Can You Hear Me Now?  Hearing Aids and Stigma

Can You Hear Me Now? Hearing Aids and Stigma

Posted on March 12, 2014 by ElderCare Resources Phoenix in Blog, Caregiver Education, Education, Hearing Loss, Independent Living

By Martha Ross – Contra Costa Times

Bonne Reiser admits it took her several years to deal with a common side effect of aging: hearing loss.

“I couldn’t catch everything everyone was saying in meetings or in restaurants, and I’d have to ask family members to repeat themselves,” says Reiser, 66, of El Cerrito.

She saw an audiologist, who diagnosed her with mild hearing loss. That was two years ago, and a “mild” loss seemed like something she could live with. Besides, she wasn’t ready to put the time, energy or money into getting fitted for hearing aids. Like many health plans, Reiser’s didn’t cover hearing aids, which can cost anywhere from $300 to more than $3,000 each.

Another main concern? In her early 60s, Reiser had a teenage daughter and dreaded wearing devices that would broadcast her age.

“It just didn’t seem fair to her to have an older mom with gray hair and hearing loss,” she says.

Reiser’s resistance to hearing aids — mainly because of the stigma of being “old” — is familiar to Bay Area health audiologists and ear, nose and throat doctors.

“There is the perception that hearing loss means you’re less intelligent,” says Lawrence Lustig, an otolaryngologist and director of UC San Francisco’s Choclear Implant Center. We live in a society that “values youth and beauty.”

There is no one cause of age-related hearing loss, but the main culprits are genetics and a lifetime of exposure to loud noises in the street, at work or at concerts.

As nerve cells in the inner ear become damaged, stop working properly or die, people begin to feel as if the volume in their ears has been turned down or they can no longer hear speech clearly.

“Everyone starts to sound like Charlie Brown’s teacher,” says Andrew Dundas, director of audiology at UC San Francisco.

Unfortunately, the damage can’t be reversed. Without intervention, hearing loss can worsen, and the consequences of not getting help can be devastating.

“There is a famous quote by Helen Keller to the effect that blindness separates a person from things, but deafness separates us from people,” Lustig says.

People with impaired hearing may become depressed and withdraw from others to avoid feeling frustrated or embarrassed about not understanding what is being said. Hearing loss has also been linked in a 2013 study by researchers at Johns Hopkins University to memory loss and a decline in cognitive skills.

Reiser kept thinking about her father, who started to lose his hearing at 60. He drove his family crazy by always asking them to repeat themselves. She didn’t want to annoy her family in the same way.

She also was concerned about being able to do her job. As a supervisor in the early child mental health program for Jewish Family and Children’s Services of Marin County, she needed to converse with a variety of people in different settings, including young children.

After a second visit to an audiologist showed the loss in one ear had progressed to “moderate,” Reiser researched her options and discovered some silver linings.

Digital technology, first introduced to hearing aids in the late 1990s, has remarkably improved how well the aids function, as well as how they look. Unlike their bulky, banana-shaped analog predecessors, today’s more compact devices are programmed to each person’s unique needs.

Increasingly sophisticated models can squelch feedback, filter out background noise and allow users to easily hear phone conversations. They may include directional microphones that are sensitive to the sounds or voices users want to hear, such as friends in a noisy restaurant. They can also come with Bluetooth technology and the ability to listen wirelessly to music or television.

The goal of hearing aids is “to make soft sounds audible, average sounds average and loud sounds OK to hear,” Dundas says.

Reiser finally sought treatment this past fall at a John Muir Health-affiliated ear, nose and throat office after receiving a direct-mail offer from a manufacturer promising 50 percent off for aids and a lifetime service guarantee.

Meg Devane, an audiologist at Kaiser Permanente’s Hearing Center in Walnut Creek, says selecting an aid depends on a patient’s level of hearing loss, listening needs and lifestyle.

“Some people don’t go out that much, but others work, are in meetings a lot and belong to clubs,” she says.

For most patients, like Reiser, the less visible their aids are the better; increasingly popular are “behind-the-ear” styles, Devane says. A sleek plastic case contains a microphone, circuitry and battery that fits behind the ear. A slender tube carries a speaker, sometimes smaller than an iPod earbud, into the ear canal.

Reiser selected a top-of-the-line, behind-the-ear model in a “Champagne color” to match her dirty-blond hair. With the discount, the two aids cost her $4,000.

“No one knows I’m wearing them unless I tell them,” she says.

Devane says it’s important for people to come back for a series of follow-up adjustments, because it can take time to become comfortable wearing them.

“With people who lose their hearing gradually, they don’t know what they are missing,” she says. “When they first get their hearing aids, it can be overwhelming.”

Experts warn that hearing aids can improve hearing, but they don’t restore the hearing a person has lost. Just as glasses can improve your vision, they can’t restore sight to the blind.

“Hearing aids are not a cure, and you won’t be able to hear like you did when you were 16,” Dundas says.

Still, it’s important to wear them, says Jonathan Kahn, associate chief of head and neck surgery at Kaiser Medical Center in Walnut Creek. There is the idea aids can retrain the brain to hear certain sounds again, so it’s important to wear them as much as possible, he says.

Reiser is delighted she took the leap. She says she is able to pick up on about 95 percent of conversations.

“I didn’t know what I was missing,” she says.

She understands the stigma that stopped her, but she hopes others won’t wait as long as she did.

“It’s totally improved the quality of my life.”

Do you having hearing loss?

If three or more of the following apply to you, the National Institute on Deafness and Other Communication Disorders says it may be time talk to a doctor or get a hearing test:

  • Difficulty hearing over the telephone
  • Trouble following a conversation when two or more people are talking at the same time
  • Straining to understand conversation
  • People complaining you play the radio or television too high
  • Difficulty hearing with a noisy background
  • Asking people to repeat themselves
  • People saying you mumble or don’t speak clearly
  • Misunderstanding what people say and responding inappropriately
  • Trouble understanding the speech of women and children
  • People getting annoyed because you misunderstand what they say

Age-Related Hearing loss

About one in three people ages 65 to 74, and half of those older than 75 have hearing loss, according to the National Institute on Deafness and Other Communication Disorders. The American Association of Retired People estimates about 10 million people from ages 45 to 64 have impaired hearing.

There is no one cause, but age-related hearing loss usually has to do with family history or repeated exposure to loud noise at work, at rock concerts, or through music cranked up too loud in your headphones. Smoking, diabetes and other medical conditions and medications sometimes cause hearing loss.

Sensorineural hearing loss occurs when the tiny hair cells in the inner ear — nerve endings that detect sound — become damaged, stop working correctly or die.

An initial evaluation includes an examination of the ear and a thorough case history to make sure an infection or more serious disorder is not the cause. Before recommending treatment, an audiologist conducts several tests to determine the degree of loss, how well a person follows speech and whether hearing loss affects both ears. Most age-related loss affects both ears.

Save the Hearing you’ve Got

You can’t reverse noise-related damage to your ears, but you can try to prevent making things worse.

Exposure to loud noises as a teen or young adult sets in place “a ticking time bomb that will manifest itself over time,” says Lawrence Lustig, an otolaryngologist and director of UC San Francisco’s Choclear Implant Center.

Because of noise exposure limits put in place by the U.S. Department of Labor’s Occupational Safety and Health Administration, loud workplaces are no longer the main threat to Americans’ hearing. It’s our hobbies, says Jonathan Kahn, associate chief of head and neck surgery at Kaiser Medical Center in Walnut Creek.

Sounds higher than 80 decibels — the level of a noisy office or traffic — can damage ears.

Wear ear muffs or ear plugs if operating power tools, mowing the lawn or attending a major sports event, experts recommend. Lustig extends that suggestion to concerts playing loud music. Some rock concerts can be as loud as a jet engine taking off. “You can still hear the music, but you’re going to take the noise level down 10 to 20 decibels. That’s big.”

Another concern among experts is the ubiquity of people blasting music into personal earphones. For some that can mean hours of daily exposure to damaging levels of noise. If a friend can hear music leaking out of your earphones, or if you can’t hear when someone talks to you, your volume is too high, and you need to turn it down, Lustig says.

Published: San Jose Mercury News