When I ask patients why they've waited so long to get help for their hearing loss, the typical answer is that, while they knew they had some loss, it wasn't bad enough.

Hearing loss has the unfortunate aspect of generally being a gradual process over many years, so it is hard to pinpoint when it becomes a real problem.

With a mild loss, the auditory system as a whole can compensate for a little less clarity fairly easily.

By context, you can fill in a missing sound or word. Was he talking about the sheep (on the farm) or the sheet (on the bed)?

The brain, which is the final step in the whole process of detecting and understanding, is also able to ignore distractions such as other voices in the restaurant, air conditioners or fans, music and engine or road noise in the car.

Once hearing loss progresses to moderate or worse, the brain can no longer compensate for these deficits. By that point, we see several changes in behavior people may not be aware are due to hearing loss.

One of the first signs is almost always you need to turn up the TV volume, which can be a major annoyance to others.

You probably start saying "What?" or ask people to repeat what they said.

People may also complain you weren't listening to them. It is often the people around you who are more aware of hearing loss than you may be yourself.

If social situations are becoming less enjoyable, or you start to avoid meetings, lectures or the book discussion group, this indicates a significant problem.

If you are more tired by the end of the day, or after time spent with family or friends, it is a sign your brain has been having to work harder to concentrate on understanding conversation.

Hearing loss as a medical condition varies from vision, dental, or other physical problems in that it doesn't affect just you. It affects everyone around you, whether family, friends, or strangers you meet on a daily basis.

Hearing well is how we stay connected to those around us. Research on aging repeatedly finds the number and strength of social connections is critical to aging well.

So, if you recognize any of these negative behaviors, your hearing loss is indeed bad enough to be evaluated and treated.

Today's hearing aids provide better sound quality, performance and ease of use than ever before.

Veralyn Davee is an audiologist at Hearing Aid Specialists in New Milford. She is a contributing writer for The Greater New Milford Spectrum.