If you find yourself straining to hear in crowded places or saying “What did you say” more often than you used to, you probably need a hearing aid. If despite the strain, you tell yourself that your hearing’s fine, you’re not alone. A whopping 80 percent of adults between the ages of 55 and 74 who would benefit from a hearing aid do not use them, according to the International Journal of Audiology. (Take this quiz to find out if you might need hearing aids.)
Why wouldn’t you correct your hearing, the same way you correct your vision if you can’t see well enough? People have a variety of reasons. Some have tried hearing aids before and complain about discomfort or difficulty handling them, or disappointment that that they’ve failed to restore their former sense of sound. Many haven’t even tried them, because they don’t want to wear something associated with “old.” For a lot of people, expense is an issue. But most people don’t realize the profound damage that uncorrected hearing loss can do to your physical, emotional and cognitive health. Studies have associated being hard of hearing with poor general health, mood disorders—even shorter lifespan.
Hearing Loss and the Brain
In a study that tracked 639 adults for nearly 12 years, Johns Hopkins expert Frank Lin, M.D., Ph.D, and his colleagues found that mild hearing loss is associated with a doubled risk of dementia. Moderate loss tripled risk, and people with a severe hearing impairment were five times more likely to develop dementia.
The fact is that hearing is not only a function of the ears, but of the brain itself. Not being able to hear well reduces stimulation of the auditory centers of the brain, and that can lead to an actual reduction in gray matter. People with uncorrected hearing loss are also more likely to withdraw from social life, which leads to increased loneliness and depression, which also increases the risk for Alzheimer’s. It’s a vicious cycle.
Straining to hear, Dr. Lin finds, may also lead to what he calls “cognitive load” or mental fatigue, and that kind of subconscious multitasking could contribute to the fact that hearing loss dramatically increases your risk of falls. Another reason is the mechanism of balance: As you walk, your ears may pick up subtle cues that help with balance. Hearing loss may mute these important signals.
Still resistant to the idea of hearing aids? Let’s take a look at the reasons for not wearing them. In every case, there are ways to get around the problem.
Pick Your Hearing Aid Problem
With new hearing technologies and consumer avenues for buying the hardware and audiologist services, many of the issues that people have with hearing aids can be remedied. We’ve explored the main reasons why so many older people deal with uncorrected hearing loss and offer some ways you might get around them. Pick your problem—and share your hearing aid problem in the poll at the end. (If we haven’t covered your issue with hearing aids, let us know in the comments section.)
1. Hearing Aids Are Too Expensive
THE PROBLEM You probably assume that hearing aids cost thousands of dollars—and generally, you’re right. Only a handful of companies manufacture hearing aids, which may be keeping prices high, and on the provider side, you’re paying an unknown amount to the audiologist for services, because traditionally, hardware and service have been “bundled”—they come as a package from the same provider.
THE ANSWER Times are changing. More audiologists are “unbundling” service from hardware, making it possible for you to compare prices and pay for only the services you’re getting. This is a new trend that many audiologists are resisting—just ask the audiologist whether she or he unbundles.
When it comes to hardware, there are bargains out there—especially with the new online-only options available for hearing aid purchase and, for people with mild hearing loss, the even newer hearables (not technically hearing aids) that are becoming available for as little as $300. Check out our story about how to find a good deal.
2. Hearing Aids Are Unattractive
THE PROBLEM Many people who really need hearing aids resist because they’re embarrassed to be seen wearing them. “If I wear these aids I’ll really start to look old!” said one respondent to an online query about the issue. It’s bad enough that my hair is totally gray.”
THE ANSWER Those ugly pieces of hardware that cover the entire ear canal are rarely prescribed today. In the past few years, new technologies have enabled hearing aid manufacturers to shrink their products so much, they’re virtually invisible. The most common versions—behind-the-ear models—are completely obscured by the top of the ear. In-the-ear hearing aids are totally invisible.
Hearing aids today aren’t just tiny, many are super techy, too. They can stream music, phone conversations and more from your smartphone and let you customize your hearing experience via a paired app. These are not your father’s hearing aids. But if even a barely visible, bluetooth enabled hearing aid isn’t an option, see if a hearable works for you. These high tech earbuds come without a prescription and both amplify and manipulate sound, as well as streaming audio, and while they’re in their infancy now, at least one model might make a difference for people with mild hearing loss. Yes, earbuds are visible—but everyone wears earbuds.
3. Hearing Aids Don’t Help
THE PROBLEM Studies show that a primary reason for what’s been called “hearing aid in the drawer syndrome” is wearer complaints that the device doesn’t provide enough benefit—they still can’t distinguish speech in noisy environments; they experience poor sound quality or hear too much background noise.
THE ANSWER There are several solutions to sound quality issues. If you can afford the latest technology, newer hearing aids like the Oticon Opn and Widex Beyond do an amazing job of distinguishing speech from background noise. Their multiple processors mimic the brain’s ability to hear sound. They’re also adjustable via a smartphone app for volume, directionality and audio environment, among other variables.
Less expensive hearing aids can provide solid benefit, too, if you can adjust your expectations: You can’t simply put in a hearing aid and expect to hear like you once did. “Older people, especially, who’ve been losing hearing over the years haven’t heard many sounds for a long time,” says Kari Lane, assistant professor of nursing at the University of Missouri. “They put hearing aids in and can hear sounds they haven’t heard for years and experience sensory overload. They get overstimulated and can’t tolerate it.”
In response, Lane came up with the Hearing Aid Reintroduction Program, or HEAR. To remedy hearing aid in the drawer syndrome HEAR uses a workbook (soon to be an app) with a 30-day schedule that increases wear time daily to help you adjust to your hearing aids. The program has had a 80 percent success rate with Lane’s group.
- Take it slow. Start by wearing your hearing aid for an hour a day and increase one hour every day. Introduce new sounds daily.
- Keep persisting. Your brain has to relearn how to hear and make sense of sounds, and the only way to do that is to be exposed to those sounds.
- Accept limits. Hearing aids are just that—an aid—and deciphering speech in a noisy environment will always be difficult. Focus on one person and don’t expect to hear more than one person at a time.
- Keep going back to your audiologist until you’re satisfied.
It can take four months to get used to hearing aids, according to the makers of Starkey hearing aids, whose site has some helpful suggestions.
4. Hearing Aids Are Uncomfortable
THE PROBLEM When it comes to comfort, unrealistic expectations are an issue. You don’t put in contact lenses and get used to them immediately. Similarly, you have to wear hearing aids for a while to acclimate to the feeling of having something in your ears. Eventually you may get so used to them, you’ll forget to take them off.
THE ANSWER The site HearingHealthMatters.org provides several tips for getting comfortable with your hearing aid, including making sure it’s well inserted and not trying to remedy pain in the ear by pulling the hearing aid out a little; it’s not going to help and in fact, it’s likely to increase the irritation. The site also recommends lubricating your ear canal by gently rubbing a little baby oil in and around it with your finger. You can even put a little of the oil on the hearing aid itself before you insert it, as long as you keep the lubricant away from the opening of the sound tube.
5. Hearing Aids Batteries Are Hard to Handle
THE PROBLEM If your manual dexterity or eyesight isn’t what it used to be, handling a hearing aid can be a stumbling block—and the smaller the hearing aid, the greater the barrier, especially in the battery department. Batteries are tiny, and getting them into a miniscule hearing aid can be impossible for someone with arthritis or poor eyesight.
THE ANSWER To address this issue, more manufacturers are coming out with rechargeable hearing aids that you can simply drop into a charger every night. Here’s a report on which type of battery hearing aid wearers prefer and which rechargeable hearing aids are available right now. If a rechargeable battery is not feasible for you due to expense or length of battery life (some of the older versions may have a short battery life), here are some other fixes:
- Get a “low profile” hearing aid that’s molded to fit in the curved outside “shell” of your ear. You won’t get the benefits of invisibility, but since low profile designs are large enough to accommodate features like directional microphones and manual controls (a volume wheel and push-button for changing programs), they’re easier to handle.
- Practice manipulating the batteries and hearing aid insertion in your audiologist’s office and then at home. After enough practice, almost anyone can do it.
- If feasible, ask a friend or relative with better dexterity to change the batteries for you—they only have to be changed once a week or so.
6. Hearing Aids Are Easy to Lose
THE PROBLEM Hearing aids are tiny and can fly off when you’re exercising or even getting undressed. People tend to take them off, put them down wherever they’re sitting and lose track of them.
THE ANSWER Some high tech hearing aids today, like those made by ReSound and Starkey, come with an iPhone locator app. Either way, consider buying insurance for loss. And always put them in the same place each time you take them off, even if you have to get up off the couch. Treat them like diamond earrings and you’ll be less likely to lose them.
Here’s a good article on taking care of your hearing aids.
7. Hearing Aids Make Me Feel/Look Old
THE PROBLEM We live in an ageist culture and want to ignore the fact that we’re getting old. You may blame others for not talking loud enough or talking too fast—or you blame theaters for keeping the volume too low.
THE ANSWER Get over it! Maybe the link between hearing loss and Alzheimer’s will convince you that it’s worth getting the most out of the life you’re living by being part of the conversation and hearing every bar of music, every beautiful sound that your world makes.
Do you need hearing aids? Take this quiz and find out.
This article was written/produced with the support of a journalism fellowship from New America Media, the Gerontological Society of America and the Silver Century Foundation.