First, the hearing loss: If you have a hearing loss your ears aren't able to provide a complete signal he brain. It's somewhat like a pianist playing the piano and some of the keys are missing. Sometimes you'll be able to glean the song anyway, but more often than not your brain will be playing a guessing game. Add background noise and your brain can't even guess well anymore. A hearing aid will help provide the needed input in this situation, however the signal still has to go through a damaged ear. Hearing aids make a difficult situation better, but it's still a difficult situation.
Second, the difficult situation: Even if you have perfect hearing, as the noise level in a room increases, it's harder and harder for your brain to filter it out so that you can focus on the person you're trying to listen to. When the noise around you becomes louder than the person you're trying to hear, it's can me nearly impossible for your brain to pick up the signal and make any sense of it.
Third, your brain: Some people have what's known as "auditory processing difficulties" or an "auditory processing disorder" that adds to the problem. Have you ever noticed that in school some people can study with a party going on and others need it quiet? That's because not all of us process sound in the same way. Your coworker may be able to hear in the conference room with no difficulty because your boss' voice is sent through his brain via a more direct route. We can actually see these differences in brain mapping studies.
The good news is that there are ways for you to train your brain to hear better in background noise. For years, a CD has been available called LACE (Listening and Communication Enhancement) that helps your brain to focus on the sounds you want to hear, and exclude those you don't. There's also a newcomer on the market called eArena (by Siemens) which is similar (I'm sure there'll be more to come). Both involve a daily exercise to actually rewire your auditory pathways. Think of it as physical therapy for your brain!
I use both of these CDs for my patients, whether they have hearing aids or not. I'm a big fan because they've been very successful. Don't expect miracles, a difficult situation will still be a difficult situation, but when trying to hear your family for the holidays, every little bit helps.
If you have questions about the use of these CD's you should contact your audiologist for more information, or just let me know. Also, if you have other ideas for hearing better in noise, post them here for the benefit of others.
Dr. Barbara Jenkins, BCABA