Chronicle of a deaf audiologist

Hear Better by Knowing More

As we get older we have more difficulty hearing in noise. This applies even to people with normal hearing.

If hearing becomes more difficult even with normal hearing, there must be something beyond hearing loss that makes hearing in noise harder.

We now know what that something is: our brains change as we age. Our brain undergoes changes in its processing speed, working memory, and ability to focus with multiple things happening at once.

Hearing aids can’t solve those problems. They exist even for people with normal hearing.

Dealing with noise is the Holy Grail for hearing care professionals (and consumers too!). If we all lived in ideal listening conditions, noise wouldn’t be much of an issue.

If every conversation took place in a quiet room with one other person, hearing conversations would be easier. If the person was familiar to us and the topic never changed, listening would be effortless.

Or at least, less effortful, according to Dr. Kathy Pichora-Fuller.

Hearing aids help solve the problem of hearing loss and its effects on communication. How can we solve the problem of aging and its effects on communication?

In a webinar offered to audiologists by Phonak Canada, Dr. Pichora-Fuller spoke about “It’s not just what you hear, but what you can do with what you hear.”

Unlike during a hearing test, we don’t live in sound proof booths, as she pointed out.

Our lives, and conversations, are filled with background noise. We often encounter more than one person talking. We have to contend with accents, changing topics, novel situations, and continuing other activities.

Conversations are fast-paced. Quick banter and wit can make a conversation more interesting. As we get older, the faster pace is problematic.

There’s no two ways about it – our brains are constantly being put to the test.

Is there anything then, that we can do?

Photo credit: © Karin Van Ijzendoorn |

In the webinar, Dr. Pichora-Fuller put forward three areas, which are expanded upon here, where we can use what we already have now to get ahead. A fourth area is included too.

  1. Use your knowledge of the situation. 
    • Older listeners can make better use of context than younger listeners. Context can give you the edge!
    • Ask for the topic or key word. As soon as you know the topic, all of the vocabulary associated with that topic comes to mind and the conversation makes sense. When you’re able to anticipate how a conversation might proceed, reasonable guesses can be made, even if you didn’t hear everything.
    • Know your topic. Your background knowledge of current affairs makes all the difference in social situations. When you read about current affairs, pick an aspect of the situation you find interesting, and delve in more fully with additional research.

For example, in a conversation about a hijacked plane, one person pointed out the hijackers made a fatal error, for themselves and most of the people on the plane, in assuming the plane had enough fuel to divert to their desired destination. For short haul flights, fuel tanks aren’t full to cut down on weight.

Where could the conversation go from here? Fuel prices and what influences fuel prices? The high cost of airline travel? The fact people shouldn’t put on their life jackets before leaving the plane? What do you know about your topic? What do you wish you knew?

    • Build your vocabulary. Another way to build on what you already know is to make a conscious effort to increase your vocabulary. Games like Scrabble and Up Words are fun ways to play with words. Consider inviting a family member you’d like more contact with to play Scrabble online.
    • Know your homophenes. We also use context in lip-reading, or speechreading. In Hearing Strategies classes, we learn about homophenes – sounds that look the same on the lips (eg. pay, may and bay). They are visually tricky to distinguish. Using the topic or context helps to figure out which sound is being said. Recognizing homophenes is a skill we can practice and improve upon.


  1. Know where to listen. 
    • Dr. Pichora-Fuller’s research tells us that as you become less certain about where to listen, your comprehension starts to suffer. Older listeners find “letting go” harder in order to switch to a new location. This happens all the time in a group conversation. The location of the person speaking changes often and rapidly.
    • Use both ears. If you have hearing loss in both ears, and two hearing aids are recommended, follow that recommendation. Two hearing aids will help you localize where the sound comes from.
    • Ask for help. If you’ve exhausted the other tips and still don’t understand, you can always ask for help. In a group conversation, a person with normal hearing beside you can give you a subtle nudge or nod in the direction of the person talking. Family members and significant others can help by pausing slightly before they continue with their part of the conversation. For example, “I know!…[pausing until they make eye contact with you]…I noticed that too. Do you think that they did it on purpose?”


  1. Get a feeling. 
    • When you know what the other person is feeling (e.g., fear, surprise, anger), you’ll understand them better. This is called emotional context.
    • Ask before guessing. When dealing with emotions, guessing what the other person is feeling can escalate things further. If you aren’t sure what the underlying feeling is, ask: “What are you feeling right now? I’ll understand what you are saying better if I know what you are feeling.”
    • Look for clues. Reading non-verbal cues like facial expressions and body language help you decipher emotions as well.


  1. Take auditory training with LACE. 

Using, and building upon, what you already have allows you to do what you already can – and beyond.

Related posts:

Seven Tips for Hearing Better in Restaurants

Auditory Training Helps Age Related Hearing Loss

May the Wind Be Always at Your Back

Context is a Crucial Skill for Hearing Loss

Are You Bluffing?

Why Do I Need Auditory Training?

What? Sorry? Pardon?

  • Photo credit:  © Alan Fortune

    Sandra Vandenhoff

    Dr. Sandra Vandenhoff is an audiologist with hearing loss, founder of HEARa, Hearing Rehabilitation teacher, and Canadian author, who does not remember saying on her first day of wearing hearing aids: "Mom, I can hear my shoelaces!"

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