Now Hear This

“Will you come tell my husband he has got to wear his hearing aids?” the woman on the other end of the line asked me. “…otherwise I might kill him.”

She was joking (kind of). The strength of the sentiment is not what got my attention; it’s because of the frequency with which I hear this complaint that I felt it important to tackle here.

Are you sure it isn’t an issue in your family? Let me tell you how common it is. According to the National Institute on Deafness and Other Communication Disorders, 25% of people between 65 and 74 have hearing loss; 50% of those over the age of 75 do. Of those over 75 who could use a hearing aid, fewer than one in three have ever even tried one.

What makes this particularly worrisome – and an important public health concern -- is that often a loss in hearing is accompanied by a concordant dip in cognition. In fact, research has found not treating hearing loss can exacerbate or hasten age-related memory loss, including increase the risk of Alzheimers by up to 5 times.

So how do you convince dad he needs to wear his hearing aid? It’s challenging.

Hearing loss happens so slowly and gradually, the people suffering from it often don’t realize it or deny that there’s a problem. Many resist hearing aids because they don’t want to be seen as someone who needs them. What can also contribute to this, according Robert Keefer, owner of Now Hear This, is that as little as ten percent of hearing aid users are satisfied with their hearing aid.

The most compelling argument in favor of hearing aid use is that not using one can significantly contribute to cognitive decline.

This makes sense. After all, participating in a conversation or listening to a radio or television program stimulates the brain. Use it or lose it is a common maxim among physicians, and those individuals not attending to (hearing and participating in) the world around them may be inadvertently leaving that world cognitively.

Whereas, according a study published last spring in the Journal of the American Geriatrics Society, researchers found the rate of cognitive decline was slowed by 75 percent following the adoption of hearing aids.

“Why are only 10% of people happy with them?” I asked Keefer.

He chalked it up to how few places offer the important support services that are used to finetune and personalize hearing aids. A Consumer Reports article said as much as 70% of hearing aides are fitted without using Real Ear Measurements. This is a critical component of the standard of hearing care established by the American Academy of Audiology.

What is Real Ear Measurement? After the hearing aid is fitted using standard audiological exams and sound booths, the audiologist does a preliminary fit using basic settings recommended by the hearing aid manufacturer. Then comes the real ear measurement. To do this, the audiologist inserts an extremely tiny microphone in the ear canal with the hearing aids in place. This microphone, which is attached to a computer, allows the audiologist to measure the gap between what the subject should hear and what he actually hears.   That information is then used to customize or fine tune the hearing aid’s performance to the patient’s exact needs.  Without it, an audiologist can only rely on guess work.

“I think most people don’t realize how much our ear canals differ in length and width and how those differences affect the performance of hearing aids,” Keefer said. “Each ear canal has its own acoustics—so you literally have to do these ‘real ear measurements” to make a patient hear their best. If they don’t hear their best, they get frustrated and will not use them. That is sad because hearing aids can solve over 90% of hearing issues, and everyone should get hear their best their whole life long. “

I thought back to the frustrated client introduced at the beginning, and to other clients and even family members. If the desire to improve one’s hearing is not motivating enough, maybe slowing down cognitive decline might be. It’s certainly worth a try.