Vera Nelson was quite the golfer, Nelson says, and the two golfed together until his aging body caught up with him. Nelson was diagnosed with retinopathy, a result of type 2 diabetes, that leads to vision loss. Eventually, his eyesight was too blurry to focus on golf.

Then, nearly eight years ago, he also began to lose his hearing. The loss was gradual; in fact, he wasn't the first to notice.

"Sometimes the wife would have to repeat herself two to three times," Nelson says. "It got worse and worse."

Vera Nelson encouraged her husband to get a hearing aid. Finally, when Gus Nelson saw an advertisement for Sears Hearing Aid Center at Westfield Oakridge Mall three years ago, he decided it was time.

Nelson had a hard time adjusting to the hearing aids, but he calls getting his hearing back "a blessing." Today, he carries on conversations without difficulty or hesitation.

Nelson's experience is shared by millions of Americans. More than 2.8 million people in this country suffer from some level of hearing loss, according to the website HearingLoss.org.

Hearing loss affects individuals in countless ways, from muting the sound of the rain to muffling the roar of an oncoming train, but today's technology has made significant advances in equipment. Hearing aids are smaller and better and much more aesthetically appealing.

The tools to ease the difficulties of hearing were once nothing more than crude hearing "trumpets," hollowed from the horns of cows, rams and other animals. By World War II, hearing aid technology began to develop, says hearing aid specialist Dennis McDonnell, who works at the Miracle Ear location in the Campbell Kirkwood Plaza.

Older versions of hearing aids include ones that were attached to eyeglasses or a box worn over the chest. These analog hearing aids amplified all sound, including speech and noise. Sometimes, people with the older hearing aids would have to physically turn to hear someone speaking behind them.

Nowadays, hearing aids are smaller, fitting inside or over the ear. Many are also digital, giving the user a wide range of adjustable options.

Besides looking more discreet, hearing aids have also evolved in their effectiveness.

"They're very sophisticated," says Rufus Wesley, of the Self Help for the Hard of Hearing (SHHH) San Jose chapter. "The technology changes as rapidly as it does in computers. We have a very hard time keeping up."

SHHH is a self-help group of more than 120 members who meet monthly at the Moose Lodge in the Safeway Shopping Center at the intersection of Hamilton and Meridian avenues in Willow Glen. The organization has existed in San Jose since 1984. The members invite audiologists and other professionals to give lectures and presentations at their meetings. Many of the members use hearing aids, Wesley says.

In recent years, he says the advancements in hearing aids have made the devices useful in a variety of situations.

The new hearing aids are digital and provide less sound distortion. They're also equipped with several microphones, including an omni-directional microphone that can capture sounds from all directions. However, in a noisy environment, such as a restaurant, the user may have difficulty hearing a dining companion over the surrounding noise.

But a directional microphone makes it possible to focus on one person, and some hearing aids automatically switch to this mode in such situations.

"Now I can tune into anyone I want to," Nelson says.

Like Nelson, many of the members in SHHH are seniors. Yet contrary to popular belief, old age is not the No. 1 cause of hearing loss. About 95 percent of people with hearing loss experience sensorineural hearing loss, which is the result of nerve damage in the inner ear. Some of the damage can be attributed to old age, but most often it's the result of extended exposure to loud noise, according McDonnell.

Hearing aids, however, can be costly at any age.

McDonnell says that typically, insurance companies and programs such as Medicare will not pay for medical equipment such as hearing aids, but only for the preliminary testing for such devices, which Miracle Ear provides for free.

Philip Lee, a physician and professor emeritus of social medicine in the School of Medicine at UC-San Francisco, confirms that Medicare does not cover hearing aids.

"The people who set the benefits felt this was more of a discretionary cost," Lee said.

Health insurance plans typically do not cover hearing aids costs either, says Bobby Pena, a spokesperson for the California Association of Health Plans.

"They're not available in the majority of individual plans," says Pena. Nor are they a standard option for employer plans.

Wesley says because most people don't have coverage, SHHH--which recently changed its name nationally to Hearing Loss Association of America--has been working on legislation on the state and federal levels that would require insurance companies to provide $1,000 for a hearing aid to those individuals with hearing loss under age 18 or older than 55.

Willow Glen resident Bertha Romano agrees with the organization's efforts.

"So many people cannot afford these things," she says, pointing to the high cost of hearing aids and the additional cost for batteries. Some people have to replace their hearing aid batteries every one to three weeks.

At Miracle Ear, for example, hearing aids range from $700 for the less technologically advanced models to $4,000, McDonnell says.

But for Romano, it was worth the investment. Now 79, Romano first began to experience hearing loss in her 60s. Romano says her sister noticed it first.

"It was rude more than anything else, asking people to repeat themselves," Romano says.

It is not uncommon for people to resist getting a hearing aid even after being fully aware of their problem. Financial constraints and a sense of pride often keep people from purchasing hearing aids.

Romano, however, is a spirited woman who didn't want her hearing loss to interfere with her life and work.

"I wanted to get them and get on with it," she says. "Without them, honey, I'd be deafer than deaf."

For more information about the San Jose chapter of the Hearing Loss Association of America, contact Bruce McClelland at 408.241.3056.

Stephanie Condon contributed to this story.