Speak Up – I Did Not Hear You

            Hearing loss as we age is universal. In young adults, hearing loss is rare and usually mild, but as we pass 60, it becomes both more common and more severe. Past 80, the vast majority have hearing loss, and it is usually at least moderate.

            Most hearing loss is gradual and so often not recognized by the individual. Family are in a better position to notice – they may comment on why you have the TV or car radio up so loud.

            Age-related hearing loss is almost always worse at higher frequencies. Because women have higher-pitched voices than men, this is a possible explanation for the “selective hearing loss” that lets men hear their buddies talk football while claiming to not hear their wives ask them to do something.

            Hearing loss can have a major negative effect on quality of life. You miss out on conversations, feel “left out,” and may begin skipping events. Those with risk of dementia may experience a more rapid decline in mental acuity because of lack of interaction with others.

            If this is a possible issue, get your hearing checked. The best way to do it is with an audiologist, who will have you in a sound-deadened room with headphones and will check the hearing in each ear at different frequencies. Most health insurance plans will pay for this. A fallback is an online hearing test you can do for free. Not as accurate, but very convenient.

            If your hearing loss is more than minor, you ought to get hearing aids of some sort. Traditionally, you could only get hearing aids from an audiologist, and they were very expensive. Starting in 2022, hearing aids became available over-the-counter, and so price options have expanded.

            Price is important, because Medicare does not cover hearing aids, though some Medicare Advantage plans offer partial coverage, and for those under 65, many commercial plans also do.

            How expensive? I went to a national chain site, and the audiologist was recommending a set that went for over $8,000.

            If price is no object, go to an audiologist and you will get custom programming of the devices and free adjustment and tuning. A good option for those without insurance coverage but who want hand-holding during the process is to go to Costco (or another big-box store), where you will get similar technology at about half the price, albeit with less customization.

            If your health insurance has a hearing-aid benefit, you will almost certainly have to use a vendor who is on their list, so check before you see anyone.

            Finally, if you have no insurance coverage and are on a limited budget, buy an over-the-counter device. The New York Times Wirecutter, Consumers Reports and Forbes have all published good reviews of these products, so browse them first. Recommended products came as low as $800 per set.

            If the budget is really tight, get a “PSAP,” a personal sound amplifying product. These have only volume controls and are clearly not perfect for anyone, but can be bought on Amazon or at Walmart for as little as $50! Using one of these devices is much better than constantly saying “what.”

            Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.

What Does The Doctor Say?

By Dr. Edward Hoffer

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