#HearingLoss

Treat the Patient, Not the Audiogram

Katherine Bouton Audiology , ,

In an effort to provide better hearing health-care, the prestigious National Academies of Sciences, Engineering, and Medicine convened a three-day meeting recently. The academy had appointed a committee of 14 hearing professionals, and invited a panel of six patients to testify about their own experiences.

Your audiologist is your most important partner in hearing healthcare.

The committee’s mandate is to examine “hearing interventions” in adults, and to establish ways to better measure the results of those interventions. “Interventions” are primarily hearing aids, but the study will also assess the efficacy of assistive devices, auditory rehabilitation, and apps that can aid communication. (Cochlear implants are not part of their study.) The committee will use this information to develop recommendations on how to evaluate outcomes of heaing healthcare, and strategies to develop and adopt new measures. NASEM hopes to publish results in April 2025. Both patients and audiologists are expected to benefit.

In the initial session, which was open to the public, the patient panel, which I was part of, was invited to talk about what works for them when it comes to hearing interventions, and what doesn’t. All of us were veteran hearing-aid users, and, coincidentally, all active in HLAA. We introduced ourselves and talked about our hearing loss and our experiences with treatment. Inevitably, audiologists were the primary focus.

Audiologists are our most important partners in coping with hearing loss. Many of us have spent years with the same audiologist, getting our hearing tested and retested, upgrading our devices, dealing with technological issues. I’ve been with my current audiologist since 2008, which is a lot longer than many marriages. She’s invaluable, but she’s also very busy, like most audiologists. The NASEM study may help to streamline audiologic care.

The impact of hearing loss on everyday life. We all referred in one way or another to the impact hearing loss had on our work life. Some of us took early retirement because we could no longer manage in the workplace. For some jobs, no existing accommodations would have changed that outcome. Just one person on the panel was still actively in the workplace, and she had altered her work significantly because of her loss. Several panel members said they had not disclosed their hearing loss in the workplace, one adding that she could “never have achieved my potential in a business setting” if she had. Hearing loss impacts on personal life were also noted.

The essential role of assistive devices. All of us use captioning apps and assistive listening devices. Most of us learned about these supplements to hearing aids through informal channels like HLAA meetings and blogs. Audiologists rarely discuss apps and ALDs, including hearing loops, and many still do not activate a telecoil in new hearing aids, which would allow users to take advantage of hearing loops or other systems when they’re available.

Refer patients to support groups, books on hearing loss, and blogs. It’s understandable that audiologists may not have time to supply information like that in the previous paragraph. But why not have a fact sheet for every new patient, with information about groups like HLAA and ALDA, about auditory rehabilitation, about speech reading, as well as a list of devices, apps, and assistive listening systems. Hearing as well as possible often requires more than a hearing aid.

The audiogram vs real-life hearing. We agreed that what sounds fine in an audiologist’s quiet office is often inadequate in the real world. Treat the patient, not the audiogram. Several panelists said their audiologists had never asked them about their lives and their hearing needs. One commented that hearing loss per se is only the tip of the iceberg. Communication should be the overriding goal. For many, hearing aids alone won’t get you to that goal, and audiologists need to understand what other assistance we might benefit from.

The financial impact of hearing loss. In addition to leaving the workplace, with the consequent reduction in income, panelists agreed that hearing loss is financially punitive in other ways as well, primarily because of the high cost of hearing aids and the lack of adequate insurance coverage.

Encourage the patient to be more proactive. No matter how good your audiologist is, the patient’s input is essential. Several panelists said that if they could fine tune their hearing aids themselves, that might work better for them. It’s already possible to choose specific environmental settings and we agreed we’d like to take this a step further. One panelist suggested that an assessment of auditory processing would help an audiologist help a patient in real-world functioning.

The social/emotional aspect of hearing loss. One panelist put it eloquently: “We know that as we develop hearing loss, whether it be sudden or gradual over time, we begin to feel diminished. Suddenly, I have to ask people to repeat themselves. Suddenly, I’m the lesser person in a group. I’m the one who is disabled or differently abled.” This patient was experienced and knew how to advocate for himself. “I knew what I needed to do to enable myself to hear,” he said. “Even so, after you repeat yourself – What?  Can you say that again? Tell me what you just said? — after you do that for so long, you just sort of throw in the towel. I’m a good advocate for my hearing, but I understand what people are going through. The social-emotional piece is rarely addressed by audiologists” despite the outsize impact it has on our lives.”

The meeting was on Zoom and was recorded. You can watch it here. You can also submit your own comments for the committee’s consideration.

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For more about hearing loss, read my books: “Shouting Won’t Help,” “Living Better with Hearing Loss,”and “Smart Hearing,” available at Amazon.com.

Excellent, Positive Article on Hearing Loss!

Katherine Bouton Healthy Hearing

Thanks to reporter Neelam Bohra and The New York Times for this informative and upbeat article on hearing loss.

“Hearing Aids are Changing. Their Users are Too.”

Zina Jawadi, pictured, is on HLAA’s National Board of Directors.

Let’s spread this far and wide.

If you can’t read the article because it’s behind a paywall, put a note in the comments and I’ll copy/paste for you.

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And don’t forget to read my books: Shouting Won’t Help and Smart Hearing.

The Sounds of Spring, with Soundtrack

Katherine Bouton Healthy Hearing

It’s spring. There’s so much to hear! And it gets louder and louder over the coming months.

Photo by Pixabay on Pexels.com

In early spring, the stream I walk along is full of ice-melt and cascades down the rocky gulley that is frozen in winter and dry in midsummer, roaring now like ocean waves.

The cardinals, with their winter “cheer, cheer, cheer,” are joined by early spring arrivals with their songs, from the dulcet coo-coo of a mourning dove to the shriek of a blue jay. In a few weeks the migratory birds heading north and those who settle here for the summer will bring new songs. If we’re lucky, the glorious rose-breasted grosbeak will stop by, its sound as beautiful as its appearance. A mocking bird can almost drive you crazy with its seemingly endless serenade. The rat-a-tat-tat of woodpeckers varies by their size and the wood they’re tapping.

Later in the season, insects provide a steady soundtrack – katydids, the whine of mosquitoes, the buzzing of bees, cicadas, crickets, grasshoppers, sometimes loud enough to drown out bird song. On late summer afternoons, before the riotous insect noise starts, you can hear the wings of hummingbirds.

The mammals are noisy too. The noisiest is the common gray squirrel, which has an impressive vocabulary, both oral and signed: “kuks, quaas, moans, twitches, and flags among them,” as an article in Wired (soundtrack included) called them.

Even the frogs are noisy. One of the loudest noises in early spring are the peepers. They’re not baby frogs, as you might think from their high pitch, but robust male tree frogs trying to allure potential mates.

I was prompted to think about the how noise heralds spring after a long, mostly silent icy winter by a lovely new book by biologist David George Haskell: “Sounds Wild and Unbroken: Sonic Marvels, Evolution’s Creativity, and the Crisis of Sensory Extinction.”

Haskell writes in an early chapter, “Sensory Bargains and Biases,” about his own progressive hearing loss. But he quickly moves on to the sounds of his title: the sounds we hear, the sounds we are endangering (by environmental carelessness), and the sounds we don’t hear: “We are … surrounded by sounds inaccessible to our unaided ears, each one tuned to its environment. Our senses live confined in a small part of the whole.” For those with hearing loss, it’s sometimes an even smaller part.

Another new book on the wonders and threats to nature is “The Sound of the Sea: Seashells and the Fate of the Oceans,” by Cynthia Barnett. It’s more a natural history of seashells and what we can learn from them than a book about sound. But one anecdote corrects some popular myths about conch shells. Contrary to the beliefs of wishful shell collectors, they neither reflect the sound of the ocean where they originated nor foretell storms; nor do they magnify the sound of our own blood. What spiral conch, welk and India’s sacred chanc shells do instead is act as perfect resonating chambers, amplifying ambient noise.

A London design studio had the brilliant idea to use bird song as a way to raise consciousness about hearing loss. Their app called “Hearing Bird Song” is an immersive experience that allows you to screen your own hearing. Users listen to recorded bird calls. Based on how well they hear them, by the app’s measures, they may find that they need to have their hearing checked more formally. Here’s an article on the app from Hearing Health and Technology Matters.

David Haskell has made a soundtrack to accompany his book. You can find it here. Even if you don’t hear well, you can adjust the volume. There are 22 tracks, from all over the world. Some are astonishing, and all are fun to listen to. “Five White Crowned Sparrows” (11 seconds) reminded me of one of my early hearing experiences after getting a cochlear implant in 2009. I had a hard time initially adjusting to the implant but one early spring day I was walking in Riverside Park in New York when I heard a cacophony coming from a nearby bush. It was full of sparrows, making a spectacular clamor.

Put in your hearing aids and enjoy the sounds of spring.

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For more about living with hearing loss, read my books “Smart Hearing: Strategies, Skills and Resources for Living Better With Hearing Loss” and “Shouting Won’t Help: Why I and 50 Million Other Americans Can’t Hear You.” Both are available as ebook and paperback on Amazon.com.

What does new drug for Alzheimer’s have to do with hearing loss?

Katherine Bouton cognitive decline, dementia

What does last week’s approval of a new drug for Alzheimer’s have to do with hearing loss? Nothing, according to the articles and commentary that I read about the drug. Hearing loss was not mentioned in a single news story or commentary.

The drug, brand-name Aduhelm, is the first new treatment for Alzheimer’s in 18 years. The FDA’s decision to approve the drug was made despite opposition from the agency’s independent advisory committee, which said that the evidence raised significant doubts about whether the drug is effective, and noted the risk of serious side effects, including swelling and bleeding in the brain.

Biogen set a list price of $56,000 a year per patient. Very few patients will end up paying that amount, but their insurance companies might. Medicare has not yet said whether it will cover the drug. The insurer Cigna said that beyond the cost of the medicine itself, diagnostic care and safety monitoring will cost another $30,000 a year.

Medicare won’t pay for your $3000 hearing aids, but should you develop signs of Alzheimer’s, it seems likely that it will kick in the $56,000 to treat you with Aduhelm.

The new drug was approved without evidence that it slows symptoms of Alzheimer’s. But it does reduce levels of amyloid, which forms a plaque in the brain, and which is thought to cause symptoms. For a fuller discussion of the new drug and the controversies around it, this New York Times article is excellent. F.D.A. Approves Alzheimer’s Drug Despite Fierce Debate Over Whether It Works.

So what does this have to do with hearing loss? In 2011 an epidemiological study by Frank Lin of Johns Hopkins School of Medicine and others found a strong association between hearing loss and dementia, including Alzheimer’s. The greater the degree of hearing loss, the earlier the onset and severity of the dementia. These findings do not suggest that hearing loss causes dementia, although that could turn out to be the case.

Lin and others are conducting a long-term study to see whether the use of hearing aids or other devices mitigate the risk. If their study shows that hearing aids do help delay the onset of dementia, or lessen its severity, many people with hearing loss will be relieved. But that has not yet been definitively proved.

A smaller study, published in 2015, did find some evidence that hearing aids could help, but not why. The researchers suggested that because hearing loss can cause depression and social isolation, which then affect brain health, the use of hearing devices helps offset those other conditions, and thus slows dementia. You can read more about this study in an article I wrote for AARP online. 

The FDA’s approval of a controversial and expensive drug for Alzheimer’s struck some with hearing loss as sadly ironic. Medicare famously does not cover hearing aids, which are expensive and out of range for many users. A typical brand-name hearing aid costs about $3000, and most people need two. But $6000 sounds cheap compared to the cost of Aduhelm.

In 2020, a study by Columbia researcher Justin Golub and others found that even subclinical hearing loss is associated with cognitive decline. Normal adult hearing is defined as the ability to hear at 25 decibels or less. Golub’s paper found that hearing levels below 25 dB were also associated with cognitive decline. The authors wrote that the findings “suggest that the association between hearing loss and impaired cognition may be present at earlier levels of hearing loss than previously recognized; the current 25-dB threshold for defining adult hearing loss may be too high.”

We may find in the next few years that treating hearing loss can help offset dementia. That would be welcome news. But without affordable hearing aids and hearing care, widespread treatment is unlikely to happen. Medicare won’t pay for your $3000 hearing aids, but should you develop signs of Alzheimer’s, it seems likely that it will kick in the $56,000 to treat you with Aduhelm.

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For more about living with hearing loss, read my books “Smart Hearing: Strategies, Skills and Resources for Living Better With Hearing Loss” and “Shouting Won’t Help: Why I and 50 Million Other Americans Can’t Hear You.” Both are available as ebook and paperback on Amazon.com.

One Step Closer to Prevention of Hereditary Hearing Loss

Katherine Bouton Genetic hearing loss, Healthy Hearing, Hereditary hearing loss

Almost half of all hearing loss has an underlying genetic cause. Late-onset hearing loss, which occurs after the acquisition of speech, may appear in generation after generation, often progressing to a severe or even profound loss. Or it may skip generations, passing the faulty gene along to unsuspecting offspring.

Those affected, even if they were aware that they might eventually lose their hearing,  are usually part of the hearing world and do not know sign language. The loss may be severe enough to be disabling, even with sophisticated hearing technology. Preventing this loss, even when anticipated, has not been possible.

On December 20th, researchers at the Broad Institute of MIT and Harvard and the Howard Hughes Medical Institute published a study in the prestigious journal “Nature” that holds promise for prevention of hereditary loss.

Why do we care about a study on mice? Mice, like all mammals including humans, cannot regrow damaged hair cells. If prevention works on mice, it may work on other mammals. Mice are also the test subject for studies on regeneration of hair cells, which would allow a reversal of hearing loss.

The mutant gene, whimsically called Beethoven by researchers, is found in the hair cells of the inner ear. Because the gene is dominant, it takes only one to cause damage. That also means it may exist alongside a healthy copy of the gene. One of the challenges for researchers was to find a way to target just the mutated gene without disrupting the normal copy.

The technique the researchers used, called CRISPR, is a gene editing technique that the journal “Science” cited as the 2015 Breakthrough of the Year. I won’t try to explain the technique (or even the acronym) but here’s a link to a reader-friendly  article in the L.A. Times that laid out the technique – and its potential dangers.

What distinguished the new study, according to the scientists, is that this is the first time a genome-editing protein has been ferried directly into the relevant cells to halt progression of genetic hearing loss.

Direct delivery of the protein allows “exquisite DNA specificity,” according to the press release. The specificity is needed to selectively disrupt the pathogenic copy of the gene without disrupting the normal copy.

Since this type of genetic hearing loss generally manifests as late onset, it would allow researchers to test suspected carriers of the defective gene (the Tmc1 gene) and to treat carriers. As co-senior author Zheng-Yi Chen, associate professor at Massachusetts Eye and Ear said, the later onset allows “a precious time window for intervention.”

The subjects of the study were 100 Beethoven-model mice carrying one copy of the defective gene and one normal copy. Untreated, the mice began to show hearing loss at four weeks, and by eight weeks were profoundly deaf (as measured by auditory brain-stem response). The treated mice, in comparison, responded to sound at about 65 decibels, the level of normal human speech.

Peter Barr-Gillespie, a sensory biologist at Oregon Health and Science University who was not involved in the study, praised it (in the “New Scientist”) as a “pretty significant piece of work.”  He noted, however, that the decibel level at which the treated mice could hear was relatively loud compared to the hearing threshold in wild mice, which is 30 to 40 decibels. “It’s nowhere near the threshold of the wild-type mice, [but] the 10-15 decibels could make a huge difference in humans,” he said. “That sort of loss of hearing is very noticeable in people and could make for substantial improvements in quality of life.”

As always with gene editing, one concern is possible undesirable changes in the DNA. Senior co-author David Liu said the researchers had not observed “any off-target editing in the animal.” In the specific cells treated, they found only one modification, in an area not known to play a role in hearing. One major concern, however, would be the potential to develop cancer. Stephen Tsang, a clinical geneticist at Columbia, praised the study as “good for basic research“ (in “Axios”) but, like others, noted that there are many more steps to prove it safe and effective for humans.

This study showed that gene editing prevented, rather than reversed, hearing loss in mice. But for those affected by genetic hearing loss, it’s a promising step. “A lot of additional work is needed before this strategy might inform the development of a therapy for humans,” co-senior author David Liu said, “but at this stage, we’re delighted and excited that the treatment preserved some hearing in the animal model.”

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For more information on living with hearing loss, see my books on Amazon.com.

 

 

 

 

 

Let’s Make Hearing Loss a Visible Disability

Katherine Bouton Healthy Hearing, Hearing Loss as a Disability , ,

Hearing loss is often referred to as an invisible disability, because there are no telltale markers — no wheelchair, no white cane. It’s invisible even compared to Deafness, with its vibrant silent language.

IMG_2787 2
NYPD Officer Daniel Carione and his attorney, Colleen Meenan, who successfully sued for the right to wear hearing aids.

For a long time, people with hearing loss wanted to keep it invisible. They wanted hearing aids no one could see, they pretended they could hear when they couldn’t. Even today hearing aid companies advertise: “So small no one will ever know you’re wearing them.” Hearing loss is for old people, or damaged people, and our culture values youth and health.

But as more and more of us use hearing aids – both because we are getting older and because we live in a noisy society – we want accommodations. We want captions on our TV’s and in movie theaters, we want hearing assistive devices that work in lectures and live theater. (The hearing assistive device that works best in large venues is the induction loop, hands down.) We want to be able to hear – even if it means “hearing” through captions – in an emergency room or hospital, in a courthouse, at a town hall meeting, at a house of worship, at a lecture, on an airplane, at a political rally, on public transportation.

We want to be able to work, and we want the accommodations that make that possible.

Hearing loss is a disability that prevents us from participating in corporate, municipal, religious, cultural, and educational life — unless accommodations are provided. Accommodations insure equal access.

We are guaranteed accommodations under the Americans with Disabilities Act. But if we want to claim those accommodations, we need to acknowledge not only that we have hearing loss but that it is a disability. (That’s the name of the act, after all.)

This notion was reinforced by the speaker at our HLAA-NYC chapter meeting last week. Dan Carione, a New York City police offer with an illustrious 28-year career, was forced to retire in 2011 when the NYPD decided officers could not wear hearing aids. He fought that ruling and won. (You can read about his four-year fight in an article published by Hearing Loss Magazine, or in a New York Times Op-Ed.)  But before he had any legal ground to stand on, he had to make an important admission to himself.

“The Americans with Disabilities Act is not this heroic shield that falls from the sky and protects each and every person who may or may not be disabled,” he said. “You have to be disabled.  That was very difficult for me to accept.”

Dan Carione does not look disabled. He was – and is – a powerful physical and intellectual presence. To use the word disabled about himself defied the visible reality.  “God bless Colleen [his attorney Colleen Meenan],” he said. “One of the first things she taught me was to use the word disabled.  It’s counter-intuitive.  Counter-intuitive, it hit me in the head like a dart because I didn’t want to use the word disabled.  But if you’re not disabled, the ADA can’t protect you.”

So if we want access equal to the access that hearing people have, we have to be open about our hearing loss. We have to acknowledge that it is a disability. That does not mean it’s disabling – it’s only disabling if we are denied the accommodations that make us equal.

For more information on living with hearing loss, see my books on Amazon.com.

No Wheelchair Ramp for the Deaf

Katherine Bouton Healthy Hearing , , , ,

Getting hearing access for those who are deaf or hard of hearing is a little more complicated.

No Wheelchair for the Deaf

One accommodation for the hard of hearing is an American Sign Language interpreter. But only a small minority of those who need it, use it. — Getty Images

 

 

Trying to get accommodations for those of us who are hard of hearing or deaf can be a long, tough slog.

Two years ago, the U.S. Equal Employment Opportunity Commission (EEOC) filed a lawsuit against shipping giant FedEx Ground, charging it with discriminating against its deaf and hard-of-hearing employees and job applicants for years.

The EEOC alleged that the company violated federal law by failing to provide needed accommodations, such as closed-caption training videos, scanners that vibrate instead of beep, flashing safety lights and American Sign Language (ASL) interpretation.

FedEx filed a motion to dismiss the suit, but this year a federal judge denied the motion. The case is still under litigation.

All of which brings me to the sticky issue of accommodations — namely, that no one type works for all. There is no wheelchair ramp equivalent when it comes to hearing loss.

Although the FedEx case involves the specific needs of a particular workplace, the problems of hearing access challenge all of us and make asking for hearing access — even for something as simple as a better-equipped lecture hall — complicated. Which access do you ask for?

One accommodation that is routinely offered is an ASL interpreter. The problem is that only a small minority of those with hearing loss (less than 5 percent) use ASL. It’s no more helpful to most than an interpreter speaking Hungarian would be.

Among the most widely used accommodations, found in theaters, houses of worship and public gathering places, are infrared or FM headsets. The person with hearing loss borrows a headset from the venue. Sound, which travels through the regular sound system and then wirelessly to the headset, is amplified. Sometimes these systems work well. More often they are helpful to those with milder losses but not for anyone else. They also work only as well as the microphone. It the microphone is badly positioned, the headsets won’t deliver clear sound.

The technology that gets people most excited is induction looping. (Here’s a short video about it.) This, too, works through the venue’s regular sound system, and the sound quality is often excellent. It consists of a wire run around the perimeter of a room that transmits a signal, again wirelessly, to the audience member’s own hearing aid or cochlear implant, set to the telecoil setting. If a hearing aid does not have a telecoil, or the user doesn’t have hearing aids, headsets similar to those used for FM devices can be worn. Sometimes hearing people use them, just to hear better.

For some, the best option is captioning. This can be open captioning on a shared screen, similar to the captions on your television or subtitles on a movie. Or it can be closed captioning, sent to your personal device (an iPhone or iPad) or one provided by a theater. Generally this kind of captioning, called CART, which I described in some detail a few months ago, is live.

Scripts can also be scanned or typed into a new device being tested by Globetitles. It sends prescreened captions to personal devices, including computer and television screens, tablets and smartphones. The captions appear as red type on a black background, so they don’t bother others. You can see a sample by clicking on the Globetitles link.

Unfortunately, no single system fits all needs. Some think captioning serves the largest number of people. Others like looping because you don’t have to do anything except change the program on your hearing aid. Live captioning could be adapted to the kind of Sony glasses used in Regal Cinemas, or something like Google Glass could put captions right before your eyes.

Most venues will probably continue to offer one form of listening assistance (or none). But if that assistance does not serve a person with a hearing disability when another type of assistance would, that person can bring a lawsuit under the ADA.

As Lise Hamlin, the Hearing Loss of America Association’s director of public policy and state development, emailed me in a discussion about accessibility: “You might be able to make a case for both a listening system and captioning under the ADA. The relevant phrase is ‘effective communication.’ The key is providing effective communication to each person who needs it. If even one person is denied effective communication, they can file a claim.”

Most of us don’t want to get involved in a lengthy lawsuit — we just want to understand the play or the sermon or the mayor’s announcement or the community meeting or the visiting candidate. Is that so much to ask?

This post first appeared on AARP Health on August 10, 2016.

Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 5o Million Other Americans — Can’t Hear You”. Both available on Amazon.com.

 

Relief from the High Cost of Hearing Aids?

Katherine Bouton Healthy Hearing, Hearing Aids ,

Last month the prestigious National Academies of Sciences, Engineering and Medicine issued a report with a series of recommendations that, if adopted, could revolutionize the way consumers receive and pay for hearing health care in the United States.images

Unfortunately, this report was not widely covered in the mainstream press, and although I wrote about this at the time, I’m also addressing it here, for those who may have missed this important development.

About 30 million Americans have hearing loss, but 67 to 86 percent of those who could benefit from hearing aids do not use them. The report called hearing loss “a significant public-health concern.” It is of course also of significant personal concern for those with hearing loss.

The June 2 report by the Committee on Accessible and Affordable Hearing Health Care for Adults represented input from experts in hearing research, public health, geriatrics and audiology, as well as from industry and consumer groups.

Consumers hope the recommendations will ultimately result in relief from the high cost of hearing aids, little insurance coverage and the limited availability of hearing professionals.

The committee listed 12 recommendations, but here are the four I consider most important.

  • Make buying a hearing aid easier by removing the Food and Drug Administration’s regulation requiring a medical evaluation or a waiver before a hearing aid can be purchased.

    It’s not difficult for consumers to waive the medical evaluation, but many people feel they are required to see a doctor before buying a hearing aid. This is a stumbling block for many. As the report pointed out, the only time a medical visit is essential is if you display “red flag” conditions, including sudden or rapidly progressing hearing loss within the previous 90 days, acute or chronic dizziness, pain or discomfort in the ear, or a visible ear deformity.

  • Promote hearing screening in wellness and medical visits.

    Most primary care doctors do not conduct even a cursory screening for hearing loss, even among the elderly. Failure to recognize hearing loss can be a threat to quality health care. A patient may not hear the doctor clearly, for instance.

  • Make lower-cost, over-the-counter hearing devices more widely available by implementing a new FDA category for them.

    This refers to personal sound amplification products, or PSAPs, and other less costly over-the-counter hearing devices.

  • Improve the compatibility of hearing technologies with other communications systems.

    This refers not only to compatibility of hearing aids with other hearing assistive devices and technologies, but also to developing “open platform” hearing aid programming. This would allow health care professionals — or, eventually, the device owner — to be able to program the settings on any device from any manufacturer, which is currently not the case.

In many ways, the report echoes the highly critical findings of a White House advisory group’s report last October. The group, as reported in the New York Times , said that industry concentration and overregulation meant that hearing aids had “not experienced the dramatic reductions in price and increases in features that have been routinely seen across consumer electronics.”

“When compared in complexity to today’s smartphones costing a few hundred dollars each,” the report said, “even premium-model hearing aids are simple devices but can cost several thousand dollars.”

The response to the White House report, as well as to these new recommendations, has varied widely among industry, consumer and health care groups — “hailed by some groups and denounced by others,” noted audiologist Barbara Weinstein, writing on the website Hearing Health & Technology Matters.

But she urged all parties to work toward common goals. “It is a win-win for all stakeholders to close the gap between the proportion of persons with untreated age-related hearing loss and the proportion of those who enjoy a measurably high quality of life as the result of hearing health care interventions purchased through audiologists.

“We are part of the problem and part of the solution. Let’s change that balance and remain essential,” she said.

One group supporting the recommendations was the Hearing Loss Association of America HLAA, the largest consumer group in the United States representing people with hearing loss. You can read HLAA’s statement here.  Many of the recommendations in the report echo earlier HLAA policy recommendations.

You can read a summary of the report here. The full report — “Hearing Health Care for Adults: Priorities for Improving Access and Affordability” — is available from the National Academies Press online or by calling 202-334-3313 or 800-624-6242.

Click on the link to read.  New Report Pushes for Cheaper, Easier Hearing Aids.

 

This post first appeared on AARP Health, June 10, 2016

Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You”. Both available on Amazon.com.

 

 

 

Would You Ask for Help With Hearing Problems at Work?

Katherine Bouton Uncategorized , , , , , ,
Accommodations for Hearing Loss at Work Dealing with the stigma of both hearing loss and aging at work can keep some employees from asking for accommodations — Thomas Barwick/Getty Images

Older workers with hearing problems face a double whammy: They’re dealing with the stigma not only of hearing loss but also of age. If they ask for accommodations on the job for hearing loss, they fear attention will be drawn to their age as well.

The Americans with Disabilities Act protects the rights of workers to ask for accommodations at work to help them hear more easily. However, research out of Oregon State University has found that older workers are less likely to feel there’s support for them to ask for that kind of help, because of worries they’ll be perceived as old by coworkers and managers.

Other research has shown that people with disabilitiesrefrain from requesting accommodations if they think coworkers would find the request “normatively inappropriate” — meaning not in keeping with the office culture. For instance, an office environment with a focus on maximizing profits like that in The Big Short or The Social Network is perceived as being much less likely to understand and tolerate a disability than would a nonprofit that prides itself on a more inclusive culture.

Research by David C. Baldridge and Michele L. Swift of Oregon State University’s College of Business, published in the journal Human Resources Management, studied the effect of age on such requests. Workers’ fear of seeming old, they found, may trump their fear of seeming to have a disability. Their findings were based on an email survey of 242 workers ages 18 to 69. Most had moderate to severe hearing loss.

Age itself has a negative stereotype in many workplaces, including the perception of “lower productivity, resistance to change, reduced ability to learn, and greater cost,” the authors wrote. “These stereotypes are often associated with fewer promotions, less training, lower performance ratings, and lower retention.”

But add disability to age and the stereotypes multiply. The older the person with a disability, the more likely they are to fear that others will attribute the request not to the disability, but to their age.

“Simply put,” the authors wrote, “people with disabilities appear to face a straightforward yet troubling question, ‘If I ask for a needed accommodation, will I be better or worse off?'”

In their discussion, the researchers advised managers and human resources personnel to realize that while many older employees may be eligible for and would benefit from disability accommodation, “these employees might also be particularly reluctant to make requests,” especially if they work in for-profit organizations or if the organization appears not to have others with disabilities.

When the disability is hearing loss, managers should make sure telephones have adjustable volume (and, I would add, be telecoil compatible). Large meetings should routinely include open captioning, which can also help employees with normal hearing follow what’s being said.

In an email interview, Baldridge said managers should think about the inclusion of persons with disabilities as “a normal aspect of diversity management.”

As the workforce ages, disability increases. The Bureau of Labor Statistics reports that about 26 percent of those ages 65 to 74 are in the workforce, and the majority are full-time workers. It’s in a company’s interest to have employees working at full capacity. If people are reluctant to ask for accommodations for a disability, their output and effectiveness are likely to suffer.

Please share your workplace experiences in the “reply” section below.

For more information about David Baldridge’s studies of disability and the workplace, email him at David.Baldridge@bus.oregonstate.edu.

For suggestions on workplace accommodations for hearing loss see HLAA’s Employment Toolkit. 

 

This post first appeared on AARP Health on June 3, 2016

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Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You”. Both available on Amazon.com.

Dogs, Debates and Doorbells

Katherine Bouton service dogs, Uncategorized , , ,

My dog is trained to respond to the doorbell when it rings. During last night’s Republican debate, the candidates repeatedly went over their tiIMG_0834me limit.

The timer signal sounded just like our doorbell.

Thus he barked through most of the debate, no doubt also agitated by the shouting and buffoonery on stage.

He looks kind of presidential, don’t you think?

For information about trained service dogs for the deaf and heard of hearing, go to Canine Companions for Independence.