Lighten Your Life Before You Kick the Bucket - Book and Contest
INTERESTING STUFF – 19 March 2016

Can You Hear Me Now?

CONTEST NOTE: The magic random number generator has spoken and selected three readers as winners of the book, Seven Ways to Lighten Your Life Before You Kick the Bucket that was offered on Wednesday.

As in merry old England where authors George and Walt tell us it originated, let's have a "tucket" - TA-DA - for the names of those winners:

Vicki Hornus
momcat christi
Norma Hall

Congratulations to all three of you. Please click the “Contact” link at the top of this page and send me your postal addresses. I will get the books off to you as quickly as possible.

If I do not receive your email by Monday 21 March 2016 at 12 noon Pacific Daylight Time, another winner will be chosen.

* * *

Remember that annoying Verizon commercial from a few years ago – Can you hear me now? For millions of elders in the United States, crappy cell phone reception is not the problem - it is their hearing itself.

According to a 2013 study, hearing loss affects 30 percent of the entire American population and numbers are much higher for elders. In fact, after hypertension and arthritis, hearing loss is the third most common chronic condition among old people. It affects

More than 40% of people age 60 and older
More than 60% of those 70 and older
Almost 80% of those age 80 and older

Obviously, this is a case of if you live long enough, you will probably have trouble hearing.

There are many causes of hearing loss, some that are medically treatable and some not. But today, we're talking about hearing aids.

(If you want some fairly in-depth medical information about hearing loss, two good resources are a regularly updated section at The New York Times and the hearing loss section at the National Institutes of Health website.)

Four years ago, it was reported (emphasis is mine) that

”Of the 26.7 million people over age 50 with a hearing impairment, only one in seven, a meager 14 percent, use a hearing aid, said Dr. Frank Lin, assistant professor of otolaryngology and epidemiology at Johns Hopkins University.

There are a lot of reasons so few people use hearing aids ranging from denial of hearing loss to vanity to annoying feedback noises to physical discomfort and for those who own them but don't use them, the fit may be irritating or the many adjustment visits are not perceived as worth the effort.

Resistance to hearing aids is high but the number one reason for not using them is price and no wonder. As the Center for Medicare Advocacy reported two years ago, the average price of one hearing aid was $2,363 and most people require two.

With a physician's referral, Medicare will pay for a diagnostic visit to an audiologist but the 1965 law specifically prohibits Medicare from paying for hearing aids themselves even though uncorrected hearing loss leads to host of other, serious medical problems.

People with hearing loss report more frequent falls (ears play a role in ability to balance). There is an increased incidence of depression, accelerated rates of cognitive decline and those with untreated hearing loss are more likely than those with normal hearing to develop dementia. In addition, as The Times recently reported,

”...hearing loss may lead to changes in brain structure. In one of Dr. Lin’s studies, magnetic resonance imaging tests showed greater brain atrophy among those with poor hearing.

“A struggle to hear can also lead to isolation, and 'we’ve known for years that social connectedness is important for cognitive health,' Dr. Lin added.”

Recently, there has been some movement toward rectifying these problems. Last fall, President's Council of Advisors on Science and Technology (PCAST) sent a letter with recommendations to President Barack Obama:

”The Federal Trade Commission (FTC) should enable a hearing-aid prescription process similar to what is available for eyeglasses and contact lenses, giving consumers a greater diversity of choices and the opportunity to shop around without being locked into the cost of a particular device or service.

“The Food and Drug Administration (FDA) should create a new category for 'basic' hearing aids and associated hearing tests that are meant for sale over-the-counter. This would allow entrepreneurs and innovators to enter the market and open a space for creative solutions to improve mild-to-moderate, age-related hearing loss with devices that can be sold widely, allowing consumers to buy a basic hearing aid at the local pharmacy, online, or at a retail store for significantly less.

“The FDA should rescind its previous draft guidance about Personal Sound Amplification Products and allow these devices to make truthful claims about capabilities like improving hearing or understanding in situations where environmental noise or crowded rooms might interfere with speech intelligibility.”

The F.D.A., has acted on those recommendations and will hold a public workshop in April next month to consider, as The Times reports, whether its hearing aid regulations 'may hinder innovation, reduce competition and lead to increased cost and reduced use.'”

Hearings and recommendations are not change and government works, as we know, at a glacial pace but according to that Times story, it is already well known that hearing aids don't need to cost as much as the public is paying:

The Department of Veterans Affairs, which negotiates with manufacturers for lower prices, provided comprehensive hearing care to more than 900,000 veterans in 2014 and dispensed almost 800,000 hearing aids without copays. The average cost per device: $400.”

Comments

I've wondered for years what a difference universal provision of vision, dental and hearing care for everyone from birth to death might make for everyone. I can think of so many circumstances in which it would have made a dramatic difference in someone's quality of life, general health and medical visits, and often, the length of life. The strong links between each of these things and mental health, as well, is something that very much needs to be taken into consideration in advancing our society and well being.

My husband has been using VA care since his employer suddenly and unexpectedly closed their doors a few years ago, about a year before he qualified for Medicare. As an insulin-dependent diabetic, we were very concerned about how we would continue to afford his life sustaining medication. We will be forever grateful to the VA. The VA provides an excellent example of how good care can be provided at much lower than general market prices. The VA also relies heavily on volunteer services by vets, which allows the provision of things that would otherwise be prohibitive, such as bringing around coffee carts to vets and their families sitting in waiting rooms for hours on end, and valet service so that cars can be parked and patients let off at the door rather than traversing the sometimes long distance from the parking lot to the clinic or hospital. Even peer-to-peer counseling is available at facilities and can be a huge help and comfort to people who simply need to talk with others, and don't necessarily need a licensed mental health practitioner or prescriptions for medication.

Due to a conflict of medications I was taking a few years back, I completely lost all my hearing in one ear. The other ear is okay and I can hear most things like TV and radio and one on one conversation without much difficulty. Only when I am in a crowded room or there is loud music do I have a problem. Too much sound coming into just one little ear is not good and, sometimes painful. I have been told that a hearing aid will not help my condition nor would surgery, so I guess I am stuck this way.
The only problem is that it does effect my balance. I'm like a car that's out of alignment and keeps wanting to pull to the right.
But the biggest regret I have is that I can no longer enjoy music in stereo. Everything I hear is in dull, boring monaural.

Great to read that efforts are being made to make hearing aids more accessible. Fortunately, I have not yet had to deal with any hearing loss, but both my parents did. Both resisted wearing aids even though it was isolating them from full engagement in conversations. My father would be off topic or misunderstood because he wasn't hearing even though he was nodding his head as if he had. Hard to say if it was vanity or stubbornness, but if hearing aids were as readily accessible as eyeglasses, perhaps more people would actually want to wear them and remain fully engaged.

Also, as a volunteer ambassador for Dogs for the Deaf, a non-profit in Central Point, Oregon, I would be remiss if I didn't mention there is help for people with severe hearing loss. A dog that alerts their partner to sounds can be a liberating phenom for people of all ages. The expense concerns involved in this case are the costs of feeding and healthcare for the dog once placed. Placement is virtually free.

The hearing aid that has not been mentioned is a Cochlear Implant. Because surgery is involved Medicare pays for this procedure. It is only available to the profoundly hearing impaired. I have had one for a number of years and it saved my life when hearing aids no longer were much help.

This is yet another reason to push for a single payer medical system. In other countries that have this cost and life saving system, hearing, dental and vision care are free. I am so tired of people resisting this system because it is "Socialism". As Cathy explained the care under VA, which is socialism, is far superior and cheaper than the care we get with the Insurance companies calling the shots based on their bottom line.

My first thought was that hearing impairment would impair driving, or make so dangerous as to be impossible. I'm not thrilled to read I'm already up to a 60% chance of hearing impairment. Of course it's entirely possible that my hearing is already impaired and I just don't realize because I'm alone so much.

I don't suppose hearing (and dental and vision) aids are not included in Medicare because the law was written mostly by young and/or wealthy people who don't have such concerns ...

Thanks for writing about this Ronni. This is a topic, as you know, that's close to my heart, or more literally, my head. Last year, I needed a second hearing aid in addition to replacing my old one. Saw three different providers before I settled on a Siemans' pair that cost $5000.00 and still leaves me with difficulty hearing in some situations. The whole purchasing process was like a crapshoot for several reasons: (1) Impossible to find any meaningful reviews of different brands; and (2) Each audiologist carries only 1-3 lines so theres no way to "test drive" or compare more than that amount without undergoing a time-consuming, laborious, expensive, and probably impractical study.

Unfortunately, the nearest Cosco was too far away to take advantage of their lower pricing and good reputation.

Do providers push particular brands because they're getting a better deal from the manufacturer? And why are the aids so expensive in the first place? I'm reminded of eyeglass frames that are ridiculously overpriced, although in this case it's apparently due to the monopoly enjoyed by an Italian company.

Another hearing problem I've recently become aware of is understanding someone speaking on their cell or VOIP phone. Seems like the sound quality of those instruments leaves a lot to be desired. As someone who may soon have to replace my old flip phone, I'm wondering if anyone can recommend a particular smart phone that's superior to the others in the quality of its sound?

Apparently the next iPhone is going to have wireless headphones that go straight in your ear, so that might help you, but the downside is that earbuds block out outside sounds.

Maddy... iPhones have microphones.

In principle, it should be possible to switch as desired between the phone-speaker track -- and outside sounds, which could be intelligently enhanced to make the buds function as hearing aids. Or even combine the two.

Of course, that's assuming a lot. But the basic hardware requirements exist. All that's needed is better software. In other words, a Hearing Aid App.

Yesterday I bought my last pair of hearing aids from Costco. Even at their prices which are about half that a comparable pair would cost elsewhere I cannot afford to buy any more. These include a program for hearing music which had been a problem before...absolutely could not stand to listen to music with the old ones. So far, so good. They allow a 6 month trial period and will refund your money if they can't be adjusted to satisfy you.

We should all buy stock in Siemans and Beltone et al because I'm sure this generation that's been listening to all the loud rock 'n'roll and heavy metal will be needing hearing aids down the road. But maybe they'll take action and insist on lower pricing. I'm sure the cost is the main reason people do not buy them, it's a big investment for something that only lasts a few years.

I am perfectly satisfied with a pair of generic hearing aids for my age related hearing loss. They are about $300.00 each. They have adjustments for hearing in noisy restaurants and work with the "loop" hearing enhancement found in concert halls, movie theaters, etc. Look online or in magazines. Sure beats trying to get along without them.

Maddy mentions wireless iPhone headphones..well thanks to Costco I have wi-fi enabled hearing aids! I worked for Ma Bell for almost 40 years..35 of those years were spent listening to high pitched tones that I read thru a meter and regulated with tiny potentiometers adjusted with a tiny tiny screw driver. The person inside who was sending these tones was supposed to block them from going into my ear, but more often than not they didn't. I have a lot of impairment in my right ear..the one I listened on the phone with of course. After living with my daughter and being asked over and over to turn my TV down, we all decided I needed to get hearing aids.

I remember my dads aids..big bulky 'flesh colored' slug like things. Costco sold me hearing aids that are about one inch long and invisible! I did order bright red and they nestle behind my ear amongst my red hair just fine.

As an added benefit, I can tune one of the aids to my iPhone and listen to music or an audio book, or to the TV with a wi-fi adaptor, while I listen to conversation thru my other ear. It's amazing!

These aids cost about $2K and really set me back, but are well worth it. I love the wi-fi aspect as does my family. We were going to close off my apartment with a door because of my TV..we have an open area style home..but now we can keep our open style floor plan because when I'm listening to music or audiobooks or the TV in my space, it's thru my aids and the family doesn't even hear it.

I looked at the generic aids such as Hattie wrote about but knew I wouldn't be happy with them. Even though it's cost me a couple of years worth of vacations, I am very satisfied with my costlier aids, specifically because of the wi-fi aspect. Apple is behind the times! Never thought I'd say that, but wi-fi enabled headphones have been on the market for several years now.

I originally went to Miracle Ear-they are so very expensive that I am glad I didn't commit to them..almost 8K for the pair that have nothing more than the Costco pair offers. Costco also offers more traditional style aids that are much less expensive, and, of course, they are not covered by medicare even if you have an audiologist prescription for necessity.

Hear Well everyone and don't let your interaction with family and friends suffer because of impaired hearing..there are answers for all of us out there!

Elle AKA Plantcrone

I tried a pair on at Costco, but the sound of the shopping carts clanging was overwhelming. Do you block out background sounds after a while? I was also surprised to learn that they only last about 5-8 years. I naively thought they would be a one time purchase, because of the high cost.

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