OK, admit it. You have trouble tracking conversations in restaurants, or at family gatherings, or in business meetings, or when your spouse speaks mumbles. And you've known it for a long time -- maybe even visited a hearing specialist who confirmed your hearing loss.

Now, finally, you're ready to take action -- another way of saying that you're more embarrassed by screwing up a conversation than you're afraid of looking like an ... an ... an old person (There. Get it out.)

"That fear of seeming frail or old is still definitely there, but I think it's dropping -- maybe because there are more baby boomers, or just more publicity," said New Brighton audiologist John Coverstone, president of the Minnesota Academy of Audiology trade association.

Or maybe your discomfort has been numbed by the gazillion ads for hearing aids that hit your newspaper and mailbox every week featuring movie stars, research trials or $800 off if you act now.

"I knew I had to do something because sometimes I wasn't hearing my patients," said Millie Christensen, a psychiatric nurse at Hennepin County Medical Center (HCMC) in Minneapolis.

"With a friend, sometimes you can sort of pretend you hear, and usually you're not far off," said Christensen, whose close scrutiny of people's faces -- and lips -- has given her the reputation as a good listener. "But you can't pretend with a patient. I found myself saying 'What?' way too often."

Average delay is 10 years

A hearing-aid patient typically has been aware of hearing loss for 10 years before taking action, researchers say. Christensen waited only about six months before seeing audiologist Janet Hansen at HCMC in December 2010.

With mild to moderate hearing loss of mostly high-frequency sounds, she bought mid-range hearing aids with thin microphone-amplifiers that fit behind her ears and soft speakers that she tucks into her ear canal.

Like most wearers who stick with it, Christensen is enthusiastic about her enhanced hearing.

"My kids are grateful. I think my friends are grateful too," she said. "And now I can pick up what my 4-year-old grandson is saying."

Success for most new patients comes when they have realistic expectations that aids will bring a major improvement in hearing and communication, and return to the shop as often as needed to ensure that the devices are comfortable and adjusted well.

A few weeks ago, St. Paul Schools Superintendent Valeria Silva was ducking in an out of a school board meeting, then finally acknowledged that a hearing aid was acting up.

"They make such a difference. I didn't realize how much I was missing until I got them about six years ago," said Silva, who had numerous operations as a child in her native Chile to repair damaged ear drums.

And it wasn't just hearing people that improved with hearing aids. She recalls attending the musical "Wizard of Oz" in New York and "screaming in delight" when she heard the music.

"And I was in my yard after I first got them, and I spun around because I thought somebody was following me, only to realize that, for the first time in my life, I heard the sound of leaves crunching under my feet," she remembered.

"I experience so much, so much that I didn't even know about when I was younger," Silva said.

Smaller, more powerful

Vast improvements in technology have allowed makers to shrink the size of hearing aides -- easier to accept for people nervous about their image -- while boosting their power and sophistication.

Most now come with computer chips that can be programmed to provide maximum hearing to fit your lifestyle. Most are easy to use with telephones.

Should you buy insurance to supplement the year's coverage typical with most hearing aids? It might be wise for people who misplace things easily, or for rambunctious children, Hansen said.

With a price range of around $1,500 to $7,500 or so for a pair of hearing aids, what should you buy?

"If you do a lot of business in restaurants or meetings where there's a lot of background noise, it might be worthwhile buying high-end aids," Hansen said. "But for most people, middle-range or even lower-cost hearing aids can work just fine."

The choice of price typically is more important than brand, said Coverstone, the New Brighton audiologist.

"Frankly, there's not all that much difference between them," he said. "Most audiologists sell three or four brands, and I pick them based on what kind of service I get from the company."

Most important after buying hearing aids is returning to the audiologist as often as necessary to make sure the devices are comfortable to wear and the sound adjusted to your needs, the audiologist said.

"The reason to buy hearing aids is to improve the quality of your life," Coverstone said. "When your delight at hearing your grandchild's first words exceeds your fear of how you look, you'll know you made a good decision. And you'll probably wish you'd done it long ago."