You don’t know what you’ve got until it’s gone
It’s an age old adage but it has stood the test of time for a reason. Hearing loss generally occurs gradually, so you start to miss out on things you used to hear all the time, without even noticing.
If you look on our previous blog ‘The Link Between Hearing and Dementia’ you will see that the correlation between the two has been present for many years. However, the risk of dementia is not the only reason that you should be taking care of your hearing health.
Many people who decide to start using hearing aids have noted that they become increasingly disengaged socially, and struggle in groups. Hearing loss can often cause speech noises to be lost against background noise, causing the individual to become embarrassed about having to ask for things to be repeated.
Hearing family and friends talking, watching the TV, and hearing on the phone are other common struggles that people with a hearing loss experience. Eventually they will also miss out on birdsong, music, and many of the other simple pleasures in life that we take for granted.
Taking care of your hearing health means addressing the loss before it is too late. Using a hearing aid can reduce deterioration of hearing, meaning that you can retain hearing for longer in life.
Ultimately, taking care of your hearing health means having an improved quality of life.
It is unlikely that anyone reading this post does not know someone suffering from, or affected by dementia. There are 1.2 million people in the UK (48 million worldwide) living with dementia. It is a far reaching disease which not only affects the individual, but all of their family, friends, and carers. Hearing loss has been identified as one of nine key modifiable factors that contributes to development of dementia.
Other factors were lack of education (8%), smoking (5%), failing to treat depression (4%), physical inactivity (3%), isolation (2%), high blood pressure (2%), obesity (1%), and type 2 diabetes (1%). The percentages are indications of how much of the risk each factor contributes, hearing loss carried the largest risk at 9%. These are all categorised as modifiable, as they can all be treated at least to some degree.
There are suggestions that hearing loss may add to the burden of a vulnerable brain, and increase the progression of dementia. Both hearing loss and dementia have been reported to cause increased social disengagement and depression, so may exacerbate or accelerate each other’s symptoms.
It is not yet completely clear whether the use of hearing aids and other instruments can prevent the onset of dementia. Hearing loss is known as a modifiable risk factor because it can be addressed and improved. Social isolation and depression contribute 6% of the modifiable dementia risk to potential cases, and hearing loss has long been known to cause both of these conditions. With this in mind, treating hearing loss, by default, often also takes care of two other major factors, and could potentially reduce dementia risk by 15%. Other risk factors could be addressed: by stopping smoking, keeping your mind agile, and regular exercise, and you could potentially negate most of the prospective 35% risk – vastly reducing the possibility of dementia onset.
Dementia is an unfortunate inevitability for many people. However disheartening this seems, to be able to potentially negate the effects of 35% of the risks puts us in a very strong position. Knowledge is always the first step towards a cure, and though currently all advice is only preventative, we are certainly heading in the right direction.
If you are worried about your hearing health in relation to dementia (or otherwise) and would like some advice, please do not hesitate to contact us for professional, friendly guidance.
Phone: 01270 611 212
Observed Hearing Loss and Incident Dementia in a Multiethnic Cohort
(Golub et al. 2017)
Hearing loss as a risk factor for dementia: A systematic review
(Thomson et al 2017)
Age-related hearing loss and dementia: a 10 year national population-based study
(Su et al. 2017)
Dementia prevention, intervention, and care
(Livingston et al. 2017)
If you’re reading this post, you’re probably thinking about getting hearing aids. You’re doing what almost everyone does today before they buy a vacuum or TV, or book a vacation or try a new restaurant — you’re doing online research.
You are smart. Consumers today have an abundance of information and reviews at their fingertips. There’s little reason today not to research a product or service before you purchase, particularly if it’s a bigger investment. And there is no getting around the fact that hearing aids and better hearing are an investment. An investment that can significantly better your life.
This article isn’t about the different makes, models or features of hearing aids. We’re going to talk about where to get hearing aids and the pros and cons of each.
There are two main options; either from a local hearing professional or from an internet retailer. Let’s compare the two.
The pros of buying hearing aids online
No doubt, buying products online is easy and convenient, and hearing aids are no exception. Ordering from the comfort of your home or office — and having it delivered to you without needing to go anywhere — is pretty much the benefit that online shopping was founded on.
Of course, returning items can quickly negate that benefit if you need to repackage it and take it to a post office or shipping facility. And certain things just beg to be “tried on” first, increasing the likelihood they’ll need to be returned if you don’t. That’s why 30% of all products ordered online are returned, vs. only 9% of products purchased in a store.1
Hearing aid prices
Cost can also be a benefit of buying online. While it’s not the case with every item (especially if there are shipping fees involved), it is when purchasing hearing aids online. In fact, cost is probably the biggest incentive for buying hearing aids on the internet.
Unfortunately, convenience and cost are where the benefits of buying hearing aids from an online retailer end. And even those two aren’t all they’re cracked up to be.
Convenience is offset by the fact that — to get a hearing aid programmed for your hearing loss — you’ll want a proper evaluation and will need to send in an audiogram, which you can only get by leaving your house and going to a hearing professional. Then there’s that 30% online return rate discussed above. Meaning there’s at least a 1 in 3 chance you’ll want or need to return it. (Probably more for hearing aids bought online due to the “try on” factor.)
Plus, if you need any adjustments made to your hearing aids to optimise comfort and performance, you first need to repackage and ship them to the retailer. Then, it can take weeks to receive the instruments back from an online service.
As for cost, while you’ll most likely find hearing aid prices are less online, most people conclude that what they get in return is not worth the savings. To explain that, let’s move into the benefits of buying hearing aids from a local hearing professional — also known as “the things you don’t get when you buy online.”
The pros of buying hearing aids from a hearing professional
Yes, a hearing aid is a tangible product that you can ship in a box and, in theory, start using after “some assembly required.” But it’s also a high-tech medical device that works best when matched to an individual’s unique physical and lifestyle characteristics, programmed and fine-tuned to their specific hearing needs, and then followed up with and supported by an expert in hearing care.
Just as you wouldn’t be satisfied buying a suit or wedding dress without measurements, consultation and tailoring, nor would you prescribe yourself and know the right dosage of medication needed to treat your specific arthritis, high blood pressure, anxiety, or diabetes, getting a one-size-fits-all hearing aid without consultation from an expert is most likely going to disappoint or not work the way you need it to.
When you buy hearing aids from a hearing professional, you get much more than just a product that makes things louder.
You also get the expert consultation, treatment knowledge and experience, and personalised fitting, support and care that a sensory function as important as hearing deserves — before, during and after you buy your hearing aids.
Before: Testing & Consultation
- Thorough hearing tests — You’ll have an ear examination and clinical tests in a soundproof environment to diagnose and verify what your hearing needs are.
- Audiological evaluation — Your hearing thresholds will be charted on an audiogram, and you’ll be given specific tests to measure listening comfort and understanding in noise.
- Intake interview — You and your provider will discuss details about your day-to-day hearing needs (including the type of work you do, how active you are, what activities you enjoy doing, your style preferences, etc.). You’ll also go your unique hearing challenges, to help you understand how to optimise your overall communication, not just your hearing.
During: Products & Fitting
- Product selection — Based on your test results, interview, and even unique ear-specific characteristics, your provider will show you solution options that fit your needs in the best way possible.
- Product test drive — While in the office, you may be able to try out and test different styles and technology options so you can hear what impact hearing aids will make.
- Expert fitting — Once a product and style are selected, your provider will program and fine-tune your hearing aids to your specific needs and sound preferences. Each ear is like a fingerprint; every person is different and requires an exact fit to maximize success.
- Solution demonstration — Your provider will show you how to use and care for your hearing aids, and answer any questions you have, so you are comfortable with them and can keep them in tip-top shape.
- Treatment consultation — Your provider will walk you through expectations and next steps, and give you additional resources or tools, so that you feel comfortable as you regain your hearing senses.
After: Follow-Up & Support
- Trial period and follow-up visits — Wearing hearing aids takes some time getting used to and sometimes requires minor adjustments and fine tuning — all covered under your trial period to maximise comfort and ensure success.
- After-care needs — Your provider will be a one-stop shop for warranty and payment plans, tune-ups and maintenance, batteries and other accessories or part replacements. This is like having your mechanic close to you. If anything goes wrong, they can fix the problem quickly.
- Better hearing partner — Your hearing needs change over time, so count on your provider as a go-to resource for all things hearing, including answers to hearing loss questions, personalised treatment plan updates, new technology demos and more.
Read more about Starkey Hearing Aids on their website
At first I pushed the realisation away, refusing to believe that my hearing was deteriorating.
It started eight years ago, gradually. First, watching TV became a struggle. I’d turn up the volume until, in time, my poor husband (younger than I!) was deafened.
At the theatre, I’d strain to hear — sometimes struggling to follow an unfamiliar play because I would miss parts of the dialogue.
At a party, where the background noise was loud, I just nodded and pretended to hear. I felt too embarrassed to keep saying ‘I’m sorry?’ or ‘Say again?’. Who knows what mistakes I might have made.
Back at home, whenever I missed something, my husband said I would stubbornly point out that he has a very soft voice.
Yes, it’s called denial. It was tough to acknowledge my hearing loss because, like many people. I associated the problem with being old — and I didn’t feel old at all.
I had an image of myself as a young, confident, 60-something woman with a successful career and responsibilities. I still felt (or should I say ‘feel’) glamorous, and a hearing aid didn’t fit this image.
So for years I went on making excuses and pretending I didn’t need help.
But, as a journalist, it’s my job to engage with people, and to listen. What’s more, I have to promote my books — which means speaking in public, and answering questions.
Phone calls need to be made, but I started to find it hard to hear what colleagues were saying.
But instead of acknowledging the issue, I started to keep phone conversations to a minimum and used email instead.
At last I saw the irony. As the Daily Mail’s advice columnist, I read problem letters every day.
I’m employed to give advice and encourage my readers to take action and find solutions.
Yet here I was, with a condition which affected all aspects of my life, refusing to come clean and admit to myself that I needed help.
There’s an old Latin saying which asks: ‘Who guards the guards themselves?’ In my case it should be re-framed as: ‘Who gives advice to the advice columnist?’
When she finally took a hearing test two and a half years ago, Bel discovered the hearing loss was more severe than she imagined
One day in 2011, I was standing outside our farmhouse near Bath with my husband. It was a very beautiful day. ‘Listen to that!’ he said. ‘I think it’s a buzzard’.
But I could hear nothing. No glorious wild sound of a bird of prey, calling high in the blue sky, disturbed my muffled ears.
When I confessed, my husband looked slightly shocked. It was then I realised I had to put this right.
At the time, grandchildren were expected (in fact, my first two were born in 2012) and I would want to hear their little voices, wouldn’t I?
Telling myself that wearing a hearing aid would be no different from wearing contact lenses, I at last vowed to act.
Hearing loss is sometimes joked about, but it’s a serious issue. A recent U.S. study connected impaired hearing to the onset of depression.
James Firman, president of the National Council on Aging, pointed out that ‘people with hearing loss, especially those who don’t use hearing aids, find it more difficult to communicate with other people, whether in family situations, social gatherings or at work’.
It could be a short step from having that problem to feeling very isolated.
After all, if you avoid people because you are embarrassed or shamed not to be able to hear them, they may (in time) turn away from you too.
My first action was to visit the GP and be referred to my local NHS hearing centre.
I was immensely pleased to have made the first step, but unfortunately it was to lead nowhere.
It took ages — more than a month — for an appointment to arrive in the post, and the date they gave was about six weeks ahead.
But then, the day before my appointment, the centre phoned to say they would have to postpone due to unexpected staff shortages, so could we make another one? Already, we were looking a couple of months ahead.
So I was back to square one — which was nowhere. Frustrated, but fatalistic, I let things slide once again.
Believe me, I don’t blame the NHS for the blip. Nevertheless, it’s been pointed out that NHS rationing of hearing aids is likely to be fuelling the epidemic of Alzheimer’s disease.
The warning follows research showing that the risk of dementia rockets as hearing fades.
The most deaf are five times more likely to develop the disease, and even mild hearing loss seems to have an effect.
Charities and medical staff have said that doctors must stop thinking of hearing loss as being inconsequential and start treating it – and that it’s imperative that the NHS stops rationing hearing aids.
Shockingly, it emerged last October that cash-strapped health boards have stopped offering the devices to those with mild hearing loss for the first time since the NHS was formed — advising patients to lip read instead.
Other patients have been given only one hearing aid, despite needing two. Overall, just one third of the six million Britons who could benefit from hearing aids have them.
My decision to take care of myself was sensible — and serendipity intervened. I was driving through Bath when I saw a modest sign on a shop. It said ‘Hidden Hearing’ — and I thought ruefully, ‘Yes, my poor old hearing is pretty hidden!’
The next day I saw an advertisement in a magazine for the same High Street chain of hearing centres, so rang and made an appointment within the week. Just like that.
This was two and a half years ago — a very long time after I first started to turn up the TV volume.
The test revealed that my hearing loss was more severe than I’d imagined, which left me shocked.
I have since learned that because hearing loss is so gradual, a person with symptoms often doesn’t realise the severity and doesn’t realise what sounds they are missing.
My audiologist spent time taking me through the different options available and I eventually settled on a pair of Orticon Intiga.
At first I rather reeled at the cost — which was £4,000.
On the other hand, I was buying a pair of exquisitely tiny computers that would tuck behind my ears, coloured to match my hair, with the part that went inside my ears pretty well invisible.
You can’t put a price on your senses. Hearing is fundamental to living, so I told myself it was a purchase worth making, especially if I considered it in terms of so much per day for at least six years.
At first I forgot to use them. I suppose I was still resisting the idea, since the thought of putting something inside your ear isn’t natural.
In fact, I’ve worn contact lenses since I was 20 and it’s actually infinitely easier to get used to a hearing aid.
Initially, though, I found the batteries fiddly and worried I was going to break the delicate little appliances.
However with some perseverance I managed to adapt and now the benefits are incredible. No more muffled living.
I vividly remember walking into my garden and hearing bird song for the first time. It was wonderful.
I now wear the hearing aids every day, and I tell people about them all the time because it’s so important to be open and counter any stigma.
I was surprised to find male acquaintances display vanity, telling me it was easier for me because the hearing aids couldn’t be seen whereas with short hair….
My advice? Grow slightly longer hair around the ears if it bothers you that much but honestly, does it really matter?
We all need to look after ourselves and be honest about what we need to do to improve our quality of life.
I haven’t just made my hearing better, I’ve improved my social life (since parties are less of a strain), family and working life.
Who wouldn’t want to hear a grandchild’s sweet little mumbling? Or every note of a favourite song?
A life without sound can be lonely. Hearing loss shouldn’t be looked at as an age-related condition because (as my hearing specialist told me) young people can have the problem too.
Even though I’m entirely satisfied with the hearing aids I invested in nearly three years ago, at the moment I’m just trialling an upgrade, the Oticon Opn, which is even more state of the art.
For example, the other night in the theatre I used a small hand control to improve the clarity of the actors.
What a revelation it was — first, to hear the sound change and second to have the power to control the technology.
I’d urge anyone who is worried about their hearing to seek help straight away. Whether you take the NHS path or seek out a High Street provider is a choice; what matters is to take action.
The longer you wait the more your hearing deteriorates and the harder it is adapt to technology.
And just think of all the lovely conversation and glorious birdsong you might be missing.
Read more: http://www.dailymail.co.uk/health/article-3786091/I-vain-wear-hearing-aids-desperately-needed-hearing-deteriorated-Mail-s-advice-columnist-felt-cut-world.html
The world of hearing aids can be a little confusing, from assorted manufacturers and product names to numerous styles and dozens of features. So what are some key things you should look for and consider when buying hearing aids? Here are five things you’ll definitely want to ask about, along with the questions you’ll want to ask your hearing professional.
Your hearing aids should have some system of directional microphones. Directionality is the ability for your hearing aids to digitally focus in on a specific sound source around you (usually a conversation partner) and it is the only proven way hearing aids improve speech understanding in noise. Simply put, a good directional microphone system will help you hear more crisply and clearly.
There are many types of directionality systems: adaptive, fixed and dynamic. Adaptive directionality systems identify people talking all around you and focus wherever the speech is coming from. Fixed directional systems focus on a specific area (usually right in front of you) and stay focused there. Dynamic directional systems automatically change between listening all around you to a fixed direction. During your trial, be sure to listen to how your hearing aids detect voices and ask your provider how they are set up to maximise benefits.
Some questions to ask:
- Do I need to manually change my hearing aid settings or will they automatically change for me?
- Do I need to face the person that is talking or will my hearing aids listen to talkers in other directions as well?
Most modern hearing aids have some type of noise reduction algorithm built in. The best algorithms are able to distinguish speech from noise, which enable the hearing aids to reduce incoming noise volume and bump up incoming speech — in real time. The degree to which they help and how they help differs from hearing aid to hearing aid.
Some questions to ask:
- How do my hearing aids handle noise?
- Does my hearing aid just turn down the overall volume in noise or is it smart enough to only cut noise and amplify when someone is talking?
- How fast do my hearing aids adapt to noisy environments?
- Do my hearing aids handle different kinds of noise, e.g., wind, car, background noise?
Hearing aids come in many shapes and styles. Some go behind the ear and have a speaker in the ear canal (RIC), some go behind the ear and transmit the sound to the ear with a little tube (BTE), and some are custom built to fit in your ear (IIC/CIC/ITE). The type of hearing aid that’s right for you depends on many factors, including comfort, degree of hearing loss, dexterity, or simply personal taste.
Some questions to ask:
- What difference does the style you’re recommending have on my ability to hear?
- Can I get something smaller?
- What is the battery life on this hearing aid vs. another style?
- Is hearing aid maintenance different depending on style?
We live in a connected world! Televisions, computers and mobile phones are becoming more and more advanced and intertwined. Some hearing aids today have the ability to connect directly to these everyday devices using Bluetooth™ or other streaming technology. You can even adjust some hearing aids using your smartphone (change volume and settings, etc.) – so you don’t need to touch your hearing aids.
Some questions to ask:
- I have an iPhone/Android phone and use it often, what is the best hearing aid for me?
- Do you have hearing aids that directly connect to my phone?
- Do I have to wear anything around my neck to connect or do they connect to my phone directly?
- Can I use my hearing aids to listen to the TV? How do these hearing aids sound when listening to music?
Historically, even people with mild hearing losses have had difficulty with a phenomenon called feedback. What is feedback? Think about what happens when you hold a microphone too close to a speaker and you get a loud squeal. That’s feedback! All modern hearing aids have feedback control — but some are much better than others. Look for hearing aids that have great feedback control, as it will make your hearing aids more comfortable to wear and less noticeable to those around you.
Some questions to ask:
- What manufacturer has the best feedback control?
- Are you confident I won’t experience feedback?
- If my hearing gets any worse, will these hearing aids still work well and not produce feedback?
- Is feedback controlled by these hearing aids by just turning down the volume (bad) or does it have a feedback cancellation circuit (good)?
These types of features and questions are why it’s always recommended that you visit a licensed hearing professional when buying hearing aids. They have the knowledge and expertise you need to answer all your questions and ensure you get fit with hearing aids that are just right for you.
What can you do?
Hearing loss is a gradual and normal part of the ageing process. However, excessive noise is still the primary cause. Permanent hearing loss can occur almost instantly with unprotected exposure to certain sounds.
To protect yourself from noise:
- If the sound level at work exceeds 85dB, reduce the noise level or wear hearing protection.
- Lower the volume of your television, stereo and iPod. Take special care if you use headphones or earbuds.
- Be careful not to turn up your car stereo volume too loudly to compensate for noise from the engine or the wind.
- Wear custom noise filters or solid earplugs if you go to rock concerts or nightclubs, and don’t stand near loud speakers.
- Wear noise-cancelling headphones or solid earplugs if you use noisy equipment such as drills, lawnmowers, etc.
To avoid damage from foreign objects:
- Don’t use cotton swabs to clean your ears. Doing so may push wax down onto your eardrum and can increase the production of wax and/or damage the eardrum.
- Avoid washing with unclean water to prevent ear infections.
What are decibels?
Decibels (dB) measure the intensity of sound: from 0dB, which is the faintest sound the human ear can detect, to the noise of a rocket during launch, which can exceed 180dB.
Experts typically consider exposure to more than 85dB to be dangerous, which means things like motorcycles, headphones and lawnmowers have potential to lead to permanent hearing loss.
Myths about hearing loss are plentiful! Medical research has made living with health conditions easier, and recovering from them much more common. Yet, conditions regarding our senses, and particularly our hearing, still seem surrounded by myths. These myths hold back diagnosis and treatment, especially when a condition is thought to be inevitable or that nothing can be done.
“Myths can’t be translated as they did in their ancient soil. We can only find our own meaning in our own time,” said Margaret Atwood. How true this is! Because myths are normally based in fact. But old fact. Rooted in the past without change that comes when new information is learned.
According to “Healthy Hearing,” there are five myths people associate with hearing loss. They are:
- Hearing loss only impacts the elderly.
- Primary care doctors will diagnosis hearing loss.
- If hearing loss is only in one ear, then it’s not really hearing loss.
- Hearing aids will restore hearing to what it was before.
- There’s nothing that really can be done about hearing loss.
The best way to debunk a myth is with accurate information, so we look at these myths and provide what is known about them:
In fact, 5 out of every 1,000 babies born each year are born with hearing deficits. And, because of noise induced hearing loss, 16% of teens experience hearing loss. Surprisingly, to most, over 50% of people with hearing loss are under the age of 65. Hearing loss is not your grandparents’ concern – it’s everyone’s.
The Doctor’s Visit
Going to the doctor for that annual office visit, or even a sick visit might leave one with the false belief that any hearing loss will be picked up. Usually, that visit will start with the doctor looking into the patient’s ears. But hearing loss can’t be diagnosed, in most cases, by sight, even with an otoscope. Often, the doctor may not even question the patient about changes in hearing. Only 16% of physicians routinely screen for hearing loss, according to the Centre for Hearing and Communication. So, if patients are experiencing ringing in the ears, or a loss in hearing, they should be sure to mention this to their physician so further audiology tests can be ordered. A hearing care practitioner or audiologist has special equipment and testing methods that go beyond a cursory examination. The diagnosis and treatment of hearing loss is a medical specialty and a referral to a specialist is appropriate to ask for.
Losing the sense of hearing in one ear is not to be ignored. And no, the ears won’t “balance out.” Balance can be affected; vertigo can set in; people are more likely to fall or have other non-hearing complications. If hearing goes uncorrected (such as clearing out an acute buildup of wax) the ear – or the brain – can actually forget how to hear certain sounds. So, regular hearing tests and getting attention for any suspected hearing loss – in one or both ears – is mandatory to have hearing loss restored, if possible. If a hearing aid is needed, more than likely there will be two, and they will work together to amplify and direct sound.
Another myth is that hearing aids won’t help. According to the National Institute of Deafness and Other Disorders (NIDCD), “Hearing aids are primarily useful in improving the hearing and speech comprehension of people who have hearing loss that results from damage to the small sensory cells in the inner ear, called hair cells.”
As technology improves, hearing aids are making a dramatic difference in restoring this sense that effects so many parts of the body and quality of life. It is true that while most times hearing aids can increase hearing dramatically, they will not return hearing to its once perfect state.
Nothing Can Be Done
While hearing aids won’t restore, in most cases, perfect hearing, there is so much that can be done. The person experiencing hearing loss may not even need a hearing aid – it could be a medication adjustment, a medical condition, ear wax removal, or a structural situation that can be corrected with surgery.
Here are a few other other myths.
Hearing aids are grossly expensive. Not true – though the newer the technology and the smaller the hearing aid the more likely the price will be higher.
Shouting at someone who can’t hear well will help them hear you – not true. That often worsens the situation with sound become garbled and muffled. Louder is not necessarily clearer.
Hearing aids will make sounds too loud. Again, not true – while sounds might seem amplified due to long periods of not hearing well – soon you will adjust to hearing normally again.
And, finally, if someone has a hearing impairment, they’d certainly know about it. The fact is hearing loss is subtle and gradual, in most cases. Our bodies adapt to a new normal and only professional screening can determine if hearing loss is happening.
Perhaps the biggest misnomer is that “mild” hearing loss has a “mild” impact on the person. According to AudiologyOnline.com, “Mild hearing losses do not have mild consequences. A consequence of mild hearing loss is reduced audibility resulting in reduced speech intelligibility in general, but especially in noise and over distance. Another consequence is increased listening fatigue with the risk of affecting social life.”