Dear George,
Our neighbor Eddie turned 95
this week. I think he’s doing
great. He does Sudoku, takes long
walks in the park, and can still do the cha-cha-cha. However, he is more grumpy than he used to be. He’s not upset about the Tea Party or
potential terrorism at the Olympics.
It’s more about the vicissitudes of everyday life. According to Eddie, people nowadays
have lost the ability to speak correctly.
They mumble all the time, slur their words, talk too softly. Because they don’t enunciate correctly,
their “f’s” and “s’s” and “th’s” all run together. Women, believe it or not, are even harder to understand than
men. Eddie is also irritated at
the manufacturers of modern appliances.
Radios and TVs don’t put out enough volume, doorbells are faint-hearted,
and half the time you can’t hear your cell phone ringing at all.
I’m sympathetic to Eddie’s
views because I’ve obsesrved some of the same annoyances myself. I told Katja about Eddie’s complaints,
but she said it was a bunch of hooey.
She was surprised I hadn’t noticed how Eddie’s hearing has been getting
worse in recent years. That was puzzling to me, but I Googled some stuff to get
more info. Here are a few of the
things I learned. [Note: numbers
in parentheses refer to sources listed at the end.]
What is “hearing loss”
anyway? There are various symptoms of hearing loss. Some are: muffling of speech;
difficulty understanding words, especially with background noise; often needing
to ask others to repeat themselves or speak more loudly; turning up the volume
on the TV; and/or avoidance of conversations or particular social situations
(6).
How common is hearing
loss? According to WebMD, hearing loss is the third most frequent
health problem in the U.S. (10). A
national survey in 1971 estimated that over 13 million American adults reported
hearing loss. That’s increased
substantially, with about 36 million adults reporting hearing problems today
(7).
How is age connected
with hearing loss? Advanced age is the single most common
cause of hearing loss (10).
However, hearing loss affects all age groups, and nearly two-thirds of
people with hearing loss are younger than 65 (14). Decline in hearing begins in early adulthood but doesn’t
usually interfere with understanding conversations till much later (1). The National Institutes of Health estimate
that 18% of American adults between 45 and 64 have some degree of hearing loss
(7). That figure goes up to
30% for persons between ages 65 and 74 and to nearly half (47%) for those 75 or
older. Men experience more hearing
loss than women. Researchers don’t
know exactly why hearing declines with age. However, it’s presumed that lifetime exposure to noise and
other damaging factors wear down mechanisms in the ear (10).
What are the causes of
hearing problems? Experts distinguish between “conductive
hearing loss” and “sensorineural hearing loss” (11). Conductive hearing loss involves a mechanical problem with
the ear due to things like buildup of ear wax, fluid in the ear, foreign
objects, or damage to the eardrum.
Often such causes can be treated through surgery. Sensorineural hearing losses, on the
other hand, are permanent and can’t be reversed. This happens when the tiny hair cells that detect sound in
the ear are injured, diseased, don’t work correctly, or have died. They don’t grow back. This is most frequently linked to
age-related hearing losses, but may also be caused by birth defects, genetic
conditions, repeated exposure to loud noises, some medications, certain
illnesses (heart disease, high blood pressure, diabetes), or other
factors. Sensorineural hearing
losses are usually treated with hearing aids and/or other assistive devices
(11).
Do hearing aids really
work? Hearing aids can help some kinds of hearing loss by making
sounds louder. However, they also
magnify background noises which interfere with how well you can hear. Using hearing aids is much more complicated
than, for example, getting glasses to improve one’s vision. You may need to have several fittings
of a hearing aid (8), and it may take months to learn to use a hearing aid
successfully.
You
need to learn to adjust the volume and to program the hearing aid for loud and
soft sounds. Hearing aids may be
uncomfortable at first, and people's own voices may sound too loud to
them. You can get feedback in the form
of whistling sounds, wind noises are bothersome, and cell phones can cause
buzzing sounds (3) Many people
quit using hearing aids because of the resulting frustration (2).
How
many people use hearing aids? About six million Americans currently
use a hearing aid (12). On the
other hand, most people with hearing loss don't use hearing aids. The National Institute for Deafness
estimates that about 20% of people who could benefit from a hearing aid
actually use them (3)
Why
do people choose not to use hearing aids? A major obstacle to
hearing aids for many people is cost.
A high-quality hearing aid can run from $2000 to $6000, and they aren’t
covered by Medicare or most insurance plans (16). In addition, according to the Disabled World website, people think that a hearing aid will make
them look older or will have a negative impact on how strangers interact with
them. Some think they don't need a
hearing aid because they can do
just fine by using visual cues to adjust for their hearing loss (4). According
to Psychology Today, "many
people with mild to moderate hearing loss can manage well enough without
them" (16).
How
satisfied are hearing aid users? In a 2008
national survey study, researchers at the Better Hearing Institute found that
74% of hearing aid owners are "satisfied" with their hearing aids, 9%
were "neutral", and 17% were dissatisfied. 12% no longer used hearing aids they owned. 82% of consumers would recommend
hearing aids to their friends, and 48% would buy their current brand of hearing
aid in a new purchase. On average,
people wear their hearing aids about 9.5 hours per day (13).
Why
do hearing aids cost so much? Tricia Romano, health writer for the
New York Times, reports that buying a hearing aid has become more confusing and
difficult than buying a new car (and almost as expensive). According to the Hearing Review and
House Institute, the average cost of a hearing aid of $3,000. And it’s standard practice for people
to have hearing aids in both ears.
Since a hearing aid is basically a microphone and amplifier in your ear,
it isn't clear why prices are so high.
TVs, computers, and cellphones have gotten cheaper and cheaper, but
prices for hearing aids have increased about 8% a year for the last twenty
years. Romano cites the CEO of a
hearing aid company who states that microphones, speakers, and processing chips
cost $10 to $15 apiece and that most hearing aids cost no more than $100 to
manufacture. Most of the price of
a hearing aid goes to audiologists and retailers because of additional
services. One industry source said
that the high prices are connected to research and development, customized
service from audiologists at private clinics, multiple follow-up visits, and
overhead costs. Another observed
that every new technological development is used to justify price
increases. Less expensive hearing
aids are available online for prices from $400 to $600, though they need to be
mailed back in when one needs adjustments (which is a nuisance). Costco is one national discount firm
that has nationwide hearing centers which offer face-to-face service and
audiologists for custom fittings.
Costco sells hearing aids made by the major companies for $500 for basic
models and $1,300 for the most advanced models. Needless to say, Costco is resented by competitors in the
industry (15)
What psychological benefits
can be associated with hearing aids? According to the Mayo Clinic,
depression, anxiety, and an incorrect perception that others are angry at you
are common consequences of hearing loss.
Sometimes older people are erroneously thought to be confused or
unresponsive simply because they don’t hear well. People using hearing aids tend to report greater
self-confidence, closer relationships with loved ones, and overall improvements
in their outlook on life (6).
I passed along all this
information to Eddie. To his
credit, he has concluded that he may have a hearing problem. Now he’s mulling it over. It’s hard to predict what he’s going to
do next. I think he wants to talk
to some of his 95 year old chums about their experiences. In the meantime, we talk loudly to one
another over the back fence.
Love,
Dave
SOURCES:
(1). “Deafness,” www.wikipedia.org;
(2). “Hating your hearing aid,” www.blogs.nytimes.com/2008;
(3). "Hearing aids," www.nidcd.nih.gov/hearing; (4). “Hearing aids --
How they work and reviews", www.disabled-world.com; (5). “Hearing loss,” www.entnet.org; (6). “Hearing loss,” www.mayoclinic.org; (7). “Hearing loss,” www.nihseniorhealth.gov; (8). “Hearing
loss and aging,” www.medicinenet.com; (9).
“Hearing loss and older adults,” www.nidcd.nih.gov;
(10). “Hearing loss: Information and resources,” www.webmd.com;
(11). “Hearing loss: Medline Plus,” www.nim.nih.gov/medlineplus;
(12). "How do hearing aids work?", www.audiology-today.com; (13): “Marke Trak
VIII: Consumer satisfaction with hearing aids is slowly increasing” (Sergei
Kochkin), www.thehearingjournal.com;
(14). “Myths about hearing loss,” www.betterhearing.org; (15). "The hunt for an affordable hearing
aid" (Tricia Romano), www.blogs.nytimes.com/2012;
(16). “Why we don’t wear hearing
aids,” www.psychologytoday.com.
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