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Do You Need a Hearing Aid? And Can You Afford It?

Voila_Capture84Despite jokes and sitcom story lines, hearing loss is not inevitable. It is common, however, affecting one in three adults over age 65, and about half of people over age 70. While some people are genetically prone to develop problems with hearing, others face increased risk because of loud noises they experience throughout their lives–on the job (such as farming, construction, or factory work) or recreationally (such as exposure to noise from firearms, fireworks, snowmobiling, motorcycle riding, or listening to high-volume music). Plus, some medications–such as the antibiotic gentamicin, some chemotherapy drugs, pain relievers, and antimalaria drugs–can damage the inner ear.

Many times, people with hearing loss are the last to know. Their loved ones and friends usually recognize problems first–they are the ones who continually have to repeat themselves and raise their voices to be heard. You don’t know what you can’t hear if you don’t hear it, so those with hearing loss often think they hear “just fine.”

There are signs that your hearing may be going. According to an article from the Cleveland Clinic, people with hearing loss may:

  • Say that people around them are mumbling
  • Often ask people to repeat what they have said
  • Avoid noisy rooms, social events, or family gatherings
  • Keep the television or radio louder than other people prefer
  • Have a hard time understanding people when they cannot see the faces of the people who are talking
  • Have trouble hearing at the movies, theater, house of worship, or other public places
  • Have a hard time understanding conversations in a group
  • Become more impatient, irritable, frustrated, or withdrawn

But even with all the symptoms, older adults often believe that they hear perfectly well, even while others recognize the hearing loss. How can that be? According to the Cleveland Clinic:

It is harder for older adults to hear high-pitched consonant sounds (such as d, t, sh, s, f, th) than low-pitched vowel sounds (such as o, a, ah, i, e). The high-pitched sounds carry the meaning of words, so they help us understand speech. In normal conversation, high-pitched sounds are softer than low-pitched vowel sounds. As a result, speech may sound loud but not clear. For example, “Do you have the time?” may sound like “Do you have a dime?”

The confusion and embarrassment of hearing loss may also lead to denial. Plus, if you admit having a problem, the obvious next step is to get help…and that often means getting a hearing aid.

The Other Effects of Hearing Loss

So what if you can’t hear everything, no one died from a little hearing loss, right?

Wrong!

Hearing loss can be very dangerous. According to an article in The New York Times:

Because the ear plays a role in balance, hearing loss can lead to falls. “Even mild hearing loss can triple the risk of falling,” said Dr. [Frank Lin, assistant professor of otolaryngology and epidemiology at Johns Hopkins University], citing his own research as well as a study of Finnish twins.

And then there is the mysterious link to dementia. Some studies have suggested that mild hearing loss is linked to a doubling of dementia risk, and that moderate hearing loss can triple it. With severe hearing loss, the risk can be five times as high, according to Dr. Lin’s 2011 study in Archives of Neurology and a report last month in The Journal of the American Medical Association.

It is possible that hearing loss leads to social isolation, itself a risk factor for dementia, said Dr. Lin.

In addition, few people realize that delayed treatment may make hearing loss worse. “If you don’t use it, you’ll lose it,” said Dr. Remensnyder. “I have a retired nurse, age 90, who has lived alone with no auditory stimulation for years. She doesn’t understand 50 percent of the words, and I can’t reverse that now.”

Add to all that the specific dangers of hearing loss:  Not being able to respond to a crying child…not hearing a car coming at you as you walk down a street…not hearing the warning sound of a smoke detector…and many other situations. So if you have hearing loss, getting a hearing aid is the most logical decision. Unfortunately, logic isn’t the only factor in play when it comes to hearing aids.

Getting a Hearing Aid…Or Not

According to The New York Times:

Even among the enlightened, hearing aids still carry a stigma. “Men think, ‘It’s a sign of weakness,’ and women think, ‘It’s showing my age,’ ” said Dr. [Eric Hagberg, an audiologist in Youngstown, Ohio, and president of the Academy of Doctors of Audiology].

Vanity also plays a part, so people will avoid getting hearing aids the same way they avoid getting glasses.

And then there is the question of money. There’s no denying that hearing aids are expensive–not just pricey, but “luxury” expensive. In general, hearing aids run from $1,800 to $6,800+ per pair…and the cost is not covered by Medicare or most insurance. The most expensive options don’t necessarily work better than cheaper models (although they may, depending on the models), but they generally will be more aesthetically pleasing.

There are some less expensive options, however. In an article titled “The Hunt for an Affordable Hearing,” The New York Times provides several low-cost, good-quality alternatives… including hearing aids now available at Costco.

Hearing loss can be frustrating, depressing, and dangerous, so it’s worth checking out hearing aids. Start by getting an appointment with a physician to rule out other potential causes of hearing loss. Before your appointment, the Mayo Clinic recommends that you:

  • List any symptoms you’re experiencing, and for how long. Ask your loved ones to help you make the list. Friends and family may have noticed changes that aren’t obvious to you, but they may be important for your doctor to know.
  • Write down key medical information, especially related to any problems you’ve had with your ears. Your doctor will want to know about chronic infections, injury to your ear or previous ear surgery. Also list any medications, vitamins or supplements you’re taking.
  • Summarize your work history, including any jobs, even those in the distant past, that exposed you to high noise levels.
  • Take a family member or friend along. Someone who accompanies you can help you absorb all the information from the doctor.
  • Write down questions to ask your doctor. Having a list of questions in advance can help you make the most of your time with your doctor.

Your doctor is likely to ask you a number of questions, including:

  • How would you describe your symptoms?
  • Did your symptoms come on suddenly?
  • Do you have ringing, roaring or hissing in your ears?
  • Do your symptoms include dizziness or balance problems?
  • Do you have pain in the affected ear?
  • Do you have a history of ear infections, ear trauma or ear surgery?
  • Have you ever worked in a job that exposed you to loud noise, flown airplanes or been in combat in the military?
  • Do you have any close relatives who have been affected by hearing loss?
  • What medications do you take?
  • Does your family complain that you turn up the volume of the television or radio too high?
  • Do you have trouble understanding someone who is talking to you in a low voice?
  • Do you have trouble understanding someone who is speaking to you on the telephone?
  • Do you frequently need to ask others to speak up or repeat themselves during conversation?
  • Do you have trouble hearing someone in a noisy setting, such as a crowded restaurant?
  • Can you follow a conversation in which more than two people are speaking at once?
  • Can you hear a coin hitting the floor?
  • Can you hear a door closing?
  • Can you hear when someone approaches you from behind?
  • How are your hearing problems affecting your life, including your close relationships?
  • Would you be willing to use a hearing aid if needed?

Then, if you discover you need a hearing aid, do your research. Check out all available options, and make sure you understand the return policies–the contract should be as clear as you want your hearing to be.

RESOURCES

Mayo Clinic article about hearing loss

The New York Times:  Why Won’t They Get Hearing Aids

The New York Times:  The Hunt for an Affordable Hearing Aid

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