When a loved one starts to turn up the volume on the TV, ask others to speak louder or becomes more aloof, it's a difficult situation. And what's happening to your own hearing can be hard to face, especially if the people around you are afraid to speak up.

Either way, hearing loss is a major issue.

About 20 percent of Americans have hearing loss in at least one ear, and only 13 percent of doctors routinely screen for it, according to Sonus Hearing Care Professionals. That's about 32 million afflicted Americans, not counting the baby boomer population that will inflate that number soon, said Dr. Ann Welker, director of audiology and rehabilitation at Audio Professional Hearing Aid Center in York Township.

As part of Better Hearing and Speech Month in May, local hearing centers want to raise awareness about screenings and hearing aid options.

A hearing screening takes only a couple of minutes. A specialist first checks the ears to see if they are clear and not clogged with ear wax. Then the patient wears a pair of ear buds, which will play low- and high-pitched tones in each ear. The patient presses a button for each beep while the specialist keeps "score."

Take care: Hearing loss is the third most common health condition affecting the United States right now, Welker said, and there are links between untreated hearing loss and dementia, relationship issues and depression.

"So it's really important to take action before it gets to that point," Welker said. "And that's where the awareness of Better Hearing and Speech Month comes in."

Those under 40 should take note of any changes in pressure or buzzing and get screened every two to five years, said Dr. Amanda Long, an audiologist with Sonus in York Township. A person closer to his or her 40s and 50s should get screenings every one or two years, regardless of a lack of symptoms.

If issues are detected during a screening, the patient will be referred to have a hearing evaluation, an in-depth assessment that will determine details about the hearing loss and treatment options.

Prevention is also key, Long said. Use ear protection when doing loud activities and turn down the headphones: You should be able to hold a conversation, and other people shouldn't hear the noise, she said. And never use Q-tips or stick anything smaller than your elbow in the ear, she said: See a doctor or use over-the-counter methods to remove ear wax.

The stigma: On average, it takes about seven years for people to take the first step in caring for their loss of hearing, she said. That can result in auditory deprivation, a "use-it-or-lose-it" hearing loss condition.

"The ears do the hearing, but the brain is actually involved in the perception and understanding of the speech sounds," Welker said. When left unused, the auditory portion in the brain begins to forget what sounds are supposed to sound like, making it hard for someone to transition seamlessly to amplification, she said.

Long said the peace of mind that comes from managing your health is worth the effort.

"It's something you really have to be honest with yourself about," she said.

Most people see hearing loss as a sign of getting older, but it can affect anybody at any age, she said, and treatment options are getting much more manageable.

"Hearing aids are getting a lot smaller and a lot more powerful," she said. Some are actually invisible.

Although hearing treatments are in the new age, people still think of hearing loss as an "older person's issue," she said.

"There's still a stigma associated with hearing loss," she said.

But that stigma is unfounded, said Sonus owner and hearing instrument specialist Bruce Bausher.

"With hearing, people just kind of let it slide," he said. "There's a lot of things that cause hearing loss besides just age."

-- Reach Mollie Durkin at mdurkin@yorkdispatch.com.