific use cases

Earplugs for sleeping

Comfort is critical when choosing earplugs for sleeping, and comfort will come down to a combination of material and fit. You’re likely to have the best luck with a soft material: foam, silicone, or wax.

Audiologist Marnie R. recommends that if you’re using earplugs primary for sleeping, size and shape are also worth considering:

“Sleeping plugs are most comfortable if they are made CIC style, just in the canal. The material should be somewhat softer than a standard earplug, so as not to cause discomfort if you are a side sleeper.”

To decide on an NRR, consider whether you want near-silence or need to be able to hear some sounds. For example, if you want to be able to hear a crying baby or are worried you won’t wake up to your alarm, you might choose an NRR in the mid to upper teens versus an NRR of 25 or above if you’re a light sleeper trying to drown out city noise or you share a room with someone who snores.

You can also try noise canceling earplugs for sleeping, but the firmer material may not be comfortable for side sleepers.

Earplugs for concerts, musicians, and movie theaters

High-fidelity (hi-fi), or uniform attenuation, earplugs are going to be your best bet when you want to clearly hear audio while lowering the noise level. Pre-molded or custom fit earplugs offer this option, using filters to preserve sound quality and still lowering your noise exposure to prevent hearing damage.

For musicians or people who frequently attend concerts or movies, custom earplugs may be worth the investment for a perfect fit plus the ability to tailor them to your specifications for sound filtering.

As far as the NRR of earplugs for concerts, the decibel level of indoor live music can easily be more than 100 decibels, so you won’t regret an NRR of 25 of higher.

Earplugs for shooting

When you’re looking for earplugs for the shooting range, go for maximum NRR. Either foam earplugs or custom earplugs with an NRR of 30+ are a must, and earmuffs on top of them is a good idea.

For hunting, it’s still important to protect your ears from the damaging decibel levels of gunfire, but it’s understandable you do want to be able to hear other sounds around you. Some companies make specialized electronic earplugs that can activate noise suppression when they detect loud noise, but amplify ambient sound when it’s quiet so you can hear what you need to.

Earplugs for focus, sensory overload, and audio sensitivity (hyperacusis and misophonia)

Individuals with sensory sensitivities, hyperacusis, or misophonia — including some people with autism or ADHD — notice significant benefit from using earplugs to reduce sensory overload or improve focus by blocking distracting noise.

What is hyperacusis? What is misophonia? And What’s the difference?

Hyperacusis is a heightened sensitivity to even everyday sounds that makes them seem louder to you than to everyone else, even to the point of hurting your ears.

Misophonia is an extreme dislike of certain noises, even at a normal volume, to the point that hearing them makes you agitated or downright angry. For example, hearing other people chew.

If you deal with hyperacusis or misophonia earplugs can stifle offending noises and offer a little peace.

Because you’re likely to wear these regularly and potentially for extended periods, comfort is likely to be a priority. Your most comfortable option is custom earplugs.

For a less expensive choice, foam, wax, or silicone putty earplugs are soft and bendable to the shape of your ear. These will block or muffle all noise, which may be exactly what you want.

You may prefer to block distracting or overstimulating ambient noise while still being able to clearly hear music or someone speaking to you, making high-fidelity custom or pre-molded varieties your best choice.

If your intended use is noise sensitivity and not hearing protection, noise cancelling earplugs may also work well for you.

Earplugs for swimming

Swimming earplugs have one job: create a watertight seal to keep water out of your ears. But that doesn’t mean you can’t put them to work on two fronts. The best earplugs for swimming can also offer hearing protection to extend their usefulness.

Custom earplugs, wax, or well-fitting pre-molded earplugs can all seal off your ear canal from water. The custom or pre-molded route are reusable and can also offer hearing protection, so they’re an investment you’ll get double use of.

Just a one-off need because you forgot your molded earplugs? Wax or silicone putty are affordable and can do the job. Avoid foam earplugs for swimming because they’ll act like a sponge in the water.

Earplug fit and comfort

Remember that the effectiveness of earplugs also depends on proper fit and usage. No matter how much you spend on a set of earplugs or how high the NRR, they’re not going to give you the results you want if the fit isn’t right or you don’t have them inserted correctly.

Audiologist Marnie R. says nothing is more important than getting the right fit on your earplugs for comfort and effectiveness:

“I work with an office that does almost as much hearing protection as we do hearing aids. What we have found is that for those wanting hearing protection for hunting/concerts/construction...etc, the fit is extremely important…Custom built hearing protection works so much better than foam earplugs.”

Without investing in custom hearing protection, you can opt for foam earplugs or wax/silicone putty for their ability to form to the shape of your ear. The softness of the material means nearly anyone can squish the material to fit their ears.

With any earplugs, proper insertion will make or break their noise reduction and comfort. With foam plugs in particular, it’s important to follow the instructions, twisting them down to the narrow width you can fit in your ear canal and then letting them expand in your ear. Earplugs that comfortably fit deep in your ear canal will provide the most sound reduction.

DeMari suggests looking in a mirror or asking someone to look at you straight on. If your earplugs are visibly sticking out, they’re not in correctly.

Even in the case of fashionable pre-molded earplugs designed to be visible, they shouldn’t be hanging out of your ears. If you can’t wear them securely without discomfort, they’re not a good fit. Because no two people’s ears are quite the same size and shape, a molded earplug that comfortably fits someone else won’t necessarily fit you.

Material makes a difference not only in fit and use case, but also if you have allergies to plastics, silicone, or latex. If you have allergies to these common earplugs materials, you can ask a doctor or audiologist about alternative options.

Where to get earplugs

Ultimately, the best choice of where to buy earplugs is going to come down to how you plan to use them.

From a hearing health provider

All of the audiologists we talked to agree that custom molded earplugs from a hearing health professional will give you the best fit for comfort and effective noise reduction. So for regular use — or if you struggle with earplugs that don’t fit your ears — they may be worth the investment.

To find a hearing health care provider, you can search through your health insurance directory, especially if you want to establish a relationship for hearing health care.

You can also look for providers in your area using an online directory like the one through Healthy Hearing to browse thousands of hearing health clinics.

Off-the-shelf

However, off-the-shelf options are perfectly acceptable for one-time or occasional use. You can find foam earplugs at a wide variety of retailers: hardware stores, pharmacies, department store chains, even some convenience stores carry them.

There’s a large selection of pre-molded earplugs and noise canceling earplugs online, but you can also find options from big box retail stores and specialty music stores.

Family is where it all begins. Those are the people who shape us and our worldview. They’re our first and most important relationships. They teach us to communicate. When hearing loss or deafness adds complexity to our family, we don’t give up on connection: we make it work.

We’re going to explore how a variety of families connect across different hearing statuses and the information and resources to support mixed hearing communication:

• Categories of hearing loss
• Communication in hard-of-hearing/hearing families
• Communication in Deaf/hearing families
• What is a Coda
• Everyday Deaf and hard-of-hearing communication solutions

What are the different categories of hearing loss?

According to the National Library of Medicine: ¹

A hearing loss of up to 20 decibels below the hearing threshold is still considered to be normal hearing. More severe hearing loss can be described according to severity, as follows:

• Mild hearing loss: Hearing loss of 20 to 40 decibels.
• Moderate hearing loss: Hearing loss of 41 to 60 decibels.
• Severe hearing loss: Hearing loss of 61 to 80 decibels.
• Profound hearing loss or deafness: Hearing loss of more than 81 decibels.

Hard-of-hearing is a loss between mild to moderate on this scale,² where there may be enough residual hearing that an auditory device, such as a hearing aid, benefits the individual.³ These people may struggle with a quiet or typical conversation.

The profound hearing loss that qualifies as medical deafness equates to very little or no functional hearing.³

For perspective, these are the decibel levels of some common sounds

• Quiet conversation: 40 dB
• Normal conversation: 60 dB
• Traffic: 80 dB
• Industrial noise: 100 dB
• Very loud music, for example at a rock concert or a nightclub: 120 dB
• Nearby thunder: 120 dB
• Jet engine: 140 dB

The only way to accurately measure a hearing loss of specific decibels is a hearing loss test. An audiologist can perform a variety of hearing loss tests and can recommend treatment or technology that may make everyday life and communication easier.

Communication in hard-of-hearing and hearing families

More than 37 million Americans say they have some trouble hearing, and it’s more common with advancing age.

There are a lot of people out there who don’t have perfect hearing, especially in older generations. The greatest amount of hearing loss is in the 60-69 age group⁴. Many of them are used to being able to hear and speak normally for most of their lives and start experiencing hearing loss at some point. Young and middle-aged adults are developing hearing loss at a higher rate than previous generations, largely due to noise exposure, including listening to media at a high volume through ear buds or headphones.⁵

People new to hearing loss often are embarrassed, apologetic, or in denial. These feelings may present additional challenges in communicating even with the people closest to them. But many families include someone with hearing loss, and they adjust to get through to each other:

• Speaking slowly and clearly, facing the person when possible if it helps them to read lips.
• Sitting/standing on someone’s “good side” in cases where someone has more hearing in one ear than the other, if they desire.
• Limiting background noise while talking.
• Practicing patience to give clarification when necessary.
• Using technology, including hearing aids, call captioning services, closed captioning, and apps.

Irene

On the other end of the spectrum is Irene, who was relieved at her recent diagnosis of “hidden hearing loss”/Central Auditory Processing Disorder (CAPD) after 47 years of not “knowing that what I was inadvertently struggling with could be managed with hearing aids.” She says for decades her hearing loss affected how she interacted with her family. “More than anything it’s been incredibly annoying. I was diagnosed … about 6 weeks ago. I ‘heard’ just fine but didn’t always understand.”

“I did not realize that I had any hearing issues until I kept using CC (closed captions) while watching TV. I was struggling to parse out different instruments while listening to music, and I had trouble hearing/understanding others while in conversation. I currently use hearing aids and keep the CC on. The hearing aids are Bluetooth, which is pretty cool and easy to manage.”

Irene is part of a growing trend of young and middle-aged people who use hearing aids to improve their quality of life and communication.⁶ They’re defying years of stigma attached to hearing loss and generating mainstream demand for assistive technology. “Oddly enough,” Irene adds, “now that I know what makes it harder for me to understand, I have zero shame in telling others. If I can help others in a similar situation, I will do it!”

She says figuring out her hearing situation has eased the frustration of trying to connect with people she cares about and enhanced her daily life. “Please, please get your hearing checked, and not just the standard test. Ask about CAPD and ask that you get tested for it. Now that I can hear and understand so much better, my burden is so much lighter. I had no idea how much mental energy I was using on a day-to-day, existing basis. I had no idea that music is so much more vast and colorful!”

Communication in Deaf and hearing families

There can be wide variations in communication methods in Deaf/hearing families to fit the preferences of Deaf people who are oral (speaking with their own voice and listening with the assistance of devices such as hearing aids or simply lipreading) or use signed languages as well as the language skills and hearing ability of their loved ones.

More than 90% of Deaf children have hearing parents⁴ — and, likewise more than 90% of Deaf parents have hearing children⁷ — so Deaf, hearing, and hard-of-hearing people learn to connect across hearing status with their own family members.

Yuliya

Yuliya is Deaf and is the only person with hearing loss in her birth family. Her husband is Deaf but they accommodate her hearing family. “None of my family members sign. My kids sign, but the adult members of my family don’t. I speak with them. I am used to it — I grew up oral. I was not really exposed to Deaf culture while growing up. When I went to college, I was exposed more to Deaf culture, the history, the language, etc., and I loved it.”

Yuliya’s children are Codas and she sees the mixture of cultures and languages in them. “My children are mostly in the Deaf culture right now because they are still pretty young and are just with my husband and me. They communicate with us through sign language. But when they see the hearing members of my family, they will use their voice, so we’ll see how things change (which culture they feel most part of) as they get older.”

What is a Coda?

With the success of the 2022 movie, CODA, this term has been in the media more. Coda (sometimes “CODA” or “coda”) stands for Child of Deaf adults. A Coda may have one Deaf parent or both, or a legal guardian raising them who is Deaf.⁸

90% of Codas are hearing. These people frequently navigate between Deaf and hearing culture as they grow up in much the same way as a child born to immigrants navigates between the culture of the country in which they live and the culture of their parents’ countries of origin. Codas frequently feel they are a part of Deaf culture even though they are not Deaf themselves.

Gregg

Gregg is a Coda — he has Deaf parents and a Deaf Aunt, uncle, cousin, and niece. He signs with his Deaf family members. He occasionally will use his voice with his mom, who has some hearing, just to get her attention and then he will sign after that. He both talks and signs with his niece, who has some hearing and wears Cochlear Implants, a version of hearing aids. He adds, “Because I can sign, I tend not to use Video Relay Services. I will text or use apps where I can sign.”

“Culturally I feel half and half. I feel the connection with my family, friends, people I grew up with. But I am also part of the hearing culture.”

Rosa

Rosa is also a Coda. On her dad’s side, he is the only one that has a hearing loss. On her mom’s side, there are many Deaf relatives — grandparents, aunts, uncles, and cousins — mixed in with the hearing relatives. “My parents are both Deaf,” Rosa said, “so it was just part of our life growing up. We’d go to events at the Deaf school such as football games and basketball games. We’d also go to other community events like Deaf bowling nights. And of course, we’d go to our parents’ friends’ or they’d come to our place.”

She said, “Our family only signs. My mom can’t hear at all so she was pretty strict about us signing instead of speaking when we were growing up, and it’s just normal now.” She keeps up easily with her family via text and FaceTime.

Britnee

Britnee is hard-of-hearing and has a Deaf mother and hearing father. Her brother is Deaf and her grandparents on both sides are Deaf. She says her communication methods depends on who she is talking to and what the situation is. Her hearing is good enough with hearing aids that she can talk verbally with hearing family members who don’t sign well. She signs with the other Deaf people in her family. If she is talking with a hearing family member who does not sign well and a Deaf member enters the room, she will start signing.

Britnee says mixed influences growing up have shaped how she identifies and communicates with the people around her. She attended a mainstream elementary school and junior high with hearing peers. Then in high school, she went to a school for the Deaf. She uses a hearing aid when she is around hearing people out in the community or with hearing family members but when she is at home, she generally takes them off.

“For the longest time I identified mostly as hard-of-hearing because I can hear pretty good and can speak and that is what others see me as. But lately I have started to identify more as Deaf since I started working at my current job. Really, I decide if I am Deaf or hard-of-hearing depending on the perception I want to create, how I want to communicate my specific words, and sometimes just my mood.”

Everyday Deaf and hard-of-hearing communication solutions

Communication is not only face-to-face, and families rely on phone and internet services to connect when they’re apart. For decades, that presented additional challenges for families who use sign language, read lips, and have difficulty hearing over the phone. But now, there are many services available to the Deaf and hard-of-hearing for communication and accessibility:

Video Relay Service

Video Relay Service (VRS) is a no-cost service Deaf or hearing people can call where the hearing person in the middle is a qualified ASL interpreter who signs with the Deaf person and speaks with the hearing person.

Videophones

A videophone is a standalone device that connects to the internet and streams both video and audio. It’s one of the devices Deaf individuals can use to make video relay calls to hearing people. The first videophones had basic dialing/ringing/answering functions and a contact list to save phone numbers. Nowadays videophones designed for the Deaf — such as the latest videophone from Sorenson, the Lumina — are more sophisticated. Some of the newest features are the ability to leave a video message (similar to voicemail), change the UI to Spanish, linking multiple devices to one VRS phone number, and customizable light-ring settings (similar to ringtones).

Computers with webcams

While videoconferencing apps such as Zoom and Microsoft Teams existed before COVID, the COVID-19 pandemic prompted an explosion in their popularity. Many businesses used these apps to continue operating. They also found widespread usage in families and friends who wanted a way to see each other when they were not able to visit in person. The arrival of Sorenson VRS for Zoom in Spring 2023 offered a new level of functionality for Deaf and hearing conversation, allowing an interpreter to join the meeting as a participant for fluid interpreter communication with everyone on the same screen.

Smartphones with cameras and videoconferencing capabilities

There are many smartphone apps that offer accessibility benefits for the Deaf and hard-of-hearing allowing users to pick and choose what’s helpful to them. For Deaf smartphone users, front-facing cameras introduced a wave of videoconferencing apps. Those apps include mobile VRS applications, like ntouch, so Deaf users can make and receive calls anywhere they take their phone.

Captioned phone calls

Phone call captioning (IP-CTS) is a no-cost service for hard-of-hearing people who need captions to use the phone. It provides real-time captions of their phone conversations on a specialized caption phone or a smartphone app.

CaptionCall by Sorenson and CaptionCall Mobile are both no-cost call captioning products. With CaptionCall, eligible users can sign up even without home internet service.

Hearing aids

Hearing aids were the first “technology” to improve communication for people with hearing loss, and they have transformed over the years. Some hearing aids are now so small they’re practically invisible in your ears.

About two percent of adults aged 45-54 have disabling hearing loss, meaning they could benefit from hearing aids. That number trends upward with age: 8.5 percent of adults aged 55 – 64, 25 percent of adults aged 65 – 74, and 50 percent of adults aged 75+ have a disabling hearing loss that hearing aids may help with.⁴

The vast majority of people who could benefit from hearing aids do not use them. Only 30% of adults 70+ in that category has ever used them and only 16% of qualifying adults 20 – 69 have ever used hearing aids.⁴

Many recent hearing aid models now have Bluetooth technology which allows users to pair them with other technology such as their smartphones or captioning phones.

Effort is the biggest factor in hard-of-hearing, hearing, and Deaf communication

Communication is critical to understanding. When the desire and effort is there, a shared language is not a necessary starting place. The effort you put into trying to communicate leads to greater understanding and a broader knowledge of other people. Personal stories suggest most of us aspire to connect beyond words.

We see the same adaptability in communication across hearing abilities in immigrant communities. When families span geography for various reasons — moving for a better life, escaping a bad situation, or uniting people from different backgrounds — and have children, those children typically are quick to learn new languages through exposure at school or friends. They can be a great example to the rest of us of how doing ones best to communicate can benefit all of us.

Putting forth the effort to communicate with people who may not hear or communicate the same way you do is a statement of value. Work together to make those connections. There are many apps available to communicate. There’s always good old paper and pen. And, if all else fails, gestures can be useful. Many are universal concepts: eat, drink, sleep, cry, laugh, love.

This concept is the one that matters with communication — if we care enough about each other, we’ll figure it out. Every family with Deaf, hearing, and hard-of-hearing people has proven that if you’re caring, patient, and willing to try, there are no insurmountable obstacles to connection across language and hearing ability.

Sources

1. Quick Statistics About Hearing, Balance, & Dizziness
2. Understanding the degrees of hearing loss
3. Child of deaf adult
4. NAD — Community and Culture – Frequently Asked Questions
5. Questions: How are the terms deaf, deafened, hard of hearing, and hearing impaired typically used?
6. The experiences of cypriot hearing adults with deaf parents in family, school, and society
7. Telecommunications device for the deaf
8. There’s an Increased Risk of Hearing Loss in Young People
9. Hearing Aids Are Changing. Their Users Are, Too.

The most common service-connected disabilities for American Veterans are hearing loss and tinnitus, which is a ringing or buzzing in the ears. An estimated 3.6 million Veterans receive compensation for hearing loss or tinnitus.¹ And this impacts Veterans from every war from World War II through the Korean, Vietnam, and Gulf Wars, as well as those who served during peace time.

Compared to the general male population, 11% fewer male Veterans have good to excellent hearing while 10% more have at least moderate trouble hearing.²

Both hearing problems and tinnitus can impact quality of life and communication. Both also contribute to isolation, frustration, and even depression without intervention.

We sat down with audiologist Stephen DeMari, who is also Sorenson’s director of business development and education, to talk about Veterans and hearing loss due to military service.

Why talk to Stephen about hearing loss in Veterans?

Stephen has more than 30 years of experience in the audiology and hearing aid industries. He earned his master’s degree in audiology from Syracuse University. He then completed a clinical and research audiologist fellowship at the Department of Veterans Affairs Medical Center in Long Beach, California. He’s a member of both the American Academy of Audiology and the American Speech-Language-Hearing Association.

Q: Do Veterans have different types of hearing loss than the general population? 

A: No. There are different types of hearing loss. Conductive hearing loss occurs in the outer and/or middle ear. It can be caused by debris, excess ear wax, disease, or trauma.

Sensorineural hearing loss (SNHL), results from noise exposure, age, disease, or a combination of these. It involves the inner-ear and/or auditory nerve. It’s usually the result of damage to the hair cells in the inner ear. Severity of SNHL can be mild to profound.

SNHL is the most common type of hearing loss for Veterans and non-Veterans. Veterans most commonly suffer from high-frequency SNHL, which means they struggle to hear high-pitched sounds.

Q: What are some of the causes of hearing loss for Veterans? 

A: Hearing is a complex mix of three parts of our ears. Sound waves vibrate tiny bones in our ears and those vibrations create waves that interact with hair cells in our ear and create an electric signal that the brain interprets as sound.

That’s a very basic and abbreviated description. The complexity of it creates a number of opportunities for aging, noise exposure, disease, and heredity to affect hearing. Still, the most common cause of hearing loss is loud noise.

Hearing loss for service members results from gunfire, aircraft, tanks, bombs, and trauma from blast explosions. With noise-induced hearing loss (NIHL), the longer the exposure and the more intense sound, the greater the damage that occurs.

A lawn mower has a decibel level of about 95, while military guns range in the 150 decibels. Grenades and louder explosives can exceed 170 decibels.  Anti-tank fire can approach 190 decibels. A single grenade or tank blast can cause immediate and permanent hearing loss. Anything over 140 decibels instantly damages nerves. Exposure to 130 decibels can cause permanent damage with as little as 30 minutes of exposure.
Q: What are some of the symptoms a veteran may experience with hearing loss or damage? 

A: Symptoms depend on the severity of impact. Tinnitus isn’t hearing loss but a sensation of ringing, buzzing, clicking, or even roaring in one or both ears. It can seem like an engine or appliance is always running nearby. For some people, it’s loud and persistent enough to be debilitating.

A feeling of fullness in the ears can be a symptom of hearing loss. It can feel something like needing to pop your ears when you go up in elevation. Other symptoms of general hearing loss include:

• Asking people to repeat themselves or misunderstanding what they say
• Needing the television volume louder than normal
• Difficulty understanding speech, especially in the presence of background noise
• Fatigue after conversation, which results from struggling to listen
• Missing the phone or doorbell ringing

With high-frequency SNHL, Veterans might struggle to hear consonants. Speech will sound like mumbling.

Often, it’s the people a veteran interacts with who first notice a change in a veteran’s hearing.

Q: Does hearing loss only affect older Veterans? 

A: Hearing loss can affect Veterans of any age. It can also affect them while still actively serving. As I mentioned, exposure to a loud enough sound, such as tank fire, can damage hearing immediately and permanently. And as we grow older, our cognitive ability to understand speech naturally declines, as does our hearing sensitivity.

If exposed to sustained, unprotected noise levels during combat or training, a service member can experience hearing loss and/or tinnitus. High-frequency SNHL is the most common form among Veterans, old and young.

Q: Are there things Veterans and active-duty service members can do to prevent hearing loss? 

A: The only preventative methods are avoiding the noise and wearing hearing protection when possible. Ear plugs offer 30 to 40 decibels of attenuation (sound reduction). The military does buy and provide a lot of ear plugs. Earmuffs — like the headphones you see naval servicemen wearing — are another option. Some helmets also have built in hearing protection. Over time though, even with hearing protection, loud noise can damage hearing.

These devices help during active duty, but a veteran exposed to loud noises who didn’t have these options has likely already suffered damage. And even though they may not yet have symptoms of NIHL, their hearing may have been damaged. Options there include Veterans Health Administration (VHA) programs that offer further NIHL prevention and aural rehabilitation services to optimize remaining hearing.

Definitely, any inactive veteran should take the same precautions to protect their hearing as everyone should by avoiding loud noise and wearing hearing protection when using power equipment.

There are a variety of things anyone can do to naturally protect their hearing.
Q: What can vets do if they’re experiencing symptoms of hearing loss and/or tinnitus? 

A: It’s important to see an audiologist. A vet can do that through their local Veterans Affairs Medical Center (informally called the VA). The U.S. Department of Veterans Affairs website is a great place to start if you don’t know your local VA yet.

In some cases, the effects of tinnitus can be alleviated by a hearing aid or tinnitus program.

Q: Can a vet just see their non-VA doctor or audiologist?

A: Vets can see any doctor they choose. If they qualify for the Veteran’s Choice Program, their care for a covered non-VA doctor is covered under their VA benefits. The potential advantage of using a VA medical facility is that those practitioners specialize in helping Veterans with issues, including hearing loss, due to military service.

Q: Are VA audiologists licensed professionals? 

A: Yes. Each of the over 1,000 audiologists employed by the VA must hold a state license and participate in continuing education according to state regulations. And the Veteran’s Health Administration (VHA) operates the nation’s largest audiology program with audiologists at 400 locations.  So, whether a vet chooses their own provider or a VHA provider, they have access to excellent care.
Q: How do Veterans get a hearing test with the VA? 

A: Once enrolled for medical services at a VA facility, they can arrange for an audiometric test. If they’re deemed eligible for hearing aids, they’ll be scheduled for a fitting as well.

Many hearing aids can be adjusted remotely through the VA’s live video conferencing service, VA Video Connect. Veterans can contact their nearest VA audiology clinic to see if telehealth visits are available in their area.

Q: Do VA benefits cover hearing tests, hearing aids, and cochlear implants?

A: They do if the hearing loss is related to military service. Vets can get their hearing aids, hearing aid batteries, and related appointments covered under their VA benefits.

The VA also covers cochlear implants, which are devices that are surgically placed in the skin and used with an external device to transmit sound directly to the auditory nerve. Cochlear implants are sometimes the only option when hearing loss is significant enough or beyond the scope of hearing aids.

If a vet’s hearing loss is deemed to not be service-connected, Medicare may pay for hearing aids for older vets.

Q: Does the VA provide the latest hearing aids and cochlear implants? 

A: Yes. For eligible vets, the VA dispenses hearing aids from the top six manufacturers, GN Resound, Oticon, Phonak, Siemens (Signia), Starkey, and Widex. The devices provided by the VA are actual premium devices that sale for the highest prices in the non-veteran sector.

They also offer cochlear implants from three FDA-approved cochlear implant manufacturers, Cochlear Corporation, Advanced Bionics, and MedEl.

Q: Does the VA offer other hearing solutions for vets?

A: Yes. The VA also offers FM systems, which are frequency modulated (FM) systems. With such a system, someone speaking wears a small microphone that is transmitted to a receiver worn by the person with hearing loss. The transmitter can even be attached to a hearing aid.

Vets also have access to TV amplifiers and transmitters, remote microphones, and internet protocol (IP) captioned telephone service through the VA and other programs and based on their needs.

A TV amplifier works like an FM system but with a TV.

Q: What else can Vets do about hearing loss?

A: There are a variety of tools available to anyone with hearing loss. There are smartphone apps designed to assist with hearing loss, including captioning apps. [*Some no-cost apps have user eligibility standards].

Captioning apps are available. And captioned telephone service uses either a specially designed phone or a smartphone to turn spoken phone conversations into readable captions. Captions on a TV or show can also help. Studies have shown that captions can help with comprehension, even when someone wears hearing aids.

There are also aural rehabilitation programs, including some offered by the VA, designed to help reduce or compensate for hearing loss.

Support groups and organizations are also available to help Veterans with hearing loss, including HLAA Veterans Across America Virtual Chapter (VAAVC).

Whether a vet has symptoms of hearing loss, practicing good hearing hygiene is always a good idea as well.

Q: How can Veterans get captioned telephone service for hearing loss? 

A: Sorenson and other providers offer captioned telephone service to vets and others with hearing loss that requires they have captions to use the phone effectively.

Sorenson offers both CaptionCall and CaptionCall Mobile app by Sorenson to help vets with hearing loss stay connected. CaptionCall transcribes phone conversations using a specially designed phone with a screen for captions. CaptionCall Mobile is a smartphone app that captions calls on a mobile phone.

Vets can ask their audiologist about this no-cost service or visit Sorenson — Global Communications Solutions for People, Businesses, and Enterprises to learn more.

Request CaptionCall by Sorenson for your home

Download the CaptionCall Mobile app

Q: How do Veterans qualify for captioned telephone service? 

A: Captioned telephone service is available at no-cost to anyone with hearing loss that necessitates the use of captioned telephone service to use the phone effectively. Vets who meet this eligibility requirement can access the service through their audiologist by self-certifying they need it when they enroll.

Q: Do Veterans need to have internet access to use CaptionCall or CaptionCall Mobile service? 

A: No. Anyone who qualifies, including Veterans, can get captioned telephone service without internet access on select phones. And all that’s needed to use the CaptionCall Mobile app is a Wi-Fi connection or mobile (cellular) data connection.

by Rupa Balachandran, PhD, CCA-A

The key principles of patient-centered care for hearing health require understanding the emotional and physical needs of the patient while developing a solution that addresses their daily lifestyle. Best practices for patient-centered care go beyond excellence in diagnostic services. Understanding the attitudes, concerns, health literacy needs, and priorities of individuals with hearing loss are key to determining the right treatment options.

What is patient-centered care?

The Institute of Medicine (IOM) defines patient-centered care as “providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient’s values guide all clinical decisions,” (IOM, 2001). The Picker Institute further divided the principles of patient care into eight categories.

These principles, when applied to hearing health care, provide valuable insights into the areas where hearing health providers can develop and enhance our current practices. Applying these principles to hearing health care improves accountability and helps gather information on how well we’re serving the needs of  patients.

In this article, I dig deeper into these eight person-centered principles of health care as they apply to hearing health.

1. Respect for the patient’s values, preferences, and expressed needs

Patients value health care providers who create a positive and supportive environment. Acceptance and adjustment to a diagnosis of hearing loss only happens in an environment where a patient receives information in an empathetic manner.

Interviews with patients about the adoption and use of hearing aids indicated that patients were more likely to pursue the use of hearing aids and overcome challenges in adapting to hearing aids when they perceived consideration, warmth, and empathy from their health care provider (Blazer et al., 2016).

A review of first-time consultations with audiologists in Australia found that patients perceived a lack of empathy and a gap between their needs and the goals of the audiologists’. For example, when the audiologists delivered the diagnosis, two-thirds of them directly transitioned into a recommendation for hearing aids, without allowing the patient time to react or ask questions about the diagnosis and without discussing other available treatment options. For example, hearing assistive technologies, communication programs, and support groups (Ekberg et al., 2014).

When the encounter with the professional creates a negative perception, the individual often delays taking action, resulting in putting off opportunities to improve quality of life and well-being (Clements, 2015).

A patient-centered care model involves going beyond understanding the needs of the patients; it includes measuring if those needs were met. Requesting feedback from patients about whether they were treated respectfully, felt their values were taken into consideration, and whether they felt their needs were met during their encounter with the provider, provides information that can be used to improve on existing clinical services.

Patient satisfaction surveys sent to a patient after an appointment can help a practice hone its patient-centered care efforts. These surveys can be easily administered electronically with web-based survey tools.

2. Information and education

The first consultation with an audiologist or other hearing health care professional can have a long-term impact on decision-making and outcomes (Clements, 2015). In the hearing health care space, discussion of different treatment options and opportunities for social and emotional support lead to a comprehensive solution for patients.

In addition to a  recommendation for hearing aids, written information about the following resources can  help people with hearing loss.

Assistive-listening devices

Other options for treating hearing loss  include assistive listening devices and technologies that give situation-specific help to people with hearing loss. Technologies such as captioned phones, amplified phones, amplified wireless headsets for television, and other audio streaming can be part of an amplification strategy.

Smart phone applications also provide options for amplification and captioning speech in real-time.

Community support

Providers should include information on community-based education programs, such as speech-reading classes and aural rehab groups.

Patient-centered care can also include providing information on support groups for people with hearing loss, such as the Hearing Loss Association of America and hearing-impaired professionals groups that are available both locally and online. These groups not only provide additional support, they help people with hearing loss develop a sense of acceptance and shared community.

Ongoing device support

Health care providers need to offer patients regular updates on the use, operation, and maintenance of hearing aids and hearing assistive technologies after the initial fit. Links to videos and tutorials on care and maintenance of devices, along with a newsletter on what devices can do are a helpful reminder of how people with hearing loss can benefit from different technologies available in their devices.

These additional avenues of support help create an environment where individuals with hearing loss can understand and accept their hearing abilities and achieve positive outcomes with amplification. This in turn strengthens the provider-patient relationship.

3. Access to care

Improving access to care involves providing easy access to the hearing health care provider and addressing the national shortage of hearing health care providers.

With the expected increase in the aging population and market factors keeping the supply of audiologists fairly low, there’s an expectation that new avenues need exploring to improve access to hearing health care (Marquardt et al., 2017). Clinicians today have access to multiple technologies that reduce the need for in-person visits.

Online technologies and patient management portals

Web-based technologies make requesting appointments easy for clinicians and patients. The ability for patients to select the day and time of their appointment themselves; timely appointments; short waiting time in the office; and timely response to emails and telephone calls can be accomplished with the use of a customized patient management portal.

Tele-audiology

The global pandemic  forced practices to transition quickly to tele-audiology, which enables remote appointments that increase efficiency and productivity for the patient and provider. Remote appointments also increase access for patients who can’t get to — or from — the office without transportation assistance. Every provider has had instances where a patient waited in the clinic long after their appointment for a transport to pick them up.

Hearing health care doesn’t reach everyone who needs it. Residents of rural and low-income urban areas are at a particular disadvantage in accessing care.

Tele-audiology holds the key to increasing access for patients who also live several hundred miles away from their provider. Increasing the infrastructure to support a variety of tele-audiology appointments goes a long way toward alleviating the lack of providers in remote areas.

4. Emotional support to relieve fear and anxiety

Despite technological advances, the psychosocial concerns of adults with hearing loss continue to have impact on the decision to seek help for their hearing loss and rehabilitation. Patient attitudes towards amplification are critical influential factors driving consultations for hearing device adoption (Meyer, 2014). Patients experience a variety of emotions when adjusting to a diagnosis of a hearing loss. These include sadness, disappointment, fear, and worry.

Clinician response to patients during this time is an important aspect of patient-centered care. For a lot of patients, the recommendation of a hearing aid triggers an unpleasant association. They may equate hearing aids with old age and lack of independence (Claesen & Pryce, 2012).

When a patient raises these issues with the provider, it’s important that they feel their concerns are heard. A clinician’s interpersonal skills, along with active and empathetic listening, can facilitate more positive associations with hearing aids and foster a strong therapeutic relationship (Grennes et. al 2015). Setting aside time within the appointment to listen to the patient’s concerns and validate them is a critical step towards a strong patient-centered hearing health care model.

5. Involvement of family and caregivers

The National Quality Forum’s National Priorities Partnership characterizes patient-centered care as health care that “honors each individual patient and family, offering voice, control, choice, skills in self-care, and total transparency, and that can and does adapt readily to individual and family circumstances, and to differing cultures, languages, and social backgrounds” (NPP, 2010). For family, friends,  and other caregivers of adults with hearing loss, their contributions fall into two categories:

1. Functional assessment: Family and caregivers can add their perspective on how the hearing loss affects the everyday activities for the person with hearing loss, including their ability to communicate with those around them.
2. Treatment efficacy: They can weigh in on the benefits or challenges associated with the different treatment options for the patient. This information helps the provider make the most suitable recommendation for managing the hearing loss.

Patient-centered care is more than just agreeing to whatever the patient wants. It involves identifying issues that are meaningful in the patient’s life and tailoring a solution that works with the patient’s values. It involves respect for their feelings and emotions along with buy-in from their family, caregivers, and loved ones.

This provision of patient-centered care is complex and time-consuming, and requires broad involvement of the patient, the family, and the care team to consider all  issues that affect the patient’s care.

6. Continuity and secure transition between healthcare settings and coordination of care

Often hearing health professionals are required to share information with other key healthcare providers and work as a part of a team to provide appropriate care for their patient. Timely sharing of health information, appropriate referral to specialists, and keeping the primary care physician informed of the care plan are all key components of patient-centered hearing healthcare.

Working with a HIPAA-compliant electronic health record alongside secure transmission channels of health records is essential. Creating workflows within the administrative office that give patients easy access to their test results and nimble coordination between different providers and insurance go a long way toward building patient confidence and trust in the healthcare provider.

7. Physical comfort

In a hearing health care environment, care must be taken to ensure that the person is in a physical space that feels safe and secure and promotes participation. Ways create a safe and secure environment include:

• Room lighting that reduces glare
• Increasing visual contrast in walkways and doorways
• Having furniture that’s solid and not prone to shifting when the person sits down or stands up
• Signage that’s clear and easily understood
• Providing marketing materials that reflect and respect the patient’s cultural beliefs
• Making pocket talkers and amplifiers available for patients to use during appointments

These techniques help create an office where the patients feel that their values are respected and that the care they receive is comprehensive, competent, and delivered by professionals who care about their well-being.

8. Support for HCP in patient-centered care environments

A comprehensive discussion of patient-centered care needs to include support for those who provide the care. For most practices, patient-centered care requires a significant investment of time and resources.

Many providers are overwhelmed by decreasing reimbursements and encroaching threats to their scope of practice. With a healthcare industry undergoing significant transformations, there’s a need to identify mechanisms that support the provider in reaching the goals of patient-centered care.

Best practices in patient centered care are those that also take into account sustainability from a practice standpoint. Conversations around patient-centered care must include adequate reimbursement for the provider through appropriate billing codes and consideration of fee-for-service models.

Conclusion

Implementation of patient-centered care has very clear benefits for both the patient and the provider — better treatment outcomes, better health outcomes, stronger therapeutic relationships, and improved financial outcomes for the practice.

About the Author

Rupa Balachandran, PhD, CCA-A

Martinez VA Medical Center
150 Muir Road
Audiology Section 126
Martinez, CA 94553-4668

Email: [email protected]
LinkedIn: linkedin.com/in/rupa-balachandran

Sources

1. Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Audiologists, on the Internet at Audiologists
2. Claesen, E., & Pryce, H. (2012). An exploration of the perspectives of help-seekers prescribed hearing aids. Primary Health Care Research & Development, 13, 279–284. doi:10.1017/ S1463423611000570
3. Clements, C. (2015). Why do older adults delay in seeking help for hearing loss. Journal of Otolaryngology-ENT Research, 3(4), 00070.
4. Ekberg, Katie, Caitlin Grenness, and Louise Hickson. “Addressing patients’ psychosocial concerns regarding hearing aids within audiology appointments for older adults.” American Journal of Audiology 23.3 (2014): 337-350.
5. Gerteis, M. (1993). Through the patient’s eyes: understanding and promoting patient-centered care.
6. Blazer DG, Domnitz S, Liverman CT, editors. Hearing Health Care for Adults: Priorities for Improving Access and Affordability. Committee on Accessible and Affordable Hearing Health Care for Adults; Board on Health Sciences Policy; Health and Medicine Division; National Academies of Sciences, Engineering, and Medicine; Washington (DC): National Academies Press (US); 2016 Sep 6. 3, Hearing Health Care Services: Improving Access and Quality. Available from: NCBI - WWW Error Blocked Diagnostic
7. Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C., & Davidson, B. (2015). The nature of communication throughout diagnosis and management planning in initial audiologic rehabilitation consultations. Journal of the American Academy of Audiology, 26(1), 36-50
8. Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C., & Davidson, B. (2015). Communication patterns in audiologic rehabilitation history-taking: Audiologists, patients, and their companions. Ear and Hearing, 36(2), 191-204.
9. Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press (US).
10. Marquardt et al 2017. Supply and Demand of Audiologists in the US | Hearing Health & Technology Matters . Meyer, C., Hickson, L., Lovelock, K., Lampert, M., & Khan, A. (2014). An investigation of factors that influence help-seeking for hearing impairment in older adults. International Journal of Audiology, 53, S3–S17. doi:10.3109/14992027.2013.83
11. NPP (National Priorities Partnership). Patient and family engagement. 2010. .
12. Picker Institute: Principles of patient-centered care.

More than 60 million Americans over age 12 have some level of hearing loss.¹ Losing your hearing can be inconvenient, and frustrating. It may even lead to isolation, which can contribute to cognitive decline.² Luckily, as with most things, there’s an app for that — an app for living your best life with hearing loss, that is!

Let’s take a look at 9 of the best smartphone apps for hearing loss. Many are great for Deaf individuals too.

Included here:

CaptionCall Mobile  |  Live Transcribe  |  Live Transcribe and Notification  | Talk to Deaf  |  Sound Amplifier (iPhone)  |  Sound Amplifier (Android)  | Subtitles Viewer! (iPhone)  |  AudioCardio Hearing & Tinnitus  |  Shazam: Music Discovery

1. CaptionCall Mobile call-captioning app

Cost: $0 if you self-certify that you have hearing loss and need captioned calls to effectively use the phone, the cost of captioning is covered by federal funds. The service is unavailable otherwise.

If you have hearing loss and need captions to understand phone calls,  CaptionCall offers two great options for connecting to our call-captioning service. One is a specially made home phone with a screen that shows captions. The other is a mobile app that turns your smartphone into a captioning screen.  CaptionCall offers both services at no cost and requires only that you self-certify you have hearing loss and need captions to effectively use the phone.

Captioned calls work like closed captions on your TV. A captioning service converts spoken words into captions or text that appear on your phone’s screen in real time, so you can read along and keep up with the conversation.

CaptionCall Mobile captions calls using speech-recognition technology. It displays the captions on your mobile phone screen instantly. This is different than using the built-in captioning on your phone. It gives you faster, more accurate captions.

Of the available mobile captioning apps, CaptionCall Mobile is our favorite, not because it’s a Sorenson product, but because it works in real-time. There’s no lag or delay between what your caller says and seeing the caption text on your phone screen

Rating on Google Play

4 out of 5 stars

Rating on Apple App Store

4.8 out of 5 stars

Get CaptionCall Mobile for your mobile phone

2. Live Transcribe

Cost: Free basic version, optional monthly subscription for more features

Live Transcribe from Mighty Fine Apps is one of the best apps available for Deaf and hard-of-hearing individuals. It transcribes voice to text for any speech in range of your phone’s microphone. You can even set it to start transcribing the moment you open the app.

One advantage compared to a standard transcription app is that it lets you make the text as big as you want. You can even have the text fill the entire screen. It also offers captions in more than 70 languages and even lets you filter out profanity.

You can also save transcripts of conversations to a messaging app or note-taking app on your phone.

A small disadvantage of Live Transcribe is that it’s only available for iOS.

Rating on Apple App Store

4.6 out of 5 stars

Download from the App Store

3. Live Transcribe and Notification

Cost: Free

Live Transcribe and Notification from Research at Google gives you both live transcriptions of spoken conversation and sound notifications.

Live Transcribe turns spoken conversation into fairly accurate written captions in real-time and supports more than 70 languages.

Unique features include the ability to add your own frequently used words, such as names and household items. You can also use it to set your smartphone to vibrate when someone says your name.

Unlike Live Transcribe above, Google’s version doesn’t automatically save transcripts, but it does give you the option to save them manually. It will also only save them for three days. To keep them longer, you can copy and paste them into another program.

The notifications part of Live Transcribe and Notifications lets you choose custom sounds, flashing lights, or vibration mode to alert you to stove timers, smoke alarms, baby monitors, sirens, and more.

Rating on Google Play

3.8 out of 5 stars

Install from Google Play

4. Talk to deaf for Android

Cost: $6.99 annually

If you don’t want or need notifications, Talk to deaf from Kickdata is a good option. It does come at an annual cost of $6.99 but has a solid 4.1 average rating.

Talk to Deaf quickly translates spoken language into text displayed on your phone screen. You can customize the font and size for easier reading. You also have the option to save your conversation history.

A disadvantage of this app — or maybe a benefit depending on your needs — is that you must press the microphone button to capture speech.

Rating from Google Play

4.1 out of 5 stars

Install from Google Play

5. Sound Amplifier

Cost: Free

Another app from Mighty Fine Apps, Sound Amplifier boosts the volume on your surroundings.

This app uses your phone’s microphone to pick up sounds and increase the volume up to 100x through your connected headphones, while also minimizing background noise and taking advantage of its voice isolation feature.

Use it to amplify conversations, TV shows, movies, lectures, and more. While this app packs a serious punch, its built-in loudness protect feature still protects your ears by preventing the volume from getting dangerously high.

One disadvantage: this Sound Amplifier app is available only for iOS.

Rating on Apple App Store

4.6 out of 5 stars

Download from the App Store

6. Sound Amplifier

Cost: Free

This is Google’s take on the Sound Amplifier app. Just like other sound amplification apps on this list, Sound Amplifier uses your device’s built-in microphone to pick up sounds in your environment, then filters, augments, and amplifies them through your connected headphones.

Sound Amplifier doesn’t just turn up the volume on all noises — you can personalize your listening experience by boosting low frequencies, low frequencies, or even quiet sounds. It can help you enjoy everything from conversations and lectures to movies, TV shows, and plays.

If you have a compatible device, the app’s Conversation Mode can focus in on a speaker’s voice for even clearer sound.

Sound Amplifier is only available for phones running Android 8.1 or later.

Rating on Google Play

3.7 out of 5 stars

Install from Google Play

7. Subtitles Viewer! for iPhone

Cost: 3 free subtitles, more than 3 requires credits acquired through in-app purchases

Subtitles Viewer! by Craig Grummitt turns your iPhone or iPad into a personal subtitles screen. The app loads subtitles from a large database of crowdsourced subtitles and syncs with the action on your TV screen or even at the movie theater.

Rating on Apple App Store

4.4 out of 5 stars

Download from App Store

8. AudioCardio Hearing & Tinnitus

Cost: Free trial, basic plan for $9.99, or Pro+ plan for $14.99 a month, $64.99 every 6 months, or $99.99 annually.

AudioCardio Hearing and Tinnitus from AudioCardio is one of the apps we mention in our post on improving hearing loss naturally. It is a unique app that may help some users improve their hearing.

The app offers personalized sound therapy based on a hearing test you take when you open your account. AudioCardio then uses these results to develop daily one-hour sound therapy sessions for both of your ears. Sticking to the schedule and using it every day may help protect your hearing.

According to the app’s description, its technology is clinically proven by researchers — including Stanford University.

Rating on Google Play

3.2 out of 5 stars

Download from Google Play Store

Rating on Apple App Store

4.3 out of 5 stars

Download from the App Store

9.  Shazam: Find Music & Concerts

Cost: Free

Shazam is a popular music-discovery app designed to help you identify music you might hear in your everyday life. Whenever you hear a song that you’ve never heard before or can’t quite place, pull up Shazam and it’ll use your phone’s microphone to listen to the music and identify the song.

Not only is it great for finding and remembering new music, but it can help you enjoy your old favorites, too.  If hearing loss makes it hard to understand the lyrics of the music you love, this app displays the lyrics of all your favorite songs while you listen. You’ll never miss out on the joy of music — or singing along — again.

Rating on the Google Play

4.8 out of 5 stars

Download from Google Play Store

Rating on Apple App Store

4.9 out of 5 stars

Download from the App Store

Sources

1. Hearing Loss Statistics 2025: More Common Than You Might Think
2. https://www.ncoa.org/adviser/hearing-aids/hearing-loss-statistics/
3. Hearing Loss and Cognition: What We Know and Where We Need to Go - PMC
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC8920093/

Say what? If you find yourself asking, maybe you’re having trouble hearing. And you’re not alone — nearly 15% of people in the U.S. over 12 years old have hearing loss in both ears. If you’re among them and are wondering how to improve hearing loss naturally, there are things you can do.¹

In this post, we break down common types of hearing loss and natural remedies you can use to help protect and improve your hearing.  

Before we dive in, let’s talk about the basics of hearing loss. 

Types of hearing loss 

There are three main types of hearing loss that each affect different parts of the ear. 

Conductive hearing loss comes from an obstruction in, or damage to, the middle or outer ear. The damage or obstruction prevents sound from reaching the auditory nerve. Conductive hearing loss can be temporary or permanent. 

The most common type of hearing loss is sensorineural hearing loss. We hear when sound waves move the hair cells (cilia) in our inner ear, and that movement creates electrical impulses that travel to the auditory nerve in our brains. Damage to our auditory nerve or cilia results in sensorineural hearing loss. 

Mixed hearing loss is a combination of sensorineural and conductive hearing loss. It happens when a blockage or damage in your middle or outer ear makes your sensorineural hearing loss worse. 

Causes of hearing loss 

Several things cause hearing loss.  

While age itself doesn’t cause hearing loss, 33% of people over 65 have hearing loss.² Age-related hearing loss, known as presbycusis, is a slow loss of hearing in both ears that results from changes in the inner ear as we age. 

A variety of factors can cause hearing loss, including:

• Genetics: age-related hearing loss tends to run in families 
• Exposure to loud noises:
  • Noises above 85 decibels (dB), the sound of a gas lawnmower, can damage your ears and hearing in a few hours³
  • Noises above 120 dB can immediately damage your ears and hearing³
• Smoking: smokers are more prone to hearing loss than nonsmokers 
• Medical conditions, including diabetes 
• Some medications, including chemotherapy drugs for cancer treatment 

Knowing what type of hearing loss you have can help you determine if it’s possible to improve it at home, or if you need the help of a doctor or hearing specialist.    

Whether you have hearing loss now or want to avoid it in the future, there are things you can do to protect and improve hearing loss naturally.  

How to improve hearing naturally 

If you’re experiencing hearing loss, there are things you can try to improve it, including natural remedies for hearing loss.  

The best thing is to prevent hearing loss in the first place. And many of the ideas here can help. 

Note that the methods here are not intended as medical advice. Before trying anything at home, talk to your doctor. And if your hearing gets worse, we advise you to see a doctor about it. Know that some hearing loss is permanent and may require assistive devices. 

Clean out the wax 

Built-up earwax is one of the leading causes of conductive hearing loss. It prevents sound waves from reaching your inner ear.  

The good news is that you can safely remove earwax. If you do it regularly, you can help maintain hearing.  

When you clean your ears, keep in mind that they’re delicate. Don’t put cotton swabs, earwax candles, or sharp instruments in your ears. Instead, follow this home remedy for cleaning your ear canal naturally:

1. Soften the wax: Put a few drops of baby oil, mineral oil, glycerin, or diluted hydrogen peroxide in the ear canal. 
2. Flush with warm water: Once the wax softens (usually after a day or two), gently squirt warm water into your ear canal. The warm water should flush out the softened wax and clear the blockage. Tip: Tilt your head to the side, so the water drains out of your ear. 
3. Dry your ear: After removing the wax, gently dry your outer ear with a soft, clean towel. 

Your doctor can also remove excess earwax for you or recommend an over-the-counter ear drop or removal kit. 

Exercise your brain 

A study by the Perelman School of Medicine found a possible connection between hearing loss and grey matter atrophy. Grey matter is the part of the brain that handles sensory perception (including hearing).  

While the study suggested a link between hearing loss to grey matter loss, it may also work the other way: grey matter atrophy may also lead to hearing loss.   

Exercising your brain — and body — can protect your grey matter. Solving puzzles is a great mental workout to get the blood flowing in your brain and improve brain and hearing health. 

Consider the following games to keep your brain and hearing sharp:

• Crossword puzzles 
• Word searches 
• Sudoku 
• Jigsaw puzzles 
• Card games 

Exercise your body 

Cardio exercise, like jogging, biking, hiking, and walking, can help improve your overall health, your brain health, and your hearing.⁴  

Just as working out your brain increases blood flow to it, working out your body increases blood flow to your brain and ears. And like the rest of your body, the tiny hairs in your ears responsible for most of your hearing are more likely to stay healthy and fully functional with good blood flow.

Do yoga 

Yoga won’t get your heart pumping as much as jogging, but it improves blood flow. Some studies show that it may improve sensorineural hearing loss too.⁵

Nix the nicotine

A study in 2013 found that smokers have a higher risk for hearing loss, particularly sensioneural hearing loss.⁶ It also found that the more someone smokes, the higher their risk.⁶ That holds for the number of cigarettes smoked a day and the number of years someone smokes. The older a smoker gets, the greater the chance of hearing loss.⁶  

Smoking can also cause tinnitus.⁸ Tinnitus isn’t hearing loss. It’s a noise or ringing in your ear. And it’s a problem for 90% of people with hearing loss and a nuisance for anyone dealing with it.⁸ 

Bottom line: If you smoke, cut back, or quit altogether to protect and improve your hearing. 

Turn down the volume already 

Listening to loud sounds, such as music or power equipment, can damage your hearing. The longer you listen, the higher the risk of noise-induced hearing loss.   

Everyday noises, even at lower volumes, can lead to some form of hearing loss over time. 

To protect your hearing and prevent further damage, avoid loud, prolonged noises. And if you can’t avoid the noise, use hearing protection. 

Hearing protection devices won’t reverse existing damage but can protect and preserve the hearing you have left. 

Earplugs 

Loud noises contribute to roughly 15% of hearing loss cases.⁹ Using earplugs can reduce the volume of loud noise. Earplugs decrease the number of sound waves entering your ear canal.  

When using earplugs to preserve your hearing:

• Find a pair that fits snugly in your outer ear canal. 
• Consider custom-fit earplugs if you work in a job with regular exposure to loud noises.

Also, turn down the volume when using headphones to listen to music or the TV. 

Earmuffs 

Earmuffs function like earplugs, but protect the entire ear, not just the outer ear canal. You want earmuffs that form an airtight seal around your ear for the best results. You can also use earmuffs with earplugs for up to 15 dBs of added hearing protection. 

Feed your nutritional needs with vitamins and minerals 

Studies aren’t conclusive, but vitamins and minerals may help hearing health.¹⁰,¹¹ They have other benefits too. 

Always talk to your doctor before adding any supplement to your diet. 

Folate 

Folate, or Folic acid, is one of the B vitamins. One study found that men over 60 who take more folate have a lower risk of hearing loss.¹² Other studies have also found correlations between low folate intake and hearing loss.¹³

Foods high in folate include:

• Peanuts 
• Beans 
• Sunflower seeds
• Dark green leafy vegetables 
• Liver 
• Seafood  

Many common foods are also fortified with folic acid, such as bread, flour, pasta, rice, and cereal. 

Potassium 

Potassium may help balance the natural fluid in the inner ear and in the part of the brain that translates noise into recognizable sounds. Research suggest higher potassium intake might lower the risk of hearing loss.¹⁴

The best way to add potassium to your diet is though foods. Potassium-rich foods include:

• Potatoes 
• Spinach
• Lima beans
• Tomatoes 
• Raisins 
• Bananas 
• Oranges 
• Yogurt 
• Milk  

Remember to check with your doctor before taking supplements. Also follow their instructions if they’ve told you to restrict your potassium intake. 

Omega 3 

Omega 3s are known for their anti-inflammatory and anti-aging properties. They may also promote brain function and communication between the brain and the ear, which might improve your hearing.¹⁵ Studies have shown Omega 3s may reduce the risk of age-related hearing loss.¹⁶

Omega 3-rich foods include:

• Mackerel 
• Salmon 
• Cod liver oil 
• Herring 
• Oysters 
• Flaxseed 
• Chia seeds 

Investigate herbal remedies 

Some herbal remedies show promise for treating hearing loss naturally. Traditional Oriental Medicine (TOM) has used herbs to treat hearing loss for centuries.  

Again, ask your doctor before adding any supplement to your diet. 

Promising herbal options as natural remedies for hearing loss 

One study found that 25 herbs and 40 compounds used in TOM might help with sensorineural hearing loss and tinnitus caused by noise, aging, ototoxic drugs, and diabetes.¹⁷ Ginkgo biloba, Panax ginseng, and Astragalus propinquus showed particular promise to improve hearing in patients with sensorineural hearing loss and to reduce symptoms of tinnitus.¹⁸ 

A year-long study found that 10 mg of Vinpocetine (VPC) three  times a day might improve acquired sensorineural hearing loss.¹⁹ Study participants reported their hearing loss not only stopped progressing but reversed. 

Another study found that Coenzyme Q10 (CoQ10) holds promise for treating sudden-onset sensorineural hearing loss.²⁰

There’s an app for your ears 

Technology isn’t necessarily natural, but it does offer helpful, do-it-yourself ways to improve hearing. Playing these apps and programs for just a few minutes a day might maintain or improve your hearing health. 

AudioCardio hearing & tinnitus 

AudioCardio is an app for hearing and sound therapy. After an initial test, the app creates a therapy session for each ear. You can complete daily sessions while you do other things. 

The app is clinically proven to “maintain, protect, and strengthen hearing.” Find AudioCardio in the app store. 

LACE (Listening & Communication Enhancement) auditory training and aural rehabilitation 

LACE is designed to train your hearing to keep up with conversations in noisy environments. The online trainings use artificial intelligence to adapt to your hearing level and keep you on track for improved comprehension.   

While LACE can’t improve your hearing as far as how your ears function, it may improve your brain’s ability to comprehend what you do hear. Find LACE online. 

Offline hearing exercises 

If you don’t want to use apps or computer programs, you can train your hearing at home, offline, with auditory training exercises. 

Start by enlisting a friend or family member to:

• Have a conversation in a noisy environment (turn up the TV or radio) and focus on the conversation to train your brain to cut through the noise. 
• Have someone move around you while your eyes are closed so you can practice identifying the direction and distance of the sound. 

When alone (or not), sing. One study found that singing helps people with age-related hearing loss better perceive speech in noisy environments.²¹

Don’t shun assistive devices 

If you find you still don’t hear as well as you’d like, talk to a doctor. Your doctor may suggest an assistive device, such as a hearing aid or a cochlear implant. You can also try captions on your TV or captioned calls on your own. 

Using assistive captioning improves perception, memory, and comprehension, which helps you and your brain.  

You may qualify for captioned calls at no cost if you have hearing loss that requires call captioning to effectively use the phone. Sorenson offers call captioning on a specially designed phone with a captioning screen and through the CaptionCall Mobile app for your cell phone.

Sources 

1. Quick Statistics About Hearing, Balance, & Dizziness
2. Age-Related Hearing Loss (Presbycusis)
3. About Noise-Induced Hearing Loss
4. Cardiorespiratory Fitness and Brain Volumes
5. Improving Hearing Performance through Yoga
6. The Effect of Smoking on the Hearing Status–A Hospital Based Study
7. The Link Between Smoking and Hearing Loss
8. Tinnitus — Symptoms and causes
9. Noise-Induced Hearing Loss
10. Interplay between Nutrition and Hearing Loss: State of Art
11. A prospective study of vitamin intake and the risk of hearing loss in men
12. A prospective study of vitamin intake and the risk of hearing loss in men
13. Folic Acid for Hearing Loss
14. Association between a High-Potassium Diet and Hearing Thresholds in the Korean Adult Population
15. Consumption of omega-3 fatty acids and fish and risk of age-related hearing loss
16. Fish and fatty acid consumption and the risk of hearing loss in women
17. Traditional oriental medicine for sensorineural hearing loss: Can ethnopharmacology contribute to potential drug discovery?
18. Traditional oriental medicine for sensorineural hearing loss: Can ethnopharmacology contribute to potential drug discovery?
19. Evaluation of vinpocetine as a therapy in patients with sensorineural hearing loss: A phase II, open-label, single-center study
20. Coenzyme Q10 in combination with steroid therapy for treatment of sudden sensorineural hearing loss: a controlled prospective study
21. Short-Term Choir Singing Supports Speech-in-Noise Perception and Neural Pitch Strength in Older Adults With Age-Related Hearing Loss  

More than 63% of the world’s population uses the internet every day. It’s the go-to tool for everything from banking and shopping to filling prescriptions and connecting with friends and family. Most captioning services and phones also use it. But you can get closed captioned telephone service without having home internet access. 

A captioned telephone uses the internet and Internet Protocol Captioned Telephone Service (IP CTS) instead of the traditional phone network to provide call captioning over the phone. IP CTS is a type of telecommunications relay service (TRS). But you don’t necessarily need home internet service to use call captioning. 

Before we dig into having call captioning with no home internet service, let’s review what call captioning is and when you want it. 

What is call captioning? 

Call captioning transcribes one or both sides of a phone conversation into easy-to-read captions. The transcription is virtually real-time and uses a live captioning agent and/or automated speech recognition (ASR) or another voice recognition technology.  

If you have a captioning app on a smartphone, you see captions on your phone’s screen. You can also use a captioning service at home with a specially designed captioning phone with a built-in screen. 

You can get call captioning service and a home phone with a captioning screen at no cost if you have hearing loss and need the service to effectively use the phone.  

Captioned calls over IP CTS are a critical tool if you’re hard of hearing. Its dependence on the internet can be a challenge, but newer phones and cellular data can help keep you connected. 

"It’s a marvelous invention. One of the best things that could happen to people with hearing loss."

— Lou

Not everyone has internet access

For people on a fixed income or living in a rural area, access to internet service with at least 25 Mbps download and 3 Mbps upload speeds continues to improve, but still falls behind access for other groups. In its last Annual Broadband Report, the FCC reports that 14.5 million Americans lack reliable high-speed internet access.  

Pew Research Center reported in 2021 that 43% of households with incomes below $30,000 annually lacked home broadband service.  

In another 2021 survey, the  Pew Research Center found that 7% of the general U.S. adult population doesn’t use the internet, but of the population over 65, 25% doesn’t use it. 

Even for people who have internet service, outages can knock out service for minutes, hours, or days. And Wi-Fi requires a power connection. So, if the power goes out, so does your internet. 

You don’t want to be in a situation where you need to make a call, especially during an emergency, and find that you can’t.  

Why a closed caption phone without internet is important

If you have hearing loss, call captioning empowers you to effectively use the phone. It’s a convenience and even a lifesaver. Especially when you’re in an isolated area or can’t reach out via online communication tools, a captioned phone or mobile phone with a captioning app keeps you connected.  

How to get captioned telephone service without internet access

Select call captioning phone services can give you closed caption phone access without an internet connection. Some use an analog-only connection, and some include a built-in access point, giving the phone the ability to create its own internet connection without the need for home internet service.

You can also get caption telephone service on your mobile phone. All you need is a captioning app and a smartphone with Wi-Fi or a cellular mobile data connection. 

Note that Wi-Fi connections depend on having internet service, especially at home. Some merchants, public libraries, and government offices do offer free public Wi-Fi access.  

Almost all cell phones offer a mobile data connection. Just be aware that you might have a limited data plan that caps the amount you can use each month. If you go over your cap, you may pay extra. Ask your mobile phone provider for details about your plan or how to get a plan with unlimited data. 

A mobile data connection also uses the internet over a cellular connection. If you’re in “dead zone,” you won’t be able to make a call. But 95% of the world’s population now has mobile broadband access. Chances are, you won’t hit dead zones too often. 

Whether your use a mobile phone or a landline home phone, you don’t need home internet service to make captioned calls.  

Here’s how to get a closed caption phone without internet 

Whether you have Internet service or not, you can get a closed caption phone at no charge to you, a family member, or friend.  

If the phone user has hearing loss that makes captions a necessity, they qualify for service and a phone from CaptionCall by Sorenson, the CaptionCall Mobile app, or similar products from other providers. As long as they qualify, there’s no cost for either service or the caption phone.  

Call captions without internet with CaptionCall by Sorenson 

If you, your family member, or friend live in a rural area, on a fixed income, or don’t have internet service, a CaptionCall captioning phone includes technology to create its own internet access point (that only the CaptionCall device can use) so you can connect without home internet service.    

Call 1 (833) 691-1600 to find out about no-internet call captioning solutions, or visit the CaptionCall page on the Sorenson website to learn more and sign up for an account.

Captioned calls without internet on your cell phone with CaptionCall Mobile  

You, your family member, or friend can also get captioned calls on a cell phone anywhere you have Wi-Fi or a mobile data connection. CaptionCall Mobile is a call captioning app available for phones with Android or IOS operating systems. 

Call +1 (800) 359-3186 or visit the web page to learn more about CaptionCall Mobile or download the app. 

Roughly 25% of Americans aged 65 to 74 have age-related hearing loss. After the age of 75 that number increases to 50%.¹ Age is the strongest predictor of hearing loss in adults, and age-related hearing loss affects quality of life more than most people realize.² One of the effects of hearing loss is that when people with hearing loss struggle try to hear, their ability to comprehend and remember speech decreases. The increased effort to understand is a hidden effect of hearing loss — one that’s critically important in understanding the challenges that anyone with hearing loss deals with.³ One way to help people with hearing loss is with assistive captioning.

What is assistive captioning and how does it help?

Assistive captioning, or closed captioning, is an assistive technology that transcribes speech or speech and sound into written text. Captioning includes:

• Subtitles that translate spoken words to written content. Subtitles are common for translating one language into another.
• Closed captions that translate spoken words and contextual sounds and actions into written content. Closed captions are ideal for viewers who have very limited hearing or are Deaf.
• Call captioning that translates what a speaker says on a phone call into written content. Call captioning requires a phone designed to show captions on a screen or an app that can add captions to a call on a smart phone

Captioning benefits people with hearing loss by:

• Improving perception, comprehension, and memory, even when there’s background noise.
• Helping them interpret sounds and speech more clearly and quickly.
• Helping them understand sounds and speech, sometimes even better than with the use of hearing aids.³

Qualify for CaptionCall by Sorenson today!

Studies have looked into how captions benefit adults with age-related hearing loss. Four of these studies showed how captions give adults with age-related hearing loss a way to overcome the challenges caused by struggling to hear.

Captions and comprehension

In the one study, researchers asked participants to listen to a list of numbers. The first half of the list was presented without distracting background sounds. The second half was presented with background noise. After participants listened to both halves of the list, they were asked to repeat the entire list of numbers.

Researchers found that listeners tried so hard to hear the numbers said with background noise that most forgot the beginning of the list.⁴

This study showed that adults with age-related hearing loss can have a harder time understanding sounds with background noise. The conclusion was that background noise interferes with comprehension and memory. The findings present a strong argument for ensuring aging adults with hearing loss have access to tools, such as assistive captioning, to help them struggle less and better understand sound and speech.

Discover CaptionCall Mobile for mobile captioning

Seeing and hearing are key

Researchers in the second study had participants listen to sentences that varied in complexity. They found that older adults with hearing impairments struggled with comprehension and recall of sentences when spoken quickly, even though they accurately perceived what was said.⁵

The study shows that perception, comprehension, and memory of speech improve for adults with age-related hearing loss when they can see and hear what’s said.

Other studies show that even just a one decibel (dB) improvement in signal-to-noise ratio corresponds to a 10% increase comprehension and memory.³

The improvement in this second study equaled a speech-to-noise ratio improvement of as much as 15 dB, which led to a significant increase in comprehension and memory.

Words and sounds work together

In a third study, researchers showed participants two videos with captions and sounds. In the first video, the captions and sounds matched. In the second video, the captions and sounds didn’t.

The results of the study determined that sounds and words (such as captions in a conversation) complement each other to help listeners understand sounds better and to hear sounds more clearly and quickly.⁶

The benefits of captions versus hearing aids

In the last study, researchers determined that real-time closed captioning of speech in television improves comprehension for adults with hearing loss. The study also showed that the benefits of captions outweigh the benefits of hearing aids. In fact, hearing aids provided no benefit to recognizing words when captioning was available.⁷ This study shows just how important captions are for hearing loss.

Assistive captioning for phone conversations

Call captioning, like CaptionCall, transcribes phone calls in real time so users can read the conversation. Call captioning, such as that provided by CaptionCall, provides advanced call captioning for phone calls. Assistive captioning for phone calls lets anyone with hearing loss necessitating call captioning better comprehend, remember, and actively participate in conversations, even when there’s background noise. Call captioning is also available at no cost.

Learn more about how CaptionCall by Sorenson and CaptionCall Mobile can help anyone with hearing loss, including adults with age-related hearing loss.

Sources

1. Quick Statistics About Hearing, Balance, & Dizziness
2. Declining Prevalence of Hearing Loss in US Adults
3. Text Captioning Buffers Against the Effects of Background Noise and Hearing Loss on Memory for Speech
4. Rabbitt, P. M. (1968). Channel-capacity, intelligibility and immediate memory. Q J Exp Psychol, 20, 241–248.
5. Wingfield, A., McCoy, S. L., Peelle, J. E., Tun, P. A., Cox, L. C. (2006). Effects of adult aging and hearing loss on comprehension of rapid speech varying in syntactic complexity. J Am Acad Audiol, 17, 487–497.
6. Frost, R., & Katz, L. (1989). Orthographic depth and the interaction of visual and auditory processing in word recognition. Mem Cognit, 17,302–310.
7. Gordon-Salant, S., & Callahan, J. S. (2009). The benefits of hearing aids and closed captioning for television viewing by older adults with hearing loss. Ear Hear, 30, 458–465.