In recent weeks, I’ve had no fewer than a half-dozen conversations with friends about a difficult—and often embarrassing–issue. No, it isn’t sexual dysfunction, incontinence, or money problems. It is hearing loss.
One of every three Americans aged 64-75 has lost some hearing. Half of those 75 and older have trouble hearing. The longer we live, the more we are going to have to confront this age-related reality. And as the rock-and-roll generation ages and the ear-bud generation follows, the problem is only likely to worsen.
Perhaps the biggest hearing-related challenge is psychological, not physical. Too many of us are struggling needlessly because we are in denial about our hearing. We are unwilling to acknowledge that we cannot hear well enough to manage our day-to-day lives.
Hearing loss is, at best, inconvenient. But it can be socially isolating and even dangerous. It isn’t hard to imagine the consequences: Older adults who stop going out with friends and family because they can’t follow the conversation. Seniors who don’t follow a doctor’s advice because they couldn’t hear it. Or who get into an automobile accident because they didn’t hear a horn honking.
My mother-in-law Ida was a smart, gregarious woman who loved to talk. But as she lost her hearing, she turned more and more inward. Eventually, she was deeply isolated from her friends and even her family at a time when she was caring for her husband and most needed support. It was hard to watch.
Many studies have shown that hearing less can significantly reduce an older adult’s quality of life. And a 2013 study published in the Journal of the American Medical Assn (JAMA) found that hearing loss was strongly associated with cognitive impairment. Those with trouble hearing—even those with mild hearing loss—had a more rapid cognitive decline than those with normal hearing.
That study, by Dr. Frank R. Lin of Johns Hopkins University and many co-authors, could not say definitively why hearing loss was associated with dementia, but the link seems strong.
As with many life changes, it often is difficult for older adults to adjust. Many deaf children and younger adults learn to communicate with sign language. Many form supportive communities. Some don’t consider hearing limitations a disability at all.
But it is different for those whose hearing loss comes on late in life. Here are some issues to think about:
Own it. Older adults can better manage their hearing loss if they acknowledge it and are proactive. Be aware of common symptoms. Tell your doctor if you are having trouble hearing. Don’t expect her to notice on her own. After all, you may be able to manage well enough in quiet exam room but not in public spaces. And remember, there is no need to be embarrassed. By age 75, half of your friends are likely to have some hearing loss too.
Technology. Hearing aids have become smaller and less obtrusive (see embarrassment above). And the technology has improved, at least for those listening in relatively quiet spaces. But aids are far from perfect. They may successfully amplify some sounds but do a poor job filtering out ambient background noise. The result: You may do OK at the dinner table at home but may be seriously challenged in a crowded room. Other devices may improve sound quality in a room but not on a phone, or vice versa.
Cost: High quality devices can be very expensive. In 2016, the average cost was $2,300 per unit (or nearly $5,000 for a pair). Unfortunately, neither traditional Medicare nor Medicare supplement (Medigap) pay for the equipment (or even basic hearing tests). Some Medicare Advantage managed care plans do cover at least partial costs for exams and hearing aids. But shop carefully.
There are other options. Much of the cost of high-end devices is pure profit—retail mark-ups are often as much as 100 percent. But low-cost hearing aids may cost only $500 and could work well for your condition. Check them out.
The auditory environment. While society acknowledges and responds to many disabilities—cities are increasingly installing curb cuts for people with mobility limitations, for example—we do little to assist those with hearing loss.
Especially for those of us who live in big cities, loud noise is a thing. Trendy restaurants seem to confuse buzz with, well, buzz. Really, really loud buzz. How many older adults have stopped going to restaurants because they can’t hear a table conversation at all? What to do? Tell the manager. Or vote with your feet.
Mostly, though, when you begin to lose your hearing, be proactive. Don’t wait to get treatment. Hearing loss is common. It can be debilitating. But it can be managed.