Written by Michelle Richards from Michelle Richards Hearing

The subtle signs many people miss — and when it’s time to have your hearing checked

One of the most common things I hear from patients is:

“I can hear people talking, but I can’t always understand what they’re saying.”

Often, this is one of the earliest signs of age-related hearing loss, known clinically as presbycusis.

Presbycusis is a gradual decline in hearing that occurs as we get older. It is a normal part of ageing for many people, but because it develops slowly, it can be surprisingly difficult to recognise in ourselves.

In fact, family members often notice the changes before we do.

What is presbycusis?

Age-related hearing loss typically affects the higher pitches first. These are the sounds that help us distinguish speech clearly, particularly consonants such as s, f, th, t, and sh.

As a result, speech may begin to sound less clear, especially in challenging listening environments.

People often describe it as:

• Hearing people speak but not always understanding them
• Feeling others are mumbling
• Struggling in restaurants, cafés or family gatherings
• Difficulty hearing children or grandchildren
• Turning the television up louder than others prefer
• Frequently asking people to repeat themselves
• Feeling tired after social situations because listening requires more effort

Because presbycusis hearing loss develops gradually, many people unconsciously adapt by avoiding noisy environments, relying on visual cues, or simply withdrawing from conversations.

Early signs you shouldn’t ignore

While hearing loss is often associated with advanced age, changes can begin much earlier than many people realise.

Some of the most common early warning signs include:

• Difficulty understanding speech in background noise
• Frequently asking “sorry?” or “what was that?”
• Missing parts of conversations
• Trouble hearing on the telephone
• Needing captions on television
• Family members commenting that the television volume is too loud
• Ringing, buzzing or tinnitus
• Feeling exhausted after social interactions

These symptoms are often dismissed as stress, fatigue, poor acoustics, or other people not speaking clearly. However, they may be your hearing trying to tell you something.

When should I have my hearing tested?

A hearing test is not just for people who already wear hearing aids.

Just as we routinely monitor our eyesight, blood pressure and cholesterol, hearing health should also be checked periodically.

I generally recommend:

• A baseline hearing assessment from around age 50
• Earlier testing if you have significant noise exposure, tinnitus, family history of hearing loss, or concerns about your hearing
• Annual reviews if any hearing loss is identified
• Immediate assessment if you experience a sudden change in hearing

Many people are relieved to learn that a hearing assessment is painless, non-invasive, and typically takes less than an hour. Importantly, a hearing test can identify issues long before they begin to significantly affect communication.

Why early detection matters

Hearing loss affects much more than the ears. When hearing becomes more difficult, the brain must work harder to fill in missing pieces of speech. This increased listening effort can contribute to fatigue, frustration and communication difficulties.

Research has also highlighted important links between hearing health, social engagement and cognitive wellbeing.

While hearing aids are not a cure for dementia, maintaining good hearing health is increasingly recognised as an important component of healthy ageing. The earlier hearing difficulties are identified, the more options are available to manage them effectively.

Choosing a hearing provider

Many Australians are unaware that they have a choice when it comes to hearing care.

When selecting a provider, consider asking:

• Are they independent or owned by a hearing aid manufacturer?
• Will they discuss all suitable options?
• Do they provide comprehensive diagnostic testing?
• Do they offer ongoing support and rehabilitation?
• Will recommendations be tailored to my lifestyle and needs?
• Do they offer at-home hearing aid trials?
• Does the clinician receive a ‘commission’ on hearing aid ‘sales’?

The relationship between clinician and patient is important. Hearing rehabilitation is not simply about fitting technology; it is about understanding communication challenges and finding practical solutions that improve quality of life.

The takeaway

If you’ve found yourself asking people to repeat themselves, struggling in background noise, or wondering whether your hearing has changed, don’t wait until communication becomes difficult.

A hearing assessment provides valuable information, reassurance, and a clear understanding of your hearing health. After all, hearing well is about much more than sound. It’s about staying connected to conversations, family, friendships, and the moments that matter most.

 Michelle Richards Hearing — Ethical. Local. Independent.

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