Hearing aids can improve access to sound—but they cannot turn back the clock
One of the most difficult conversations we have at AIM Hearing is with someone who has waited many years before seeking help.
They may finally purchase excellent hearing aids with advanced noise reduction, directional microphones, artificial intelligence and deep neural network processing.
The hearing aids may be working exactly as intended.
Yet the person still says:
“I can hear people talking, but I cannot understand what they are saying.”
That difference matters.
Hearing is not simply about making sounds louder. The ears detect sound, but the brain must recognise it, separate speech from noise, interpret the words and attach meaning to them.
When hearing loss remains untreated for years:
- Important speech sounds may become less audible.
- Listening requires more mental effort.
- Communication confidence may decline.
- The person may avoid difficult conversations.
- Age-related changes in memory, attention and processing speed may make rehabilitation harder.
Older adults can still achieve excellent results with hearing aids. However, waiting until communication has seriously deteriorated can make rehabilitation more difficult than it needed to be.
Hearing and listening are not the same thing
Hearing is the detection of sound.
Listening is what the brain does with that sound.
Listening requires attention, memory, interpretation and practice.
A useful way to understand this is to think about algebra.
Imagine you completed algebra every day as a child and became very good at it. Then you stopped doing it completely for years. At 65, someone places an algebra equation in front of you.
You can see it. You can read the numbers and symbols. You know it is algebra.
But can you still solve it quickly?
Possibly not.
The information is visible, but the skill has not been practised.
Communication can become similar.
A person may still hear that someone is speaking. Hearing aids may make the voice more audible. But if the brain has received an incomplete or distorted speech signal for many years, understanding the words—especially in noise—may remain difficult.
The person can hear the equation. The challenge is solving it.
Listening needs to remain active
People with hearing loss often begin withdrawing from difficult situations.
They may stop attending busy restaurants, speak less in groups, rely on their partner to answer questions or pretend they understood.
This creates a damaging cycle
Hearing becomes harder, so the person participates less. Because they participate less, they get less listening practice and lose confidence. As confidence falls, they withdraw further.
Early intervention is therefore not only about hearing aids. It is also about maintaining listening ability, communication confidence and social participation.
Your brain’s processing speed matters
Think about running a 100-metre sprint.
At 17, you may run quickly. At 27, particularly if you remain fit, you may still perform well.
At 47, 57 or 67, you can remain active and healthy, but most people would not expect to run at exactly the same speed they did at 17.
Listening is similar in one important respect.
The speed and efficiency with which the brain processes information can change with age. Understanding speech in background noise is demanding. The brain must:
- Detect the voice
- Separate it from competing noise
- Identify the words
- Remember the beginning of the sentence
- Fill in missing information
- Interpret the meaning
- Prepare a response
It must do all of this almost instantly.
When hearing loss removes parts of the speech signal, the brain must work even harder.
The same audiogram does not guarantee the same result
Consider two people with similar hearing-test results.
One is 25.
The other is 80.
Their audiograms may look almost identical. They may require similar amplification to make speech audible.
But they may not understand speech equally well?
A standard audiogram measures the quietest tones a person can detect. It does not fully measure the following:
- Processing speed
- Working memory
- Attention
- Speech understanding in noise
- Separation of competing voices
- Auditory timing
- Listening effort
The younger person may be better able to reconstruct missing information and keep up with rapid speech.
The older person may hear approximately the same amount of sound but require far more effort to interpret it.
This is not a question of intelligence.
It is about the speed and efficiency of the auditory and cognitive systems.
Research has shown that older adults can experience poorer speech understanding than younger adults even when their hearing sensitivity is closely matched.
The audiogram measures part of the hearing system. It does not measure the entire listening brain.
Ageing does not mean treatment is pointless
An 80-year-old can still achieve meaningful benefits from hearing aids.
Older adults may improve their communication, confidence, independence and quality of life.
However, they may require:
- More gradual adjustment
- Additional follow-up
- Careful verification
- More support in background noise
- Auditory training
- Communication strategies
- Family involvement
- Realistic expectations
Age alone does not determine success.
Some people in their eighties have excellent speech-understanding ability, while some younger people experience significant processing difficulties.
The message is not that older people should give up.
The message is:
Earlier is usually easier.
Hearing aids are essential—but they are not a magic bullet
A hearing aid is called a hearing aid for a reason.
It assists the hearing system.
It does not restore the ear to normal.
It does not reverse cochlear damage.
It does not restore lost processing speed.
It does not automatically teach the brain to understand speech in noise.
That does not make hearing aids any less important.
For many people, hearing aids are the foundation of rehabilitation because they restore access to speech sounds that have become difficult to hear.
But providing sound and understanding sound are not exactly the same things.
A hearing aid can help deliver more of the speech signal.
The brain must still interpret it.
That is why hearing rehabilitation should not finish when hearing aids are fitted.
In many cases, that is where rehabilitation begins.
Technology helps, but timing still matters
Modern hearing aids may include:
- Deep neural network processing
- Automatic environmental analysis
- Directional microphones
- Background-noise management
- Bluetooth connectivity
- Rechargeable batteries
- Discreet designs
These advances are valuable. But even the best hearing aid cannot completely remove every competing voice, eliminate all reverberation or perfectly recreate normal biological hearing.
It also cannot reverse ageing.
From a rehabilitation perspective, early intervention may be more valuable than waiting many years and then relying on premium technology to solve everything.
Better technology helps. But timing matters.
LACE AI Pro and auditory training
Auditory training is structured listening practice designed to help the brain make better use of the sound it receives.
One option is LACE AI Pro, a home-based auditory training programme that can be supported by a hearing care professional.
LACE stands for Listening and Communication Enhancement.
The programme may include exercises involving:
- Speech in background noise
- Competing speakers
- Rapid speech
- Auditory memory
- Attention
- Communication strategies
- Listening confidence
LACE AI Pro does not make damaged hearing normal and does not replace hearing aids. Instead, it gives the brain structured opportunities to practise listening.
The concept is similar to physical rehabilitation. A brace may provide essential support, but exercises help the person use that support more effectively.
In the same way: Hearing aids improve access to sound. Auditory training helps the brain practise using it.
Research into LACE and other computer-based auditory training programmes has reported improvements in trained speech-in-noise and competing-speech tasks, although results vary between individuals.
Auditory training is best treated as one part of a broader rehabilitation programme—not as another magic bullet.
Structured practice is different from passive exposure
Simply wearing hearing aids is important, but passive exposure to sound is not the same as deliberately practising listening. Structured training asks the person to focus, respond, make mistakes and try again.
The aim is not to achieve a perfect score. The aim is to challenge the brain consistently.
Listening practice may also include:
- Following an audiobook while reading the text
- Listening to a podcast and summarising it
- Practising conversation in gradually more difficult environments
- Using captions as a temporary support
- Participating actively rather than letting a partner answer everything
The goal is not to make communication exhausting.
The goal is to keep listening active.
Communication is a two-person responsibility
Successful communication requires effort from both the speaker and the listener.
The speaker should:
- Gain the listener’s attention first
- Face them directly
- Keep their face visible
- Speak clearly without shouting
- Avoid speaking from another room
- Reduce background noise where possible
- Rephrase rather than repeatedly saying the same sentence
Instead of repeating:
“The appointment is at quarter past three.”
say:
“You need to be there at 3:15 this afternoon.”
The listener should:
- Wear hearing aids consistently
- Face the speaker
- Move closer where possible
- Reduce distractions
- Ask for specific clarification
- Confirm important information
- Explain which part was missed
Instead of saying:
“What?”
say:
“I heard that the appointment is this afternoon, but I missed the time.”
Good communication is a shared responsibility.
Optimise the environment—do not withdraw from it
Optimising the listening environment does not mean staying home. Social participation remains important.
It means making sensible choices.
At a restaurant:
- Ring ahead, explain you have hearing loss, and ask if it is possible to sit away from the kitchen, bar or coffee machine.
- Choose a booth or a table near a wall. If you sit in the middle of a room, you have to deal with 360 degrees of spatial noise. If you sit against a wall, you have 180 degrees of noise that was previously at your back reduced
- Avoid sitting under loudspeakers.
- Face the people you most want to hear from.
- Visit outside the busiest period where possible.
- Use a remote microphone if appropriate. (Thats a big one.)
At home:
- Mute the television during important conversations.
- Move into the same room before speaking.
- Improve lighting.
- Sit closer rather than shouting across the house.
At meetings:
- Sit near the main speaker.
- Keep a clear view of the group.
- Ask people to speak one at a time.
- Request written information.
- Confirm key instructions.
These changes are not signs of weakness.
They improve the signal reaching the brain.
Better positioning can be more useful than more volume
When someone struggles, the first reaction is often to turn the hearing aids up. But greater volume does not always produce greater clarity.
Sometimes the better solution is improving the signal-to-noise ratio—the difference between the voice and the surrounding noise.
Moving closer to the speaker, moving away from the kitchen or using a remote microphone can be more effective than simply increasing volume.
The best hearing technology still performs better when it is given a better environment in which to work.
Consistent use matters
Some people wear hearing aids only in restaurants or at family gatherings.
Unfortunately, these are often the hardest listening environments.
The person is then expecting the brain to process unfamiliar amplified sound in the most difficult possible situation.
Consistent use in quieter environments helps the brain adjust to speech, household sounds and the person’s own voice.
However, hearing aids should not be uncomfortable.
If they are too loud, unclear or difficult to manage, they should be reviewed and adjusted.
Consistent use should follow appropriate fitting and verification.
Hearing rehabilitation is a complete programme
A comprehensive rehabilitation plan may include:
- Hearing and speech testing
- Speech-in-noise assessment
- Appropriately fitted hearing aids
- Real-ear verification
- Fine-tuning
- LACE AI Pro or other auditory training
- Communication counselling
- Family training
- Environmental strategies
- Remote microphone technology
- Regular follow-up
Different people require different levels of support.
The hearing aids remain vital.
But they should not be expected to carry the entire burden.
The stigma is costing people valuable time
Some people tolerate years of missed conversation because they fear hearing aids will make them look old.
Yet during those years, they may:
- Constantly ask for repetition
- Misunderstand family members
- Become exhausted in groups
- Appear distracted or confused
- Withdraw socially
- Become dependent on their partner
Ironically, visibly struggling to follow conversation may be far more noticeable than wearing a small modern hearing aid.
Wearing hearing aids is not an admission of weakness.
It is a decision to remain connected.
Do not wait for a crisis
You do not need to purchase hearing aids simply because you have had a hearing test.
A proper assessment should determine whether hearing loss is present, whether medical investigation is needed and what type of rehabilitation may help.
But delaying an assessment because of embarrassment achieves nothing.
The most heartbreaking cases are often the people who say the following:
“I wish I had done something ten years ago.”
Hearing aids may still help later in life.
But adaptation may take longer, speech understanding may be poorer and expectations may need to be more modest.
The hearing aids may finally deliver the equation—but the brain may no longer solve it as quickly as it once could.
It is not necessarily ever too late
Nobody should conclude they are too old to seek help.
Meaningful improvement remains possible.
The message is not that older people should give up.
The message is:
Earlier is usually easier.
Do not wait until every conversation feels like hard work.
Do not wait until you withdraw socially.
Do not wait until you can hear a voice but cannot reliably understand the words.
Hearing aids provide access to sound.
Auditory training exercises the listening system.
Communication strategies improve the message.
Environmental choices improve the signal.
Together, they create hearing rehabilitation.
Are you hearing people speak but struggling to understand the words?
A comprehensive hearing assessment can help identify whether hearing loss, speech discrimination, background noise, auditory processing or another factor is contributing to the problem.
AIM Hearing Locally owned and independent in Bundaberg Shop 1, 1 Heidke Street, Avoca Next to McDonald’s Sugarland and one block from Bunnings Bundaberg Phone: (07) 4153 1317
Hearing Services Programme: DVA and private clients welcome.
References and further reading
World Health Organization — Deafness and Hearing Loss
Overview of the communication, social and health consequences associated with unaddressed hearing loss.
World Health Organization — World Report on Hearing
Comprehensive report examining hearing loss, rehabilitation, communication and access to hearing care.
Livingston et al. — 2024 Lancet Commission on Dementia Prevention
Identifies hearing loss as one of several potentially modifiable factors associated with dementia risk.
Lin et al. — ACHIEVE Randomised Clinical Trial
Examined whether a comprehensive hearing intervention could reduce cognitive decline in older adults.
Füllgrabe, Moore and Stone — Age Differences Despite Matched Hearing
Found age-related differences in speech identification even when younger and older participants had closely matched hearing sensitivity.
Lee — Ageing and Speech Understanding
Explains why older adults may experience greater difficulty understanding speech than predicted by their audiogram alone.
Pichora-Fuller, Schneider and Daneman — Listening and Remembering Speech in Noise
Examined age-related differences in recognising and remembering speech in background noise.
Peelle — Listening Effort and Difficult Listening Conditions
Explains how degraded speech increases cognitive effort and can interfere with memory and language processing.
Neurotone — LACE AI Pro
Official information about LACE AI Pro and its role in clinician-supported auditory training.
Olson et al. — LACE Training in Hearing-Aid Users
Reported improvements in speech-in-noise, competing-speech performance and self-reported communication following LACE training.
Fallahnezhad et al. — Computer-Based Auditory Training
Systematic review and meta-analysis examining the effect of auditory training on speech understanding in noise.
American Speech-Language-Hearing Association — Aural Rehabilitation for Adults
Clinical guidance on combining hearing aids, auditory training, communication strategies and family involvement.
Important context
Hearing loss is not the sole cause of dementia, and hearing aids cannot guarantee dementia prevention.
Auditory training does not replace hearing aids when amplification is appropriate, and not everyone experiences the same results.
The purpose of comprehensive hearing rehabilitation is to improve access to speech, reduce listening effort, strengthen communication and help people remain socially engaged.