Next month, over-the-counter sales of hearing aids to adults without a prescription commences. How tempting that will look with probably a cost range of $250 to $1,000 a pair, especially when hearing aids are only available with a prescription after visiting an audiologist. Often, you must spend more than $5,000 with costs not covered by Medicare or many private insurance companies. The high cost has been a real deterrent for many who have a diminished quality of life.
But for others like me who feared that hearing loss might contribute to dementia and depression, or add to the fear of falling since we may miss ambient sounds or could even exacerbate cardiovascular disease due to stress and isolation, any help with hearing became welcome news. Thus, it is no wonder that Health and Human Services Secretary Xavier Becerra hopes the FDA’s recent action to make hearing aids more cost effective and accessible could help many and reduce the price of some hearing aids by as much as $2,800. More manufacturers will be competing in the market and companies will vie to entice us by changing technology and improving the way they work and even how they look.
The Importance of Hearing Aids
Today, 38.2 million Americans aged 12 and older have hearing loss and that problem will definitely become more common and more severe as more of us age. More than half of us in our 70s, and more than 80% of elders in their 80s, have moderate to severe hearing loss, some even approaching total deafness. Dr. Frank R. Lin, Director of the Cochlear Center for Hearing and Public Health at the John Hopkins’ Bloomberg School of Public Health, has conducted an extensive amount of research and joins other specialists in warning that untreated hearing loss is linked to several costly ailments so hearing loss has to be taken more seriously.
Though not hearing is inconvenient and annoying, it’s also a serious health hazard that will eventually cost Medicare much more than it would if hearing aids and services would be more accessible and provided to those of us with hearing loss, so this new initiative in offering over the counter hearing aids is certainly a step in the right direction.
Dr. Lin reported that two new major studies demonstrated that untreated hearing loss can lead to an increased risk of dementia, depression, falls and even cardiovascular disease. In many, uncorrected hearing loss itself was the cause of those health problems such as vertigo or dizziness, ringing in the ears or more loss in one ear than the other. In a John Hopkins’ University study, untreated hearing loss increased the risk of developing dementia by 50% and depression by 40% in just five years when compared to those without hearing loss. My own father was living proof.
Disgusted with ill-fitting hearing aids and impatient with changing batteries on a regular basis, he refused to wear them and eventually was cut off in his social interactions, became depressed, and eventually developed dementia as his brain could no longer process sounds needed to stimulate cellular activity and keep the brain cognitively engaged. Input decreased and so did brain activity. Like a textbook case, his hearing loss led to frequent and long hospitalizations, repeated re-admissions and more visits to the emergency room.
Statistically, studies show that within 10 years, untreated hearing loss accounts for 3.2% of all cases of dementia; 3.5% of those suffering major injuries in a fall, and 6.8% of those needing treatment for depression. Even more surprising, according to Dr. Lin, 85% of those with hearing loss don’t seek treatment, so health care costs increased by 46% over 10 years compared to those with normal hearing.
Considering such statistics, treating hearing loss is cheap compared to the results of hearing loss’ effects on other aspects of health. Considering such statistics, I probably waited too long to get tested and treated, and the longer I waited, the harder it was to treat, which I learned from Dr. Lin. Most people wait an average of 5 to 7 years and the worse the loss, the harder it is for the brain to adjust. One should act as soon as one thinks they have a problem.
My own problem was related to DOB (date of birth) or, in other words, it was age-related so it came on slowly while I fought the stigma until the hearing loss became overwhelming. Dr. Lin says one should get tested when family members make comments or when one mishears or doesn’t know what others are saying. And even after they invest in hearing aids, many, like my dad, leave them in a drawer, lose them, complain of buzzing or that all sounds are amplified and wearing them is just too bothersome.
But hearing tests are often free, and one can experiment with different types. Although they need periodic adjustments, the results are dramatic. However, some people have unrealistic expectations, and as Dr. Lin warns, they are not like glasses that you immediately put on and notice a vast improvement. The brain needs a good month or two to adjust to hearing aids, and the earlier hearing loss is treated, the easier it is for the brain to adapt.
When there’s a heavy load on the brain while processing sounds, parts of words drop out, speech resembles mumbling, and then the resulting garble makes the brain work even harder to understand what used to be easy. Eventually, unclear information impedes memory. When the brain works overtime to decode sounds, memory is affected because the brain can’t stay focused on what is heard.
Balance problems may also occur then because when we can’t hear clearly, we are not as aware of sounds around us or of our exact place in surrounding spaces. The stress and social isolation also may progress to play a role in heart problems. Of course, with the increase in noise pollution, higher volumes of music and loud restaurant noise due to low ceilings and crowded tables, environmental noise all lead to hearing problems for us seniors.
However, don’t let the advertised home test kits lull you into self-diagnosis and treatments. Audiologists still are the best for correct diagnosis, according to the American Speech, Language, and Hearing Association. Audiologists hold a Master’s or Doctoral degree in audiology, so it’s best to get a referral from your doctor.
The test will be administered in a sound-treated room that keeps other sounds out. They use special earphones and equipment that meet national standards. Online hearing screenings don’t have to meet these standards and may lead to incorrect results, plus audiologists eliminate more serious issues that impact hearing loss using more sophisticated diagnostic tools and they assist patients in the proper fitting, very necessary when a lot of devices sold over the counter as hearing aids aren’t even legally permitted to call themselves “hearing aids.”
Those aids sold online or in stores don’t fit every person or treat every degree of loss, but the audiologist can demonstrate the best for you and program the device to your degree of loss for you to experience how it works. A simulated sound field can also show how the hearing aid works in particular situations like noisy settings and can help you set up changing the settings on your iPhone. Directional microphones help you hear in noisy places and feedback cancellation prevents the hearing aid from squealing, but you may not even need advanced features–it’s all based on your lifestyle like going out in crowds or entertaining others.
You can even request a “real ear test” to see how the model works and how it feels and how it looks. Be sure to note the make and model, the price, trial period, warranty, learn to clean and care for them and ask about nonrefundable fees, check-ups, and costs for adjustments. Most allow a 30 to 60 day trial period and follow-up visits are a must, at least during the first few months.
Remember that there’s more than just sticking it in your ear. Barry Freeman, an audiologist and chair of the Board of the National Council for Better Hearing, reminds us that we don’t hear with our ear, but with our brain, and your brain doesn’t know what to do with the sound after we get our hearing aids. Aural education and rehabilitation is necessary through training at home, on a computer, or with others.
Veterans can get hearing aids if the loss is connected to service and some federal employees and families are entitled to coverage through insurance plans. Medical flexible spending accounts may reimburse one for the hearing aid and batteries, and some nonprofits have recycling programs.
If tempted by any over-the-counter offers coming in October, just make sure the device is medical grade, approved by the FDA, has a generous return or trial period, a long warranty, and contains a good smartphone app. For those who are not really sure they need to explore all the options, ask yourself if sounds now are muffled, if you have trouble hearing on the phone or in noisy areas, if you ask people to speak louder and slower, and if you frequently ask a spouse or roommate to turn up the TV volume.
I was pulling up my chair closer to my doctor during discussions or sitting closer to people at gatherings and starting to scream at them, so these were hints that I needed help, but I denied it for too long, went to movies and couldn’t hear most of the lines, and found myself repeating “Pardon me?” when speaking to store clerks. Background noise in restaurants drove me crazy, so I finally put vanity and pride aside and asked my doctor to recommend an audiologist for a hearing test and then requested her advice on what kind of hearing aids to get.
After a consultation, purchase and few adjustments, I was thrilled that I could hear clearly again. Of course, they took getting used to, they needed to be cleaned regularly and charged or required me to take along extra batteries and I had to spring for the expense, but now, I can actively participate in group conversations and, once again, enjoy the company of others. Shockingly, many of my-hard-of-hearing friends refused to be bothered with them and gave up their benefits but what I and many doctors are preaching to others is, if needed, get them soon and wear them.
The best of all news about next month’s over-the-counter initiatives for offering hearing aids that are less expensive is that the stigma of wearing them may lessen. Even a new Barbie Doll has already been introduced by Mattel and one buyer said, “I was so excited when this doll came out as it represents me and so many in the hard-of-hearing community and the pink hearing aids on Barbie are visible. This teaches kids that being different isn’t a bad thing.”
Even I had a choice between purchasing hearing aids in a flesh tone or in silver to give my life some glamour and if hearing aids become more common, I might go the sparkle route, but right now, I want them to blend in and remain unobtrusive, no matter that at my last dinner party, most in attendance admitted having worn them for years!