Hearing loss can come in many forms and levels of severity: a slight ringing in your ears or difficulty hearing high-pitched voices all the way up to challenges hearing the majority of sounds. But no matter the severity, it’s important to understand how hearing loss actually works and the steps you can take to cope with it, whether it’s key questions to ask your physician or ways to manage your important relationships.
To truly understand hearing loss, it helps to understand how we hear in the first place. Remember, when dealing with your health, equipping yourself with the proper information can be enormously empowering. If you understand the issue, it’s much easier to figure out how to cope with it.
How Hearing Works
When we hear a sound, we are actually interpreting sound waves that enter our ears and reach our brain via nerves. Sound waves travel into the ear via the ear canal and through the eardrum, which passes vibrations through a series of small bones into the inner ear. Once sound reaches the inner ear, thousands of hair cells pass the waves to the auditory nerve, which carries it to the brain.
How Hearing Loss Works
Over time, the component parts of the ear can begin to fail. One of the most common age-related issues is the gradual loss of hair cells in the inner ear, making it more difficult for sound waves to travel through the inner ear and into the brain. This process can be exacerbated by years of exposure to loud noises (such as live music and gas powered motors or machinery), which can cause a buildup of damage in the ear.
The National Institutes of Health estimates that nearly 50% of adults over age 75 have some form of age-related hearing loss.
There are other complications that can lead to hearing loss, too, although age-related loss is most common. Infections, trauma to the head, tumors, and severe allergies can all play a role in a loss of hearing ability.
It’s important, if you think you’re suffering from hearing loss, to consult your physician, who will likely recommend a hearing test to better understand the type and severity of your loss.
How to Cope: Ask Questions
Once you find out that you’re suffering from hearing loss—and have an understanding of why it’s happening—it’s time to figure out what to do next.
One of the most important steps in the process is to consult with your physician and the audiologist who carried out your hearing test. They can examine your audiogram (the graphical results of your hearing test) to determine the most appropriate next steps.
For many hearing loss sufferers, perhaps the best first step they can take is to simply ask questions. Here are a few common questions you may want to consider asking your doctor or audiologist:
- How severe is my hearing loss? Though you may think you understand how severe your hearing loss is, your physician or audiologist has access to diagnostic tools that can provide you answers with much greater detail. For example, an audiogram can reveal the severity of hearing loss through multiple measurements—so make sure to ask your physician or audiologist to explain the severity of your hearing loss to you and provide you with your test results.
- Why should I treat my hearing loss? One of the most common questions facing many hearing loss sufferers is why they should treat their hearing loss at all, as many have figured out coping mechanisms to deal with their hearing issues. But most doctors and audiologists will tell you that hearing loss left untreated can result in everything from social isolation to trouble with balance and movement. For example, a 2012 study found that hearing loss even at low levels tripled the risk of falls, while another found it doubled the risk of developing dementia.
- Am I a good candidate for hearing aids? Many hearing loss sufferers believe that hearing aids will restore their hearing to the same level they enjoyed prior to loss. While hearing aids can be a major step forward in terms of quality of life and overall health, not every hearing loss sufferer is a good candidate for using them. Make sure to ask a hearing professional whether your type of hearing loss is the right fit for hearing aids. If your doctor does recommend hearing aids, don’t be daunted by the retail sticker price of $4000 to $7000. High-quality hearing aids can be purchased online, at retailers like Embrace Hearing, for about $1,500 to $2,000.
How To Cope: Take Care of Yourself
“Hearing loss can create a psychological solitary confinement,” wrote Dr. Claudia Dewane, who suffers hearing loss herself and counsels others through the process. Despite this, Dewane notes, “many older adults with hearing loss deny the disability or the impact it exerts on their quality of life.”
Dewane and other professionals urge hearing loss sufferers—whether they have struggled with hearing loss for a long time or are suddenly learning to cope with it—to make recognizing the issue the first, and most crucial, step.
While this may seem obvious, statistics say otherwise: an estimated 22 million Americans suffer from hearing loss but don’t seek out hearing aids for help.
If you’re able to recognize that your hearing loss is an issue, you can take positive steps to help yourself cope mentally, too, including:
- finding a support group or engaging with your peers who also suffer hearing loss;
- learning more about hearing loss and the technologies that exist to help, including hearing aids and hearing loops;
- visiting a therapist, counselor or other professional who can help teach coping strategies, including boosting your self-esteem.
For many people, hearing loss is a natural part of life—but that doesn’t mean you can’t understand it and learn how to cope with its effects. The more you know about your own hearing loss, the more proactive you can be in finding solutions that work for you.
The single most essential step in finding the right hearing aid begins before you even start shopping. It’s the hearing test, an audiologist-administered exam that determines the severity and type of hearing loss you or a loved one might be experiencing.
And though it can sound daunting, the test itself shouldn’t be a cause for anxiety. Instead, a well-administered exam can help you answer some crucial questions and put you on the path towards better hearing.
To help you prepare for a hearing test, here are some commonly asked questions from test participants:
What does a hearing test really measure? Hearing tests look for the amount of sound a person can hear via their inner ear. During the hearing process, sound waves hit the inner ear as vibrations, triggering nerves to send signals to the brain, which interprets the noise. With hearing loss, those waves don’t reach your brain as effectively, often due to difficulties within the inner ear or the nerves transmitting signals to the brain. A hearing test can diagnose how effectively sound is traveling through your inner ear by measuring a variety of factors, which, when combined, present a portrait of your current level of hearing ability.
How does a hearing test work? A hearing test often consists of a series of exams conducted by a trained audiologist. Among the most common types of hearing exams include:
Hearing a tone: Typically an audiologist will transmit a sound tone set at multiple pitches (how high or low the sound seems to your brain) to study how you hear at different frequencies.
Hearing a whisper: An audiologist will often test your ability to hear spoken speech by speaking (or playing a recording of someone else speaking) at different volume levels. They may also have you repeat words back to them to test your perception.
Testing your brain’s response to sound: Hearing tests frequently include an exam that studies the electrical stimulation within the brain to sound waves, which helps audiologists determine how much sound information your brain is receiving.
A typical hearing test takes about 30 to 40 minutes to complete. Hearing tests can cost anything from $0 to $150 but are often—although not always—covered by insurance. Check with your health insurance provider to determine your coverage. If there are out-of-pocket costs, Costco provides hearing tests free of charge.
What’s an audiogram, and how do I read it? An audiogram is the series of graphic results that are given to you after you complete your hearing test, and which are also used to program hearing aids, should you need them. You’ll receive one audiogram which shows results for both your ears, graphed independently of each other so you can see how each ear responds to sound.
Make sure you ask your audiologist for help interpreting your audiogram results. Audiograms show a variety of data in a line graph format, with the pitch (how high or low a sound seems to your brain) graphed vertically and the intensity (or volume of a sound) graphed horizontally.
You’ll also find that audiograms typically have a score for your ability to recognize spoken words, too, which is listed separately.
Audiograms are essential components of a hearing test. Make sure you’re confident that you fully understand your results before leaving your audiologist. You may also ask the audiologist to explain what spectrum of hearing loss you’re experiencing, which will help in determining if a hearing aid is right for you (or if your type of hearing loss can be improved by a hearing aid at all.)
How important are hearing tests? Who should conduct them? A hearing test is a vital step in determining how to treat hearing loss. If you suspect that you may be experiencing hearing loss, seek out an audiologist for a test. It’s a relatively quick process that can result in crucial information about your health.
Too many hearing loss sufferers delay receiving a hearing test. “Every hearing health professional is familiar with the statistics that show a delay of seven to 10 years or more between the time an older person first suspects a hearing loss and professional help is sought,” notes audiologist Dr. Arlene Carson.
Yet once they’re administered, hearing tests can equip a hearing loss sufferer with important information that can later be used to properly program hearing aids and inform doctors about the current state of their hearing.
When looking for a hearing test provider, make sure you choose a professional who has completed graduate-level training in audiology. In many states, professional audiologists must be licensed by both national and state-level boards. Above all, though, make sure you choose someone who makes you comfortable and is open, honest, and willing to tackle any questions you may have.
Like any device we rely upon—whether it’s a laptop, a cell phone, or a desktop printer—ahearing aid has to work when we need it. And like any of those, hearing aids work better when they are properly maintained.
Keeping your hearing aids in top working condition doesn’t have to be daunting, or an excuse for a costly trip to a repair shop. Instead, some basic preventive maintenance can go a long way towards keeping your hearing aid functional and error-free.
Among the most basic steps you can take to maintain your hearing aids is to be mindful of earwax.
How can I keep my hearing aid free of earwax?
The human body produces earwax to keep our ear canals moist and free of unwanted debris. Unfortunately, that means it can also hinder devices we do want in our ears, including earbud headphones and hearing aids.
Though BtE (behind the ear) hearing aids, such as Embrace Hearing models, are less susceptible to wax than aids that sit fully in the ear, it’s still important to consider the impact that earwax build-up has on your aid. In fact, researchers found that earwax is one of the most common reasons that all types of hearing aids stop working. In fact, they are still working fine, they are just plugged.
Wax is particularly common on any parts of the aid that sit inside the ear canal, such as the speaker (also called the receiver) in Embrace Hearing aids, which projects sound into the ear canal. If enough wax builds up on the speaker, it can muffle sound or even damage the aid. In some cases, earwax can even lead the hearing aid to switch itself off.
Simple daily cleaning of the aid will not only help reduce the risk of wax-related damage but also ensure that you’re hearing the clearest sounds from the aid. Many hearing aid professionals recommend inspecting your hearing aids in the evening as part of a regular routine. It is also a good idea to replace the domes when they become discolored or damaged.
Most premium hearing aids come with replaceable wax guards. These very small white “guards” can only be seen when the dome is removed. They perform the critical job of keeping wax out of the speaker. Any time your hearing aids seem quieter than normal and seem to cut in and out, always start by replacing the wax guards.
For guidelines on cleaning the components of Embrace Hearing aids, including how to replace wax guards and domes, take a look at our library of instructional videos, including methods for cleaning the hearing aid tubing and replacing an earwax guard.
What steps can I take to make earwax less of an issue?
A good place to start is to simply be diligent in talking to your doctor about when it’s necessary to remove earwax. Unlike the cotton swabs of your youth, doctors now recommend a variety of non-invasive removal methods to treat earwax buildup, including wax softeners and water rinses.
Depending on how much earwax you produce, your doctor also might recommend simply washing out your ear canals while taking a shower.
Sure, earwax is an unpleasant fact of life, but don’t let it stop you from utilizing your hearing aids to the fullest. A brief conversation with your doctor and some routine preventive maintenance will go a long way towards ensuring optimal performance from your aid.
If you’ve been meaning to invest in a hearing aid for you or a dependent this year, take a look at your FSA or HSA options—but do so quickly. These tax-free savings accounts are great assets that can help lower the cost of hearing aids significantly, but some accounts need to be used before the end of the year.
How can I use my FSA/HSA account to buy a hearing aid?
If you have one of these accounts already set up in 2015, hearing aids are reimbursed in the same way as any other covered medical expense, such as eyeglasses or dental work.
I have an FSA/HSA account but I don’t have enough money in it to pay for hearing aids. What should I do?
If you need hearing aids but don’t have sufficient funds in your account, speak to your plan holder about increasing your deposit to cover the hearing aids you are looking for. Remember these funds are deposited tax free so you can still save significantly on your aids.
I don’t have an FSA or HSA. What are they?
If you are covered under an employer’s health insurance plan, you may have access to a flexible spending account (FSA) or a health savings account (HSA), where you can store funds intended for out-of-pocket medical expenses. The funds in these accounts can be used for medical costs not covered by your insurance, including buying a hearing aid.
An HSA/FSA allows account holders to pay for current health care expenses and save for those in the future. Its advantage is that contributions are tax-deductible, or if made through a payroll deduction, are pre-tax. Second, the interest earned on the account balance is tax-free.
How do they work?
You deposit money as a payroll deduction (FSA) or directly (HSA). When it comes time to actually make the purchase, it’s easy to access the funds in your account. Often you can access your FSA and HSA funds via a debit card, which can be used when you make your purchase. If you don’t have access to a debit card, you can submit receipts from your purchases to your insurance company or employer for reimbursement from your account. Since this is your money simply stored in an outside account, there is never a debate about how much insurance companies will reimburse, as long as it’s a qualified expense.
How much time do I have to use these accounts?
HSA accounts roll over into the following year. But if you’re planning on using FSA funds, remember that you need to make your purchase by December 31 to be eligible to use your account.
How do I set up an account for next year?
Talk to your employer or insurance company about how to set up an account. It’s easy: you commit to an annual amount at the beginning of the year and you use the money when you need it. Remember this is a pre-tax payment, so you don’t pay income tax on your deposits or when you use the funds for a qualified expense. So by using these accounts in your purchase, you are buying your hearing aids income-tax free!
Think about the first time you went to an electronics store to buy a computer or a television. Remember the seemingly endless options, features, and functionality that the salesperson demonstrated to you? At the end of the day, you likely wondered which features were essential and which were simply unnecessary add-ons designed to sell a product.
Buying a hearing aid can be a lot like that experience, except now you are relying upon this device to make a real impact on your quality of life. It’s more important than ever to understand what you truly need in a hearing aid and what you don’t. Unfortunately, many hearing aid retailers make the process just as confusing as trying to buy that first computer or TV. Instead of explaining the basics of their products, they offer up confusing jargon and showcase hundreds of different models from dozens of major manufacturers.
To help, we’ve put together some tips to remember during your shopping process.
Learn the basics behind hearing aid technology.
As a consumer, one of the first steps you can take is to educate yourself about the basic components of hearing aid technology. It’s helpful to start with functionality that’s common amongst all devices, then learn more about additional customization and add-ons.
For example, two terms you’ll likely see during your shopping experience are “channels” and “programs”—most hearing aids have them, but that doesn’t mean all the hearing aids you consider are equal.
“Since a consumer might have to pay more for hearing aids with a greater number of channels, this not only becomes a question of performance but of cost,” according to Dr. Mark Ross, who has studied hearing loss for Gallaudet University.
Let’s start with the “channels” on a hearing aid, which refer to the range of frequencies that can be detected by an aid. Some hearing aid dispensers will insist that you choose an aid with the highest number of channels possible, but it’s important to remember that quantity does not always equal quality.
Researchers have found that hearing aids with more than 20 channels can actually garble speech or make sound harder to decipher. So while it may be a benefit to have a higher number of channels, at a certain point increasing the amount of channels won’t help your hearing—in fact, it may actually make it harder to hear.
Another sometimes misunderstood feature of hearing aids are the “programs” on the device, modes that hearing aids use to compensate for background noise or to adapt to a different noise level. Some hearing aids are equipped with programs that help the user hear better in a crowded room or even turn down the volume in quiet moments. But on many aids, the user has to manually adjust the settings, which can be tricky when trying to operate such a small device. Others, including Embrace Hearing models, eliminate the need to switch programs altogether by handling the switching automatically.
When shopping for a hearing aid, don’t forget to ask about devices that make switching between programs easiest for you.
Be honest about your comfort level with technology.
If you’re an early adopter of all sorts of new technology in your life, from smartphones to smartwatches, then you will likely want a hearing aid that also comes with a full suite of advanced features. On the other hand, if you find feature-laden devices confusing or complicated, it’s best to stick with a simpler option.
For example, consider the use of BlueTooth in hearing aids. A wireless technology that allows a user to connect their hearing aid to another device without any additional cables or connections, BlueTooth is essentially a radio wave connecting one device to another.
In the case of hearing aids, BlueTooth connectivity enables you to connect your aid directly to the sound output of your TV or mobile phone, improving your listening experience. Deciding whether to invest in BlueTooth capability will depend largely on how much you interact with technology, such as talking on a cell phone, watching television, or listening to music on a portable digital player. If those are important aspects of your life, a hearing aid with BlueTooth capabilities should be on your list. If that level of technology makes your head spin, it may not be worth the extra investment.
“Even if they had Bluetooth programming technology available to them, [many clients] are not...capable of embracing that kind of technology easily,” Bettie Borton of the American Academy of Audiology told the New York Times.
Don’t be afraid to ask questions.
Perhaps the most important aspect to remember when shopping for a hearing aid is that you are making an investment in improving your own quality of life, so don’t let a dispenser or salesperson talk you into a hearing aid model that isn’t right for you. Don’t shy away from asking questions and making sure you are equipped with the knowledge you need to make the appropriate choice for you—and if you aren’t getting the answers you need, take your business elsewhere. Remember that while technology can do many wonderful things, it only works if you understand it.
Hearing loss, unlike vision impairment or physical ailments, isn’t always noticeable at first. Because the slow loss of hearing can often be ignored or downplayed, sufferers frequently delay getting help as long as possible—research shows that the average sufferer waits ten years between receiving a diagnosis of hearing loss and actually purchasing hearing aids.
At least some of these people delay their purchases because they have heard many of the widespread myths surrounding hearing loss. If you or a loved one is considering a hearing aid purchase, take a moment to look over some of the common misconceptions below. They show that the benefits of hearing aids far outweigh the (often overstated) costs.
People won’t notice my hearing loss, but they will notice my hearing aids.
“What many people with hearing loss don’t realize is that the signs of the untreated hearing loss are more noticeable to others than hearing aids,” audiologist Deborah Touchette told the New York Times. Hearing loss sufferers can experience a range of related issues, from difficulties at work (including, in some cases, a pay reduction) to trouble holding conversations in noisy places to even having difficulty hearing the voices of young children—all issues that can be improved with proper hearing aids, many of which are small and easily overlooked.
Hearing aids are uncomfortable and don’t work well.
Hearing aids today have become smaller, more discreet and more powerful, just like other forms of popular technology like cellphones and computers. In fact, the digital revolution that has transformed phone technology has also impacted hearing aids, with newer models featuring powerful components that allow for advanced filtering of background noise and multiple microphones.
Hearing aids are too expensive.
Though hearing aids are not inexpensive, their cost is reasonable relative to their compact technology. For example, a typical digital hearing aid contains advanced microphones, computer chips, and a power source in a package able to fit behind (or within) the ear—all for under $1000 for a basic device.
New business models are trying to lower the cost for premium devices as well. While small, independent local hearing shops charge an average of well over $5000 for a hearing aid, you can save 60%-70% of that cost by purchasing a comparable aid online and still have full audiology support.
Hearing aids won’t improve my quality of life.
Hearing aids can’t restore your hearing back to its normal level, but they can make major improvements in your ability to function in daily life. Researchers found that most hearing aid users reported improvements in their social lives, confidence, and ability to communicate.
I won’t be able to get a hearing aid to work properly for me.
With advances in technology, hearing aids have become much easier for the wearer to operate. Now, computer chips and digital technology inside many hearing aids allows the device to automatically adjust to changes in the sound environment without the user having to take any action at all.
Navigating the cacophonous streets of New York City can be daunting process for practically anyone -- and for people who wear hearing aids, the task has long been made more difficult by constant background noise and a lack of infrastructure to make the process easier.
Fortunately, there's an easy solution -- hearing loops, which allow wireless connectivity to hearing aids with telecoils, effectively transmitting sound from its source directly to the hearing aid, and mitigating the effect of background noise. Unfortunately, adoption of hearing loops, which are widespread in Europe, has been painfully slow.
Until recently, that is. Largely thanks to the founder of the Hearing Access Program, Janice Schacter, New Yorkers are benefiting from increased accommodations for hearing aids:
Following a successful pilot program, the Taxi and Limousine commission announced that it had approved the induction loop technology for voluntary installation across all TLC-related industries, including taxi cabs. The transition to 100% looped taxis (which London has enjoyed since 1998) was accelerate when it was announced that New York's "taxis of tomorrow" will all have induction loops to help people with hearing aids communicate more easily with their drivers.
In addition to taxis, the Hearing Access Program has brought hearing loops to such public spaces as the New York Historical Society, the Lower East Side Tenement Museum, and the Metropolitan Museum of Art, and the new Yankee Stadium.
Additionally, the Hearing Access Program spearheaded a drive to install hearing loops at all of New York's ~450 subway stations, which is now complete.
Finally, the hearing aids on the subways have been getting some extra attention lately from the New York City Department of Health, with advertisements that caution headphone users to turn down their music to avoid permanent hearing loss. It's worth noting that Starkey, a hearing aid manufacturer, helped funds these advertisements, and deserves praise for its role.
We think New York City is mostly on the right track recently with hearing aids -- hearing loss should be prevented where possible, and people with hearing aids deserve to benefit from hearing loop systems in public spaces wherever possible. We wish that New York and other governments could see fit to bring resources to bear on making hearing aids more affordable -- but at least for now, it looks like it's up to private companies to play this role.
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