At Emerald Medicare, we’re committed to empowering our clients with the knowledge they need to make informed decisions about their healthcare. Hearing care is a critical – yet often overlooked – aspect of overall health, and we believe the topic deserves special attention. To shed light on the subject, we had the pleasure of speaking with Dr. Kathleen Wallace, Au.D., from Anywhere Audiology. Dr. Wallace is a well-respected and innovative audiologist with years of experience in hearing care & aural management. In this interview, Dr. Wallace shares her insights on hearing loss, the latest advancements in hearing aids, and how Medicare beneficiaries can access the care they need. Whether you’re already experiencing hearing loss or simply planning for the future, her expertise offers invaluable guidance.
Q: How does untreated hearing loss affect a person’s overall health, independence, and quality of life?
A: Untreated hearing loss has been linked to every facet of someone’s life; Studies show untreated hearing loss is linked to a reduction in quality of life, increased loneliness & social isolation, poorer mood, and increased depression. In addition, there are effects on your earning potential, relationship strain, and, when severe enough, safety concerns that may impact one’s independence. Perhaps most compelling is the correlation with dementia… Untreated hearing loss, particularly in mid-life, has been found to be the largest potentially modifiable risk factor for dementia in large studies published by the Lancet Commission and Johns Hopkins, to name a few. I must emphasize, however, that this is an example of correlation and not causation, meaning hearing loss itself does not cause dementia, but they often happen together. In other words, there are some changes that result from hearing loss (changes to the brain, social behavior, and cognitive load) that we know are not good for brain function. The good news is there is a robust body of evidence supporting the reversal of many of these negative effects of unmanaged hearing loss when hearing loss is managed through audiologic care, including the use of hearing aids, auditory training, or cochlear implantation.
Q: How often should seniors get hearing exams, and why is it important to do so?
A: Ideally, folks over the age of 65 should be getting annual hearing tests, first to establish a baseline and to assess changes thereafter. This is particularly important for two reasons: 1. We are not very good at perceiving our own hearing sensitivity. The best course of action is to actually measure it to allow for more timely intervention, which will ultimately lead to better outcomes. 2. Not only does hearing loss become more prevalent as we age, but so do other health conditions that may increase your risk of hearing loss. Hearing is an important part of your overall health management, particularly when we think about healthy aging and maintaining independence.
Q: Are there specific signs that indicate a senior should seek hearing care?
A: If you’ve never had a formal hearing test, or haven’t had a hearing test in a number of years, I highly recommend you get a test to establish a baseline. There is a lot of power in simply knowing your hearing sensitivity, and there is never an expectation for you to move forward immediately with hearing aids. Beyond that, it is important for you to have an honest look at your hearing – are you asking others to repeat themselves? Do you feel less confident at parties or social gatherings? Are you avoiding the phone? Do you need closed captions on your TV? Are family members or loved ones noticing your hearing? It might be uncomfortable to think about, but there is no shame in hearing loss.
There is a great questionnaire called the Hearing Handicap Inventory for Adults; this is a free online tool that may be a good place to start, whether it’s for yourself or for a family member. Lastly, it is recommended to pursue hearing care if you have ringing or buzzing in your ears (tinnitus), and medical evaluation by an ENT is recommended for any pain, fullness, discharge, dizziness, or sudden changes in hearing.
Q: Have hearing aids evolved in terms of technology and usability and pricing for seniors? If so, how?
A: Hearing aids have changed drastically over the last 5 years, and even more dramatically when compared to those of previous generations. Modern hearing aids are essentially tiny computers- they have chips inside that use advanced algorithms to sample the sounds in your listening environment (up to thousands of times per second!) and automatically adjust themselves to the most appropriate setting for your environment. For example: are you at the beach with windy noise? Reading in a quiet room? At the theater? Eating out at a restaurant? All of these are very different environments from an acoustic perspective, and today’s hearing aids can automatically adjust & compensate appropriately.
Further, hearing aids are programmed uniquely to your own ears and tailored to sensitive areas across the frequency spectrum (or ‘pitches’) that you may have trouble with. Nowadays, they can go a step further to determine what amplification method(s) to employ based on the nature of the incoming sound in real time (ie. Dialogue vs. ambient noise vs. musical sounds, etc.). In this regard, it is almost like having a sound mixer in your ears.
While all of this might sound overwhelming, the good news is the advancements in technology have allowed for nearly all of this work to happen behind the scenes – and is based on how the audiologist programs your hearing aids. As the hearing aid user, all you must worry about is putting them in in the morning, taking them out at night, and some minimal cleaning. Hearing aids are often rechargeable now and offer Bluetooth connectivity if those are additional features you desire.
Q: What are the core features that patients should consider when comparing different hearing aid models and brands?
A: The top priorities should always be sound quality for the user and practicality. 1: is it giving you the improvement you need in as natural a sound quality as possible? And 2: Can you use the hearing aids daily? Do they create more problems than they solve? I encourage anyone interested in exploring hearing aids to hear it for yourself – visit your Audiologist and demo multiple models from different manufacturers. From there, I’d say it’s the audiologist’s job to guide you on the pros and cons of all the additional features and considerations based on your unique hearing needs.
For example, you may desire the smallest hearing aid on the market, but your ear anatomy and/or severity of hearing loss may tell us that this is not the best treatment option for you. In addition, I think it’s important to mention if you intend to use your hearing aids everyday, make sure your audiologist understands your daily life. Maybe you are an avid golfer; you’d then need a hearing aid that can deal with wind noises well. If you love audiobooks, Bluetooth streaming may be important. If your hands aren’t working quite like they used to, rechargeable devices may be easier to use.
Q: What are some common misconceptions about hearing care or hearing aids that you wish more people understood?
A: A lot of people think that hearing care equals hearing aids and that hearing aids are a “plug and play” solution. Your auditory system is quite complex, however, and hearing loss can lead to significant distortion and/or permanent damage to the hearing organs. There is a lot that goes into properly fitting hearing aids, and how the devices are programmed is far more important than the technology itself. If they are not set up appropriately for your hearing loss and anatomy, you will be substantially limiting your hearing aid benefit, if not further impacting your hearing abilities. I’d also mention that hearing aids, even when programmed well, should not be thought of as a “cure-all” solution; unfortunately, hearing loss is irreversible. We employ hearing aids to essentially harness & repurpose the hearing capacity that you have left. You may need to use other tools like good communication strategies, remote microphones, or auditory training programs to maximize your benefit.
Q: Could you talk about some of the social aspects of hearing loss? How may hearing loss affect one’s social life?
A: Evidence shows untreated hearing loss is linked to social isolation and loneliness, as well as reduced fulfillment in interpersonal relationships. To me, this is the most important aspect of hearing loss to consider. This also tends to be the most powerful motivator for people to do something about their untreated hearing. If you notice yourself withdrawing from conversation, opting out of social gatherings, or choosing not to take part in activities that typically bring you joy, I’d highly encourage you to think about how your hearing may be factoring in.
I’d also think about whether this is affecting anyone else in your life. There is something called Third Party Disability, which is the idea that your health condition could have an impact on loved one even if they do not have the condition themself. This is very common for people with hearing loss. For example, if one person in a married couple is withdrawing from social situations, odds are it will begin to impact the social life of their spouse as well. The good news is hearing loss management leads to a reversal of many of these negative social effects, not just for the person with hearing loss but also their loved ones.
Q: What role(s) do family members or caregivers play in supporting seniors with hearing loss, and how can they be more involved in the process?
A: Family members can be very valuable assets to an audiology appointment. Because hearing loss tends to occur gradually over time, it is common for people’s loved ones to pick up on the hearing loss before they recognize it in themselves. To put it simply- you don’t know what you don’t hear. I find it helpful, when done tactfully, for family members to share their perspective and insights. The key, however, is to continue to emphasize that this is coming from a caring place and wanting the best for them. It should never be combative or a blame game, especially if the person is in denial. When a family member does pursue hearing care, I encourage you to be supportive and patient. Hearing loss and hearing aids are not easy! There may be a learning curve and there may still be times when you’ll need to repeat yourself. Just continue to be supportive and encouraging. As far as day-to-day maintenance, family members can be helpful to check if the hearing aids are inserted properly, the devices are being charged, or the batteries have been changed, and potentially taking on some of the tasks that require good vision and dexterity if those are concerns for the patient.
Q: Could you share some important statistics on hearing loss amongst seniors today and/or overtime?
A: A simplification of the prevalence of hearing loss with age is that roughly 60% of people in their 60s, 70% of people in their 70s, 80% of people in the 80s and over 90% of people in their 90s have hearing loss. The odds are it will affect you at some point in your life!
Over 50 million adults in the United States have hearing loss and it ranks as the third most prevalent chronic condition in the US. Yet, only about 20% of people who would benefit from hearing aids actually use them. There are many contributing factors that tell us why this is the case, but the top 3 typically are: not perceiving enough difficulty, stigma, and price/cost.
Q: Do you ever encounter patients struggling to afford hearing aids? If so, what advice do you offer to seniors seeking affordable solutions?
A: Yes, unfortunately. Traditionally, hearing aids have not been covered, or are fairly limited in their coverage. This includes Medicare and dates back to how audiologists were categorized as providers with CMS and an outdated understanding of hearing treatment. Hearing aids typically retail anywhere from $3000 – $7000 for a pair through most practices, with no assistance from insurance. There are a few supplemental plans that may offer some limited coverage, but I’d be sure to read those benefits carefully to understand if there is a particular manufacturer of hearing aid or clinic you must use to take advantage of the benefit. If hearing aids remain out of reach, you can discuss a payment plan with the audiologist, consider an older model, see if you qualify for services through the VA if you are a veteran, look for funding through local organizations, determine if Costco is appropriate for you, or check if you meet the criteria for over the counter hearing aid options. There are also a few non-profits out there who offer hearing aids, but that will depend on your region.
Q: What advice would you give to seniors about selecting a hearing care provider or audiologist?
A: I think it is very important for you to select a hearing provider / audiologist you can trust. Typically, it is a good sign when an audiologist works with multiple hearing aid manufacturers because this will give you as many care options as possible. I’d find one that is in a location that is accessible and with a schedule that works for you. I’d also ask them questions about how they approach clinical decision making to see if matches your preference. For example, some people want joint decision making and others prefer more of a “doctor-knows-best” strategy. Lastly, ask around and see if there is someone your community trusts. This could be through word-of-mouth or reading reviews online.
I’m also happy to answer any questions you may have! And if you believe being seen in your home would be best for you, please let me know! Anywhere Audiology sees residents throughout the New York Tristate Area and we’re proud to be an independent, brand agnostic team of doctors of audiology.
