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Audiologists can help combat social isolation

The hearing loss statistics are daunting. The number is sizable – 38 million Americans have some degree of hearing loss. But probably the most startling statistic is related to older adults – half of those age 75+ difficulty hearing. Of those age 70 and older with hearing loss, only 30% have hearing aids.  How is this the status quo?  Even though age is the single greatest predictor of hearing loss, many people wait 7 or more years before attempting to address it. That could include purchasing a sound amplification product (PSAP), hearing aid, or the newest amplification category, hearables. The consequences of untreated hearing loss include social isolation, which itself is related to poorer health outcomes.  

Why do older adults wait to address hearing loss?  Experts cite denial as the primary reason, followed by perceived stigma of wearing hearing aids, but price may be a factor. Half of those age 75+ have hearing loss typically occurring in both ears, and more likely in men than in women. The median income of households aged 75+ is $32K. Contrast that with the average price (private pay) of today’s best hearing aids is upwards of $2,400/ear. New features like fall detection and artificial intelligence makes these devices differentiated and perhaps appealing for older adults. But at close to $5,000 or more for a sophisticated pair of hearing aids, it’s no wonder that seniors may delay or seek low-cost alternatives. There remains a patchwork of options to help fund the expense. But delay worsens the isolation – and possibly contributes to risk from poorer health outcomes.

Hearing aids are just a piece of the puzzle at overcoming social isolation.  For seniors who have delayed acquiring hearing aids – and as a result have become increasingly isolated – the new experience of using hearing aids can be a shock. A positive shock in regard to reconnecting with close family members, but also a shock in understanding what the devices do – and do not – fix. Moving from little or no sound to the noisy environment of stores, restaurants, office buildings and streets requires adjustment – not just the device itself – but also user training and personal expectation setting and accommodation.

Audiologists and hearing care professionals can help mitigate social isolation. Although hearing aids are not covered by Medicare. But as of 2017, Medicare Advantage plans, held by 30% of seniors and expected to grow to 47% by 2029 – are beginning to contribute a portion of the cost of hearing aids. Therefore there will be more seniors eligible (and hopefully leveraging) benefits from hearing aids. Further, the initial satisfaction level for hearing aid recipients can be problematic. The role of hearing care professionals is changing and when dealing with older adults, it will involve more focus and consideration of the whole person, and the degree to which they have been isolated from others as a result of their hearing loss.

Comments

Yes, however, the cost of hearing aids for many low income seniors is a huge barrier.

The social stigma of hearing aids is very high, and people are extremely resistant to buying and wearing these. Plus, people with cognitive impairment can not put on/take off/keep track of them. 

I regret that most of these issues can't be solved by audiologists. 

Cognitive impairment or fingers that just don't work very well any longer cause less adoption.  Plus, remembering to change, clean, recharge, etc., make adoption less likely.  Caregivers don't always know the schedule, procedure, etc., to keep the hearing aids operational.  As a result, "they don't work," and that can lead to a downward spiral of the hearing aids not being used.  So frustrating!

I read your blog on hearing loss in the elderly population. You may want to alert consumers to some interesting Over-The-Counter Technology such as the BeHear Access devices that also include a telecoil for access in public places equipped with ADA Mandated hearing loops and neckloops.

You may have been trying to be kind, Laurie, when you said, "price may be a factor." More reasonably priced solutions would lead to greater adoption and less stigma.  $2,400/ear is the cost before supplies and additional bells and whistles that allow users to truly benefit.  

Even under Medicare advantage the cost of hearing aids is ridiculous . My MA plan recently reduced their contribution from $1500 to $500. I have lived with progressive hearing loss for 30 plus years and I need new aids and dread the process. This is a good post but with all due respect I am so sick of hearing that people are in denial about hearing loss or aids! I have also worked in public health for many years. What is called “denial” is a failure of policy and health education! When you have heart disease you have a plethora of primary secondary and tertiary prevention resources...books, pamphlets, videos, coaches, support groups, courses, resource guides, check-ins etc. We get almost zero.Hearing loss isn’t even mentioned in many health education guides. From providers all I’ve received is a couple of pamphlets from hearing aid companies, much less an unbiased guide to hearing aids as they have in the UK. We need consumer informed evidence based education. What all this boils down to is a lack of policy influence and a failure of policy. If there was that influence primary care doctors would still be required to screen for hearing loss and hearing health providers would be subject to quality and cost indicators like PCPs.