Most of us don’t realize how bad our hearing loss is, says Dr. Holly Kaplan, clinical professor and audiologist at the UGA Speech and Hearing Clinic. Typically, it’s gradual and high frequency in nature so we just turn up the volume, request repetition or speech read. We might even become defensive or hostile. In fact, among those with hearing loss, fewer than 20 percent report using hearing aids – a rate that hasn’t changed in 40 years, according to Hearing Loss Magazine.
The damage to our hearing could have started in high school band, not to mention rock concerts and stereo headsets. Then there was the lawn mower, even the hair dryer, hunting, or a loud work environment. So that by age 65, 25 to 50 percent of Americans have significant hearing loss; by age 70, it’s two out of three. Kaplan says people first begin noticing the loss in noisy restaurants or perhaps conversation becomes a little garbled or there’s a feeling a fullness in their ears.
At this degree of loss, most people won’t buy a hearing aid. Instead they opt for listening headsets with a microphone, perhaps closed captioning TV, or a Personal Sound Amplification Device (PSAP). In fact, Kaplan notes that it’s an average of seven years from diagnosis before people will buy a hearing aid. And that’s unfortunate. “Hearing loss without an aid will increase faster.”
She describes the various ways we typically cope in the meantime: we smile and nod, perhaps ultimately withdraw from socializing, and become depressed. Aggressively, we might dominate conversations and place the blame for communication breakdowns on others, leading to alienation. No matter what avoidance techniques we use, we’re hurting ourselves because “hearing keeps us attached to the world and pushes off senility,” she explains.
Cost can discourage
Fifty percent of the people who need a hearing aid cite cost as a factor for going without. Prices can vary from $500 to $3,000 each.
“The circuit inside the aid is the difference,” explains clinic audiologist Alice Sanderson. “A basic aid amplifies everything – the more sophisticated ones can sample the environment and adjust.”
The clinic offers a $400 version with no custom mold, a fitting fee of $175, and separately priced visits. Bundled aids and follow-up range from $1,000 to $3,000, with two- and three-year warranties that include cleaning and repair. Students may conduct hearing tests but are always supervised by an audiologist. The clinic also provides second opinions.
“A person can be totally acclimated in six months – the more they wear it, the better,” Sanderson notes. If worn sporadically, “it will never sound right. The brain interprets sound signals and the auditory cortex will never adjust to amplification.”
Over the counter?
In December 2016, the Food and Drug Administration voted to no longer enforce the requirement that adults over 18 need to see a physician or sign a medical waiver prior to a hearing aid fitting. At that time, the FDA also announced a commitment to consider over the counter hearing aids after noting that “hearing loss is a significant public health issue and that hearing aids cost too much.”
Last year, after passage by the House and Senate, President Trump signed the Over-the-Counter Hearing Aid Act into law on Aug. 18, 2017. The FDA has three years to draft rules and regulations for it. There will also be an extended rulemaking period.
In the meantime, there are also Personal Sound Amplification Products (PSAPs). These cannot be legally marketed to people with hearing loss as a “hearing aid,” only to those with normal hearing as an amplification device. However, they have thanks to advances in electronic circuitry and technology, they’ve gotten smaller and more sophisticated. The better ones range from $250 to $350. In a laboratory study conducted at the Hearing Aid Research Laboratory at the University of Memphis, researchers sought to compare hearing aids and PSAPs in subjects with mild to moderate hearing loss and some listening difficulties in everyday situations.
They studied two premium BTE aids, two basic BTE aids, and two high quality PSAPs. Results showed the PSAP candidates preferred hearing aids over PSAPs for listening to speech. There was no clear preference for listening to everyday noises or music. In addition, premium hearing aids were not significantly preferred over basic aids for either speech, noise or music. However, the researchers noted it was a laboratory setting, the devices were fit to an average hearing loss and some features such as directional microphones or vented ear molds were not considered in the study. Kaplan also cautions purchasers of PSAPs to check return policies.
In the end, Kaplan advised her OLLI audience that those with hearing loss should not be passive or aggressive but assertive by being open and honest, admit mistakes, ask for help, and problem solve by planning ahead when going out.
Captioned Telephone (Captel). Provides a special phone and service that allows the hearing impaired to talk to the other party and then listen while reading word-for-word captions of what the person is saying. CapTel phones are also available for Smartphone, tablets, and computers. Call Hamilton Relay at 877-455-4227 or www.HamiltonCaptel.com. Free phones are available to those who qualify medically and financially through the Ga. Telecommunication Equipment Distribution Program; call Georgia Relay at 866-694-5824 or www.GeorgiaRelay.org.
Georgia Center for the Deaf and Hard of Hearing, Decatur, 1-888-297-9461. www.gcdhh.org/gatedp. Provides specialized telecommunications equipment to Georgia residents who cannot communicate by phone because of a hearing or speech impairment. The equipment is on loan for free with training and a warranty once eligibility is determined.
Georgia Lions Lighthouse Foundation, Atlanta. 404-325-3630, www. lionslighthouse.org. Provides financial assistance for hearing aids to legal Georgia residents who qualify. UGA Speech and Hearing Clinic is the only Lighthouse-approved provider in Athens. 706-542-4598.
Hearing Loops, www.americanhearingloop.com. This is an initiative in Georgia, S.C. and N.C. to encourage public venues to install hearing loops or induction loops. They transmit a signal from a microphone or sound system through an installed wire that “loops” around the listening area. Sound is broadcast directly to the listener’s ear with improved clarity and the elimination of background noise or reverberation.
Hearing Loss Association of America. www.hearingloss.org. Founded in 1979, HLA has a very robust website that provides information, education, and opportunities for support and advocacy. Some of their issues include the need for itemization of professional services and price transparency; hearing aid tax credit legislation; insurance coverage and tax relief; more lower cost options.
UGA Speech and Hearing Clinic. 706-542-4598. www.coe.uga.edu/shc. Provides comprehensive evaluation and treatment services for all ages by graduate students under the supervision of clinical faculty or directly by faculty. Insurance coverage accepted for some services, and some financial assistance. Free speech and hearing screenings offered each fall and spring.