THE HEARING HANDICAP INVENTORY FOR THE ELDERLY

THE HEARING HANDICAP INVENTORY - SCREENING FORM
INSTRUCTIONS: The purpose of this scale is to identify the problems your hearing loss may be causing you. Please select YES, SOMETIMES, or NO for each question. Do not skip a question if you avoid a situation because of your hearing problem. If you use a hearing aid, please answer the way you hear without a hearing aid.
Does a hearing problem cause you to feel embarrassed when you meet new people?	Yes Sometimes No
Does a hearing problem cause you to feel frustrated when talking to members of your family?	Yes Sometimes No
Do you have difficulty when someone speaks in a whisper?	Yes Sometimes No
Do you feel handicapped by a hearing problem?	Yes Sometimes No
Does a hearing problem cause you difficulty when visiting friends, relatives, or neighbors?	Yes Sometimes No
Does a hearing problem cause you to attend religious services less often than you would like?	Yes Sometimes No
Does a hearing problem cause you to have arguments with family members?	Yes Sometimes No
Does a hearing problem cause you difficulty when listening to TV or radio?	Yes Sometimes No
Do you feel that any difficulty with your hearing limits or hampers your personal or social life?	Yes Sometimes No
Does a hearing problem cause you difficulty when in a restaurant with relatives or friends?	Yes Sometimes No