Using hearing aids can be frustrating for older adults, but it is necessary | Trending Viral hub


This article was originally published in KFF Health News.

It was a daily routine, full of frustration.

Every time my husband called his father, who was 94 when he died in 2022, he would wait for him to find his hearing aids and put them on before he started talking.

Even then, my father-in-law could barely hear what my husband was saying. “That?” he would ask again and again.

Then there were the problems my father-in-law had replacing the batteries in the devices. And the times he ended up in the hospital, unable to understand what people were saying because his hearing aids didn’t seem to work. And the times he dropped one of the devices and couldn’t find it.

How many older adults have problems of this type?

There is no good data on this topic, according to Nicholas Reed, an assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health who studies hearing loss. He did a literature search when I posed the question and found nothing.

Reed was co-author of more definitive study to date on hearing problems in older Americans, published in JAMA Open Network last year. Previous studies excluded people aged 80 or older. But the data became available when a 2021 survey by the National Health and Aging Trends Study included hearing screenings conducted in people’s homes.

The results, based on a nationally representative sample of 2,803 people aged 71 and older, are revealing. Hearing problems become widespread as age advances, exceeding 90% in people aged 85 and older, compared to 53% among people aged 71 to 74. Additionally, hearing worsens over time, with more people experiencing moderate or severe deficits once they reach or surpass age 80, compared to people in their 70s.

However, only 29% of people with hearing loss used hearing aids. Multiple studies have documented barriers that inhibit its use. These devices, which Medicare does not cover, are expensive, ranging from nearly $1,000 for a good over-the-counter set (over-the-counter hearing aids became available in 2022) to more than $6,000 for some prescription models. In some communities, it is difficult to find hearing screening services. Additionally, people often associate hearing aids with old age and feel self-conscious when using them. And they tend to underestimate hearing problems that develop gradually.

Barbara Weinstein, a professor of audiology at the City University of New York Graduate Center and author of the textbook “Geriatric Audiology,” added another concern to this list when I contacted her: usability.

“Hearing aids aren’t really designed for the population that needs them the most,” he told me. “The decision to make smaller, more technologically sophisticated devices is not suitable for many older people.”

This is problematic because hearing loss increases the risk of cognitive decline, dementia, falls, depression, and social isolation.

What advice do hearing health specialists have for older adults who have difficulty using their hearing aids? Here are some thoughts they shared.

Consider larger, more custom devices

Many older people, especially those with arthritis, poor fine motor skills, compromised vision, and some degree of cognitive impairment, have difficulty manipulating small hearing aids and using them correctly.

Lindsay Creed, associate director of audiology practices at the American Speech-Language-Hearing Association, said about half of her older clients have “some type of dexterity problem, whether it’s numbness, reduced movement, tremor or lack of coordination”. Shekinah Mast, owner of Mast Audiology Services in Seaford, Delaware, estimates that almost half of her clients have vision problems.

For clients with dexterity issues, Creed often recommends “behind-the-ear hearing aids,” with an over-the-ear loop and custom earmolds that fit snugly in the ear. Custom headphones are larger than standardized models.

“The more dexterity challenges you have, the better you will do with a larger device and a lot of practice picking it up, orienting it, and putting it in your ear,” said Marquitta Merkison, associate director of audiology practice at ASHA.

For seniors with vision problems, Mast sometimes orders hearing aids in different colors for different ears. Additionally, it will help customers install stands at home to store devices, chargers and accessories so they can easily find them whenever they need them.

Go for ease of use

Instead of purchasing devices that require replacing small batteries, select a device that can be charged overnight and run for at least a day before being recharged, recommended Thomas Powers, a consultant with the Hearing Industries Association. These are now widely available.

People who are comfortable using a smartphone should consider using a phone app to change the volume and other device settings. Dave Fabry, director of hearing health at Starkey, a major hearing aid manufacturer, said he has patients in their 80s and 90s “who have found that being able to hold a phone and use larger visible controls is easier than manipulating the hearing aid. “

If that’s too difficult, try a remote control. GN ReSound, another major manufacturer, has designed one with two large buttons that activate the volume control and programming of its hearing aids, said Megan Quilter, the company’s lead research and development audiologist.

See the accessories

Let’s say you have trouble hearing other people in restaurants. You can ask the person across the table to clip a microphone to their shirt or place the microphone in the center of the table. (The hearing aids will need to be programmed to allow sound to reach your ears.)

Another low-tech option: a hearing aid clip that attaches to an article of clothing to prevent the device from falling to the floor if it comes off your ear.

Wear your hearing aids all day

“The biggest thing I hear from older adults is that they think they don’t need to put on hearing aids when they are at home in a quiet environment,” said Erika Shakespeare, owner of Audiology and Hearing Aid Associates in Los Angeles. Grande, Oregon.

That is based on a misunderstanding. Our brains need regular, not occasional, stimulation from our environment to optimize hearing, Shakespeare explained. This includes noises in seemingly quiet environments, such as the whistling of a fan, the creaking of a floor, or the moan of the wind outside a window.

“If the only time you use hearing aids is when you think you need them, your brain doesn’t know how to process all those sounds,” he told me. His rule of thumb: “Wear headphones every waking hour.”

Consult a hearing professional

Everyone’s needs are different, so it’s a good idea to find an audiologist or hearing specialist who, for a fee, can provide guidance.

“Most seniors won’t know what they need” or what options exist without professional assistance, said Virginia Ramachandran, director of audiology at Oticon, a major hearing aid maker, and former president of the American Academy of Audiology.

Her advice to older adults: be “really open” about your challenges.

If you can’t afford hearing aids, make an appointment with a hearing professional to discuss what features to look for in over-the-counter devices. Make it clear that you want the appointment to be about your needs, not a sales pitch, Reed said. Audiology offices do not typically offer this type of service, but there are good reasons to ask, as Medicare began covering visits to the audiologist once a year last year.

KFF Health News is a national newsroom that produces in-depth journalism on health issues and is one of the core operating programs of KFF, an independent source of research, polling and health policy journalism. Learn more about KFF.


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