Hearing loss often co-occurs with chronic illness in older adults. Self-care of chronic illness is necessary to maintain health but requires health communication. Hearing loss is a barrier to health communication. The purpose of this dissertation is to examine self-care of chronic illness in older adults with hearing loss to advance our understanding of how hearing loss impacts health outcomes in older adults. This dissertation includes a cross-sectional analysis using the nationally representative Medicare Current Beneficiary Survey (MCBS) to examine associations between self-reported hearing loss and hypertension self-care behaviors and self-care confidence among Medicare beneficiaries with hypertension (N=6,313) and the moderating effect of age, sex and race/ethnicity. This dissertation also includes a convergent parallel mixed methods study to examine self-care behaviors and self-care confidence in a clinical sample of hospitalized older adults with chronic illness and hearing loss (N=60), while exploring the experience of self-care of chronic illness in the context of hearing loss among a subsample of participants (N=17) using semi-structured interviews and an integrated inductive-deductive qualitative content analysis approach. Qualitative and quantitative data of the mixed methods study were combined to compare self-care experiences by self-care and hearing handicap scores. Findings reveal that hearing loss is associated with reduced self-care confidence, but not self-care behaviors. The association between hearing loss and reduced self-care confidence was found to be moderated by age and sex. Disengagement from care, missed health information, and strategies to support communication emerged as themes characterizing self-care of chronic illness with hearing loss, suggesting that hearing loss impacts the underlying self-care processes of knowledge and engagement, but not specific behaviors. Themes were most prominent among participants with greater hearing handicap. Findings suggest that hearing loss may influence self-care of chronic illness for older adults with concurrent hearing loss and chronic illness. Simple and low-cost communication strategies and accommodations in care settings may support self-care in this population. Future research is needed to examine how hearing loss impacts self-care across illnesses, over time and among specific groups.