Dear Carol: My 93-year-old grandma has hearing aids, but she refuses to wear them. Her hearing without them is poor, and while she's taught herself to read lips, that only works if I'm standing right in front of her. My husband's so frustrated that he stood in front of her the other morning and said, “I am not going to talk to you until you put your hearing aids in your ears.” I understand his frustration, but his response doesn't seem right either. Could there be some logical reason why Grandma won't wear her hearing aids? — WS.

Dear WS: I appreciate your compassion and your willingness to help your grandma. While it can be frustrating when people have hearing aids yet won't wear them, your instincts are right in that the problem behind your grandma's refusal is what needs to be addressed.

If sympathetically asked about this, Grandma may provide the best clues. If she is unresponsive, I have other suggestions.

First, there's the stigma. Unfortunately, hearing aids are erroneously viewed as a device that indicates aging. This stigma isn't often a problem at age 93, but surprisingly for some, it is. Therefore, it's worth mentioning that even at your grandma's age, stubbornly refusing to use an aid of some type — whether it’s a walker or a hearing aid — isn’t unheard of.

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Additionally, from what friends who use hearing aids tell me, they do require getting used to partly because the sound of the human voice through these devices often loses some of the warm qualities that make voices pleasant. Still, most people who need hearing aids wouldn't want to be without them once they've adjusted.

If either of these instances seems to describe your grandma’s problem, a hearing professional may be able to provide assistance.

Two medical situations to also consider: If your grandma's hearing aids are new, she may be resisting either because the fit is not right, which could make them physically uncomfortable, or the sound is off because they aren't calibrated correctly for her. Conversely, if the hearing aids are older, they might need to be updated or replaced because of poor performance. Again, in either of these cases, her hearing specialist should be able to help.

Another thought is her cognitive health, though the fact that she's learned to lip-read makes her seem pretty sharp to me. Still, try to determine if she seems confused about why she should wear the devices. Confusion could point to either physical or cognitive problems so a doctor should be consulted, preferably a gerontologist to thoroughly check her general health and, if necessary, provide you with a referral to a neurologist if that is warranted.

I hope you can take your grandma to the appropriate medical appointments. Correcting her hearing deficit could improve her quality of life dramatically, so this deserves the attention that you're giving it.

Of course, a solution to this problem will make life smoother for you and your husband, as well.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached at carolbradleybursack@mindingourelders.com.