It begins with having to turn up the volume on the television or missing words in conversation. On average, people with hearing loss wait about seven years before getting help.
A new Johns Hopkins University report reveals of the 27 million older Americans with significant hearing problems, only about 14 percent use hearing aids, even though most could benefit from them. One reason: people think it makes them look old.
Dr. Rick Friedman, an otologist and skull base surgeon at the House Ear Clinic, says the pros outweigh the cons.
"The social isolation you may feel. The difficulty at work. The difficulty in crowds. Weigh that against the concerns you have about cosmetics," said Friedman.
Once you get over the stigma of wearing a hearing aid, doctors say there's just one more challenge: the cost.
"For a really nice set, $5,000. That's a lot for people," said Friedman.
Medicare may cover some of that cost depending on the level of hearing loss, but most insurance companies either don't cover it or only pay for part of it.
Other studies show that not treating hearing loss in the elderly is associated with poor thinking, depression and dementia.
In California, legislation gives patients a 30-day money-back guarantee if the hearing aids don't work for them. So it's worth a try, says Friedman.
"Get the information. Hearing evaluations aren't terribly expensive," said Friedman.
Study authors also point out there's a misconception that hearing aids work instantaneously. Doctors say it can take months for the brain to adjust to sounds amplified by a hearing aid.
Also, authors note that for a large portion of people with hearing impairment, the devices just don't work.