This feared handicap is hearing loss, one of the most prevalent chronic conditions in America; a total of 28 million are hard of hearing or deaf. Ten million of these Americans are ages 45 to 64 and 9 million are over 65.

Older adults whose hearing losses are untreated are more likely to report depression, anxiety, and paranoia and are less likely to participate in social activities, even with their families, than those who use hearing aids. These seniors have resigned themselves to their loss and believe that life will never be as good again.

However, rather than give in to resignation, other seniors will pretend to understand conversations, laugh with others at jokes they haven't heard, and watch television and movie plots they can barely follow, so that no one will know that they cannot hear. They are ashamed of their handicap because, as one woman exclaimed, "A hearing aid will tell everyone that I'm old!"

A few will register their frustration and denial by growling at other people who, they believe, must be the real reason they can't hear. "Speak up! Stop mumbling!"

People with a hearing loss wait an average of seven years before seeking help. Among the 9 million afflicted Americans over 65 years of age, three out of five do not use hearing aids. These devices are the last resort after years of frustration from trying to communicate; the world of the hearing fades further away, finally leaving these victims on a lonely island of muffled nonsensical sounds or complete silence. A higher rate of divorce is seen among the hearing-impaired than among the hearing.

Referring to one of the studies that examined the impacts of unresolved hearing loss, James Firman, president and CEO of the National Council on the Aging, stated, "This study debunks the myth that untreated hearing loss is a harmless condition."

The symptoms of early hearing loss can be subtle and gradual and may begin as early as middle age. Typical self-check tests for hearing include such questions as: Do you have trouble identifying where sounds come from? Do you have difficulty understanding the speech of women and children? Do you have trouble hearing conversations in noisy backgrounds such as a party? Many who affirm that they have trouble in these situations might argue that some of these conditions could be troublesome for anyone. Denial? Perhaps.

Of the two basic types of hearing loss, conductive and sensorineural, the former can be corrected medically or surgically. It involves only the outer and middle ear, and the damage has resulted usually from a punctured eardrum, an ear infection, or blockage by earwax.

Sensorineural or nerve hearing loss involves the inner ear, and the damage has been caused by viral or bacterial infections, prenatal or birth-related problems, aging, or trauma from a severe blow to the head, exposure to loud noises, use of certain drugs (especially aspirin and certain antibiotics), fluid build-up in the inner ear, or a benign tumor in the inner ear. Rarely correctable by surgery, sensorineural hearing loss is typically managed by hearing aids or other similar devices.

While aging is inevitable, other causes of nerve damage can be prevented to preserve hearing. Seniors should be aware of potential sources of damaging noise such as leaf blowers, lawn mowers, heavy machinery, kitchen appliances, snowmobiles, unmuffled automobiles, guns, loud music, and so on. Earplugs or protective earmuffs should be worn in a noisy workplace. Hearing should be tested regularly to detect early changes and prevent further damage.

If hearing is impaired, a hearing specialist (audiologist) can improve what is heard. Hearing aids are not the only remedy available.

A variety of assistive listening devices (ALDs) are now in use for different situations and settings. Movie theaters, performance theaters, and other places of entertainment routinely provide infrared or FM-based ALDs. A new ALD using a loop system and a T-coil embedded in hearing aids has been recently developed and offers hope even for severely deaf persons. It provides a surround of sound for large groups of people equipped with the new T-coil hearing aids.

Self Help for Hard of Hearing People Inc. (SHHH) is an international advocacy organization of volunteers that evaluates new hearing devices and presses for better legislation. Members are hard of hearing or are relatives and friends of the hearing impaired.

Paul Stein of the San Jose Chapter of SHHH is one of the many members who actively lobby for changes in laws that affect people with disabilities. He traveled to Washington, D.C., with a research document he produced, successfully demanding that the courts provide assistive listening devices for the hard of hearing who otherwise could not serve as jurors. "It took two years," Stein says, "but they called me when they finally realized that I was right."

For information about SHHH meetings in San Jose, call 408.229.1041 or email shhhsj@pacbell.net.