President Clinton may be among the more famous Baby Boomers to wear hearing aids to correct a high-frequency hearing loss, but he’s hardly alone.
Almost six million Americans wear them. Unfortunately, that’s only 20 percent of the estimated 28 million people who are classified as having some form of hearing loss, according to the Better Hearing Institute, a non-profit consumer education organization in Annandale, Va.
A host of reasons account for the lack of use, including their price, says Dean Garstecki, a clinical audiologist and chairman of the Communications Sciences and Disorders Department at Northwestern University. Other factors are the lack of reimbursement by health carriers, the perception or belief that hearing aids don’t work well and the stigma some associate with wearing them.
The estimated annual cost of care for those with hearing impairment has swelled to a whopping $56 billion, according to the Better Hearing Institute.
But there’s good news. Hearing aids can correct hearing loss for approximately 95 percent of those who have an impairment, the institute says.
Furthermore, technology has greatly improved the aids and also made them smaller so they can be worn discreetly in the ear canal rather than behind the ear. They’re also now available in colors so the left and right aid can be distinguished in the same way that dots differentiate right and left contact lenses. And some health plans have begun to cover the cost, or at least a portion of it.
The price of the newest aids has climbed higher, however, but many who’ve begun wearing them feel their improved hearing is worth the extra expense. “They’ve been fabulous,” says Arlene Neary of suburban St. Louis, who was diagnosed with an impairment more than 30 years ago when she was a teenager.
Though she was thrilled with her improved hearing when she started wearing conventional analog hearing aids as a teenager, she said the downside was that they distorted sounds. “Using them was like listening to someone on a phone when the line wasn’t clear.”
The reason was that the conventional analog aids amplified speech but also heightened other noise, including trains rumbling by, dishes breaking and music blasting, says Ross J. Roeser, an audiologist and professor at the University of Texas at Dallas’ Callier Center for Communication Disorders. And because many patients had difficulty tolerating all loud sounds, many never used the aids, he said.
The newer digital aids take care of that problem, though they can be awkward for other reasons. “It took a bit of adjustment because they block out sounds,” said Neary. “At first I thought the aids had stopped working. But I now feel they’re the best instrument I’ve used.”
A computer chip in these aids can amplify speech and be programmed to different listening environments while it blocks background noise. They also work for longer periods without needing a new battery and are smaller, says Robert Mareing, an audiologist who fitted Neary.
“You can buy an aid with three programs and set it accordingly–for your key listening environment, possibly at work; for a second noisier setting, such as your office cafeteria; and for a third, for amplified sounds such as religious services,” adds Carol Rogin, president of the Hearing Industries Association in Alexandria, Va., which represents 37 manufacturers that produce 95 percent of all hearing aids in the U.S.
The major downside remains the cost. Even conventional analog hearing aids average $800 to $1,000 per ear or, with a remote control, $1,600 to $2,500 per ear.
Digital hearing aids start at about $2,000 and can climb far beyond that. Widex Hearing Aid Co. in Long Island City, N.Y., says its suggested retail price for its nearly invisible aid that fits into the ear canal is $3,799, while its other more visible versions run almost $3,000.
And another downside of some of the newer, smaller digital aids is that older adults may find it harder to manipulate the smaller controls and to insert batteries because of failing eyesight or diminished motor skills.
Like any electronics device, all hearing aids require maintenance, primarily new batteries periodically. How often depends on use, experts say. Certain factors such as humidity, water, hairspray and ear wax can adversely affect their lifespan. “The average aid lasts four to five years, but I’ve had patients have them for 15 years,” says Roeser. A professional cleaning every six months is also wise.
Before you make any decision, however, have your hearing checked, particularly if you’ve had a problem or are more than 50 years old, which is the age that a gradual loss of high-frequency hearing commonly begins. It is more rapid in males than females, Roeser says. Exposure to noise represents the largest factor accounting for a loss of adult hearing.
An initial diagnostic exam may cost anywhere between $75 and $120 and is usually performed by an audiologist, a hearing-instruments specialist or a medical doctor called an otolaryngologist.
“Hearing loss is measured in decibels, with good normal hearing starting at zero decibels, hearing of 20 to 25 decibels considered mild hearing loss and 35 to 55 decibels moderate,” says Susan Coffman of The American-Speech-Language-Hearing Association in Rockville, Md.
Of the 1.8 million aids purchased annually, approximately 80 percent are custom made, and the vast majority are worn in the ear. Fifteen years ago, most were worn behind the ears. “There’s general agreement that one per ear offers better acceptance and performance than only one in the same way that if you wear glasses you get two lenses,” Roeser says.
Always demand a 30-day trial period for any new aids and a warranty, Roeser says. Neary’s came with a one-year warranty and she bought a second-year extension. Expect to return once a year for a checkup of your hearing and your aid.
For those whose inner ears are profoundly damaged so that even the most powerful hearing aids won’t offer a benefit, they should consider a cochlear implant, a multichannel device that provides reception of sophisticated sounds. The cost is very steep, about $38,000 to $40,000, which includes $18,000 for the device, $7,000 to $10,000 for the diagnostics and surgery and the rest for rehabilitation, Roeser says.
For the name of an audiologist or a speech-language pathologist or for general information in your area, call The American-Speech-Language-Hearing Association in Rockville, Md., at 800-638-8255, the American Academy of Audiology in McLean, Va., at 800-222-2336 or the Better Hearing Institute in Annandale, Va., at 800-EAR-WELL. The Better Hearing Institute has a Web site at www.betterhearing.org, and the American Academy of Audiology has a Web site at www.audiology.com.
