Hearing impairment is a common problem in elderly people that produces significant personal morbidity and isolation. Hearing impairment in elderly people often has a treatable cause. Presbycusis is only one cause of hearing loss, and may coexist with other causes. The clinical examination, if performed correctly and corroborated by caregivers, is probably adequate screening for hearing loss. However, formal testing should be administered if doubt remains. Hearing aids, although expensive, are helpful for most patients, but they are only part of a total program of aural rehabilitation. Patients, family, and health care provides can all benefit from improvement of communication skills.