Baby boomers who need hearing aids have many choices in a Bluetooth/iPod world

April 9, 2012

When we were kids, hearing loss was funny.

My sister and I made a game out of saying what we believed to be hilarious things, in normal tones, right in front of our grandmother, who we were sure couldn’t hear a thing.

“Do you think Grandma got up at 3 in the morning to start cooking the canned peas?” I asked Julie at the Thanksgiving table.

“Yes,” my sister said, causing us both to dissolve into hysterics.

“What’s so funny, girls?” Grandma asked.

“Nothing,” we said, wiping tears of holiday joy from our eyes.

At the end of the meal, over Mrs. Smith’s frozen pumpkin pie with non-dairy whipped topping, we pretended to talk to each other with no sound at all coming from our mouths. Really, what could be funnier?

Needless to say, the powers that be were not amused, and my sister and I got our just deserts: hearing aids in our 40s. Both of us. Now in our 50s, we’re forced to make jokes about being ahead of the curve.

A recent study in the Journals of Gerontology reports that 63.1 percent of adults in the United States — nearly two out of every three — will contend with significant hearing loss by the time they’re 70. At age 85 and older, it’s four out of five.

With the first of 78 million baby boomers turning 66 this year, it won’t be long before you’ll be able to walk down the middle of any street in America and hear a chorus of blaring televisions.

“Eventually this is going to be all of us,” Julie said to me recently. “Anyone who’s feeling smug now, check your watch.”

Whoa, relax. My sister’s not talking about you. She’s talking about your parents or your spouse or the nearly 23 million other people older than 50 who are having trouble hearing but have yet to seek help. Researchers at Johns Hopkins University report that about six out of seven of Americans over 50 who have hearing loss don’t wear hearing aids.

The reluctance to get hearing aids can be tough on spouses and adult children. Yelling, nagging and enunciating (“I said sects, not sex!”) probably won’t push a relative to get his hearing tested. But maybe attacking the problem in a bigger way would, a way that chips away some of the stigma and marshals the power of tens of millions of boomers who don’t want to age the way their parents did. Or, frankly, at all.

Maybe we can find a way to make hearing aids cool. If you’re with me, here are a few things we can do to get this revolution started.

Step 1: Be proud

Say it with me: I am over 50, and I have trouble hearing people who mumble. No, try that again: I am over 50, and I have trouble hearing.

Given the ubiquity of age-related hearing loss, it seems silly to be embarrassed. If we were adolescents, we’d be thrilled to be like everyone else.

We don’t need to nod and smile, pretending to hear. And we don’t need to avoid wearing hearing aids. Not when everyone under 40 is wearing ear buds, headphones and Bluetooth devices clipped to their ears.

Now it’s our turn — our chance — to buy ridiculously expensive, tiny technological toys that go in, on or behind our ears. Our turn to dazzle our friends with their tricks: “You gotta see this . . . ”

Step 2: Understand your new techno-powers

Today’s hearing aids are not ear trumpets. They are digital devices, meaning they’re driven by a computer chip capable of more than a million instructions per second.

Old hearing aids amplified sounds — all sounds, even the ones in the background and the ones you heard just fine. But today’s hearing aids are programmed to match your unique hearing loss, providing amplification in the exact way you need it (turning up just the higher tones, for instance), while cutting down on distracting background noise.

David Myers, a psychology professor at Hope College in Michigan and author of “A Quiet World: Living with Hearing Loss,” got hearing aids in his 40s and wasn’t exactly impressed. Now 69, Myers said technological improvements in the past 10 years have changed his mind. “I now love the hearing instruments I once barely tolerated,” he told me.

Myers wears behind-the-ear hearing aids, which don’t block up the ear the way in-the-canal aids can. As a result, he says, the world no longer “sounds like your head is in a bucket.”

Myers has a variety of settings on his hearing aids to help him hear in different situations. One setting engages a directional microphone, which “prioritizes where I’m looking,” he said. “It amplifies sound from right in front of me and dampens sound from behind or to the side of me,” which helps in rooms with a lot of background noise, such as restaurants.

A noise-reduction setting, explained Meyers, helps “in a car or near an air conditioning system”; a reverberation-reduction setting is for use in rooms where there’s a lot of echoing sound,” such as large churches or gyms; and a default setting “allows the hearing instrument to choose what to do.”

Myers also has settings for a telecoil, which allows him to use his hearing aids in conjunction with assistive hearing loops installed in some public places.

Myers can change the volume on his hearing aid or move from setting to setting by pressing buttons on the aid itself or, in this era of wireless communication, by using a hand-held remote control, like a tiny television clicker.

Technophiles will have a great time with a device like Myers’s. But if you never learned how to set your VCR and all this makes your palms sweat, never fear. “Some people want the hearing aid to make all the decisions,” said Margaret McCabe, director of audiological services in the Department of Hearing and Speech Sciences at the University of Maryland at College Park. “The aids are getting better at doing that.”

Step 3: Embrace low expectations

The plain truth is that hearing aids, no matter how much you pay for them, won’t restore your hearing to what it was. “It takes work,” said Tobie Stanger, a senior editor at Consumer Reports who has researched hearing aids. “It’s not like putting on a pair of glasses and immediately seeing better.”

“As good as the technology is,” my audiologist, Jeff Zolt, explained, “the thing that stands in the way of perfection is hearing loss. The hearing aid can produce a wonderful signal, but once it goes into the ear and the auditory system takes over, there are a hundred different ways from the ear to the brain where something can go wrong, and the hearing aid can’t fix that.”

Hearing aids “rehabilitate the auditory system that you’ve got,” said Zolt. “You’re not getting a new one.”

Sigh.

When hearing aids are fitted and programmed correctly, when people have “appropriate expectations,” and when they’re trained to use their hearing aids properly, Zolt said, “most patients find they hear better most of the time.”

Or, as he said when fitting me for a new pair of hearing aids in Silver Spring last month: “When somebody buys a cane, it doesn’t make them able to run a four-minute mile. Nobody says the cane doesn’t work.”

Canes are relatively cheap. But hearing aids can run thousands of dollars, theyare rarely covered by health insurance, and you may want to replace them as technology improves.

McCabe says there’s “a huge range of prices out there,” from $500 per ear to $5,000 per ear. Yes, per ear. And most people need two. Most states require those who distribute hearing aids to provide trial periods during which you can return a hearing aid for a full refund.

Even with the sticker shock and the complaints about how hard it still is to hear in restaurants, most people who get hearing aids are glad they did. A 2011 survey sponsored by AARP and the American Speech-Language-Hearing Association found that 82 percent of Americans older than 50 who have hearing aids are happy with them, and 73 percent say the quality of their lives is better since they began wearing them.

I confess I find it hard to love my hearing aids. I’ve been deaf in my right ear since 43. A microphone in that ear sends all sound wirelessly to my good ear, which too often makes me feel inundated with background noise. I’m hoping for more improvements in the technology soon.

Step 4: Accessorize

The biggest advances these days may be in wireless devices you can use in conjunction with your hearing aid. In other words, the toys have gotten better.

“The hot and heavy attention these days has to do with connectivity,” said Sandra Gordon-Salant, director of the doctoral program in clinical audiology at the University of Maryland. “With the proper device paired to your hearing aids, you can connect to your TV, land line, iPod or cellphone. If you’re the least bit tech-savvy, it’s easy to figure out.”

Want to hear your wife when she’s giving driving directions from the passenger seat? Pin a mike on her that wirelessly connects directly to your hearing aids.

Want to cook dinner while talking on the phone hands-free? Get a phone clip — you can wear it around your neck or attach to a key chain — that provides a wireless connection to your cell phone or landline. When the phone rings, you hear it in your hearing aid; you click on the clip, which has a microphone, to answer the call, then click on the clip again to hang up. You don’t even have to touch your phone.

Sick of complaining about the television being too loud? Buy your spouse a necklace he can wear that wirelessly connects the TV directly to his hearing aids. Or get a necklace that controls both the TV and phone.

Again, be aware that all this magic is cool but not cheap.

Step 5: Learn to innovate

Richard Einhorn, a former record producer and composer who lost most of his hearing a few years back, is determined to find ways to hear quality sound again. He uses apps on his iPhone to help.

“Download an app called soundAMP R,” Einhorn said, “plug in earphones, really good earphones (the in-ear style seems to work best), run soundAMP R, then point the iPhone at the person you want to speak to, and you will be able to hear extremely well. It’s amazing.

“If you want to refine that,” Einhorn continued, “get a professional directional microphone, then attach it to an iPhone, put on your headphones, then just point the mike at the person you want to talk to. It’s the single best solution for restaurants and parties.”

Einhorn recommends other apps you can try: Amplify’d, Ear Trumpet and Ears. All cost less than $10. If you love tech toys, have a field day. If you don’t, consider asking (or paying) a grandchild (yours or someone else’s) to help.

If you don’t have a friend like Einhorn, visit some of the Web sites that can help you connect with others with lessons to share. Try www.myhearingloss.org/forum, www.hearingaidforums.com or a Google group called alt.support.
hearing-loss
. (My favorite post: “dropped my hearing aid by accident into a bowl of cereal and now it makes noises.”)

Step 6: Be a good consumer

If you’re among the 99 percent, it’s incredibly uncool to pay more than you need to. But my friend Judy Goggin, who lives in Boston, was in a hurry the day she went to get her hearing tested.

“The audiologist asked me a lot of questions about my lifestyle, then gave me three options for hearing aids: lower cost, middle and higher cost.” Goggin picked the middle ones, then “just laid down my credit card and bought them. Once I got home, I was like, ‘$4,000? What did I just do?’ ”

Heeding advice from her brother, who also has congenital hearing loss, and several online forums, Goggin decided to visit the hearing aid counter at Costco. There she spoke with a “hearing aid specialist” (in most states, specialists are licensed after six months to two years of supervised training), not an audiologist. (New audiologists typically have doctorates and more than 1,000 hours of clinical training.)

The Costco employee was an irritating know-it-all, Goggin said, but she bought a $2,000 pair of hearing aids from him anyway.

“I walked around for a couple of weeks trying to figure out if the $4,000 hearing aids were $2,000 better,” Goggin said. Trying not to panic about the $6,000 now sitting on her credit card, she compared the cost of servicing, the warranty, the customer service, the feel and the sound. She went back to both places for adjustments.

In the end, Goggin bought the $2,000 pair and returned the more expensive ones for a full refund. She’s happy with her choice. “They work,” she told me. “They make things better for me.”

With hearing aids, it’s not easy to be a good consumer. “It took us a decade to figure out how to test hearing aids,” said Consumer Reports’ Stanger, author of a 2009 article that tried to make sense of the “confusing marketplace.”

The magazine said its researchers “followed a dozen actual patients for six months as they shopped for and used hearing aids, conducted a national survey of 1,100 people who had bought a hearing aid in the past three years, and lab-tested the features of 44 hearing aids.”

And the researchers still couldn’t compare brands. There’s too much individual variation, Stanger said, too many variables to draw clear conclusions. Instead, the magazine rated some of the features of hearing aids, encouraged people to go first to a doctor’s office staffed by an audiologist, and offered dozens of tips from “resist the upsell” to “insist on having brand and style choices.”

There are choices out there, after all — choices my grandmother never had.

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