Sound familiar? The Journal of the American Medical Association reports that age-related hearing loss is the third most prevalent chronic condition in seniors. Between 25 and 40 percent of people 65 years or older are hearing impaired.
Yet, many of them resist getting hearing aids. “There’s a stigma surrounding hearing aids—that they’re bulky, stick out and make people look old,” says Dr. Andrew Chuma of Chester County Otolaryngology and Allergy Associates in Kennett Square. “But new technology has made a wide variety of hearing aids possible—many of which sit in the ear or just behind it and are almost invisible.”
Chuma knows this first-hand. Born with otosclerosis, he wears a hearing aid. “Mine sits behind the ear; there’s a thin wire that leads to my ear drum, which is almost invisible,” says Chuma.
Often, people don’t realize the severity of their impairment. “It’s a gradual loss and the brain compensates for it,” Chuma says. “People turn up the volume on TVs or telephones. The brain signals other senses—especially vision—to help. Most people begin to lip read without realizing it.”
Presbycusis is the medical term for age-related hearing loss, and it’s a problem of degenerating cells. “There are minuscule hair cells in the ear that catch sound waves, evaluate them and send that information to the brain,” says Dr. Richard Herman of Otolaryngology Plastic Surgery Associates, with offices in Doylestown, Lansdale and Sellersville. “The degeneration of those hair cells causes the loss in auditory processing.”
And it’s not just an inconvenience. Presbycusis is more serious than many people realize, because it has far-reaching implications. “Over time and left untreated, it becomes a communication disorder,” Herman says. “The ability to hear high frequencies—doorbells, the phone, etc.—is usually the first to go. Then, presbycusis takes away the ability to hear letters and sounds at certain frequencies. People can’t hear some of what’s said within words and sentences; the brain loses the ability to discriminate between those sounds and process them.”
When caught and treated early, presbycusis can be halted and sometimes reversed. With time and the right hearing aids, the brain might even relearn to distinguish sounds. “It could take months or years to recover, and if the loss is too severe, it might not happen,” says Chuma. “But it is possible for the brain to retrain itself to hear sounds. That’s only possible if the hearing aid is worn all the time so the brain hears background noise, complex sentences and the rest of the sound in the world. And, of course, the right hearing aid is required.”
That’s where Dr. Barbara Madden comes in. “There’s so much we can do to help people improve the quality of their lives if we see them early enough,” she says Madden.
A doctor of audiology at the Audiology and Hearing Aid Center of Riddle Hospital, Madden has patients go into a soundproof room, where she tests their hearing for two things: frequency and decibel level. “The whole session lasts an hour, which breaks down to 20 minutes getting a case history, 20 minutes of testing and 20 minutes of discussing options,” she says. “There are no electrodes, no injections, no pain.”
Once the level of hearing loss has been diagnosed, audiologists find the right hearing aid for the patient—and there are many brands and options. “The technology is really astounding,” says Madden. “We have aids with Bluetooth, aids that fit right inside the ear and are invisible, and on and on.”
Madden advises people to go to an audiologist—not a retail store offering a free hearing test. “An audiologist will provide an independent assessment of which products from which manufacturers are best for the patient,” she says. The other factor is comfort. I went through several kinds of aids before I settled on the one I have,” says Chuma. “An audiologist will be able to provide options, then tweaks and updates.”
Hearing aids start at about $1,000 an ear, topping out at more than $2,500. They usually need to be replaced every five to seven years. Manufacturers continually update their technology and introduce new models, then stop making replacement parts for older ones.
Hearing aids to alleviate presbycusis aren’t covered by most health-insurance plans, Medicaid or Medicare. But reimbursements are offered by the U.S. Department of Veterans Affairs, the Federal Employees Health Benefits Program and some teachers’ unions. “I wish that more people would investigate hearing aids,” says Herman. “They vastly improve quality of life.”