Scare Tactics: Benefit or Backfire?

Like many others, I’ve written repeatedly about the negative health consequences of hearing loss. These include a greater risk of falls, depression and isolation, and earlier and more severe cognitive decline. A recent study even linked hearing loss to earlier death.

I write about these in part because they are news, the results of solid epidemiological studies. But I also write about them to encourage people to treat their hearing loss.

It’s a way of getting people to face facts. It’s also scare tactic.

Is it working? Hearing aid sales seem to be on the rise , but overall numbers remain low, and some say stressing the scary consequences of untreated hearing loss is not the best tactic.

Recently, Julie Olson, a past president of the Hearing Loss Association of America (HLAA), addressed this question in comments to the Ida Institute, a think tank on issues about hearing loss. These recent studies on dementia, falling and now death, she wrote, “add to the stigma problem. They frighten people into further denial of the problem and prevent many from seeking help.”

She wishes there were more emphasis on the “success stories” of how hearing devices improved a person’s life.

I wish that I could say definitively that treating hearing loss will help offset or mitigate cognitive decline and falls, but more research is needed.

A French study last year found a correlation between the use of hearing aids and reduced cognitive decline. An earlier French study found a reversal of cognitive decline in people with cochlear implants who also received intensive rehabilitative therapy. But these were relatively small studies. Further research — such as a proposed large study to be led by hearing expert Frank Lin, M.D., of Johns Hopkins University — may tell us more.

Common sense tells us that treating hearing loss will encourage socialization and thus help fend off depression and isolation. Depression and isolation are known risk factors for cognitive decline. It also makes sense that hearing more easily and clearly (with hearing aids) will ease the cognitive load that comes with expending disproportionate effort to hear. As for balance, better hearing may allow us to take in our surroundings more easily and avoid falling. Physical fitness and balance training may help, too.

Jan Blustein, M.D., professor of health policy and medicine at New York University, and a fellow board member of HLAA, said to me, “As a person with hearing loss, I understand concerns about stigma.” But, she added, “It’s complicated. Much of the evidence on hearing loss and cognitive decline is correlational — so we don’t know whether the hearing loss causes the problem [falls, hospitalizations, faster cognitive decline], or whether other factors are at play. We’re working toward better knowledge about the consequences of treated versus untreated hearing loss.”

Whether treating loss helps offset these conditions is the big question, of course. But there are much better and more immediate reasons to treat your hearing loss.

I wear a hearing aid not because I’m worried about possible dementia in the future but so I can hear better right now.

I wear a hearing aid so that I can understand what people say to me, so that I can hear birds chirping and leaves rustling, so that I can ask for directions and understand the answer.

I also wear a hearing aid so that I can continue to be an active, involved member of my family, my social groups, the world.

If wearing a hearing aid helps offset dementia, all the better. But I wear one for the benefits I get right now, every day.

 

21 thoughts on “Scare Tactics: Benefit or Backfire?

  1. Well said, Katherine! I wear hearing aids to stay connected to my communities
    and communicate in a hearing world. I have a profound hearing loss, have been
    wearing aids for 45+ years and am grateful for what they continue to do for me.

    Liked by 1 person

  2. wHAT ABOUT PEOPLE WHO ARE LATE DEAFENED – THAT CAN’T BE HELPED BY A HEAR AID. sTUDIES SEEM TO RELATE TO THE HARD OF HEARING, HAVE SEEN VERY LITTLE ON LATE DEAFENED. Would be very interested to know how both HOH and deaf people deal with dementia. And how does staff deal with their hearing issues?

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    • Cochlear implants are increasingly available to people who can’t benefit from hearing aids. The studies I refer to in this post are mostly late-deafened. They are not about the Culturally Deaf, who do communicate. The problem is isolation, depression, cognitive load. These can all be helped by Cochlear implants.

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  3. August 1977. A failed stapendectomy surgery left me completely deaf in my right ear. In later years, I learned antibiotics are what caused the massive hearing damage in the other ear. I was told my right ear was dead and said the day the paraplegics walked would be the day the deaf would hear. Since, ototoxic drugs have been identified and I am so thankful for the cochlear implant I received in my right ear in 2013.

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  4. One thing I know for sure… When we put a headset attached to an assistive system receiver; loop or FM, on a person livings in a retirement community who has been isolated and disconnected from the world around them, boy oh boy do their eyes light up with the delivery of recognizable sound. The joy of understanding speech after it has been lost can be truly transformative.

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    • Absolutely. And, unlike hearing aids, these devices are inexpensive and can be used by many different people, which makes them a relatively small investment for a retirement community. The fact that they are not generally available in elder care facilities is a jolting reminder of how little we appreciate the ubiquity of hearing loss in this age group, the psychological damage of leaving it untreated, and the easy ways in which people can be reconnected to the hearing world. Your description about their eyes lighting up is proof enough how much these things are needed.

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  5. Katherine, thanks for your post and thanks for what you do. A couple of thought–I think these consequences are real, but they exist in the context of no education in provider offices, few supports, etc. I’d like to see much more research into consumer behavior. To me, as a consumer and public health person, depression and isolation are in part a consequences of HL being ignored in policy and treatment and coverage. I was despairing a couple of years ago when I couldn’t afford $6800 for hearing aids. What if we had the supports/education given to people with for example, heart disease–support groups, coaching, powerful policy lobbies, care management, educated providers., etc.? I really think if HL leaders want to engage the boomer consumers who face this issue, there really needs to be a stress on disability rights because structural issues are partly behind depression and isolation. I think the rights perspective will engage boomers who see themselves as having a medical issue. The fact that the healthcare, disability, aging and public health sectors are siloed is a big part of the problem.

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    • The Hearing Loss Association of America is very active in lobbying for lower costs for hearing aids, for better accommodations for people with hearing loss, for FDA approval of cheaper hearing aids and hearing aid alternatives. Their website is hearingloss.org. They could really use the support and knowledge of people like you, and they need the funding to keep on lobbying in Congress for measures that will make life easier for the deaf and hard of hearing. Joining — and even more, becoming active — is a good way to support the activities you mention in your comment.

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  6. Early death? Cognitive decline? Definitely scare tactics in this awful article. More like what my parents heard back in the 60’s. There are many successful deaf individuals who are just fine. There is American Sign Language, Gallaudet University which I graduated from. This article is insulting and demeaning. No wonder my mom cried when she found out I was deaf, in this time and age the stigma must be removed!

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    • Gosh, I’m sorry. None of those things are new — they’ve all been in the news. But also they apply to the late-deafened rather than to the Deaf. The Deaf have a lively culture, lots of communication. The problem for late-deafened adults is that they often can’t be part of the hearing world anymore and they’re not part of the Deaf world. So they’re isolated, and that’s not good for your health. I think all these studies are on late-deafened adults, not on people who are culturally Deaf. They’re about giving up social interaction, resulting depression, etc. All of which may contribute to cognitive decline. I mentioned the study about death only because I thought it was really pretty absurd. We do all die eventually.

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      • As a late deafened invididual I can reply that those comments about not fitting into the hearing or the deaf world are 100% accurate.

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  7. Great article, but the mother of 2 kids with hearing loss, I can tell you why people don’t get hearing aids. The cost. Plain and simple. Insurance companies do not cover them. We just spent 12,200 on a credit card to buy the kids new ones. Is sucks and it’s not fair.

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    • I couldn’t agree more. The situation with insurance companies — and Medicare — is unacceptable. The hearing aid companies can — and must — lower their prices. It’s even more shocking when it comes to children, who outgrow hearing aids and whose formative minds need to be able to hear — whether through their ears, their brains via cochlear implants or through signing. Are you a member of AG Bell — they are a great advocacy and support group for families of children with hearing loss. They may also have ways of helping parents pay for hearing aids.

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      • But of you are deaf because of Neurofibromatosis 2, which many late deafened adults are,
        most cannot use a cochlear implant because of surgical damage.

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  8. I have been wearing a hearing aid, off and on, for 40 years and I agree. Hearing aids are a huge help in relating to the world as it is. However, having gone through all stages of denial, confusions etc about my partial hearing loss since birth, about 50%, I would like to state:
    Despite their major benefits, hearing aids are uncomfortable. They are a machine and you have to get used to them. So, please before we lecture and scare future wearers on how important and beneficial hearing aids are, perhaps we need to step up on information on how these little machines work best. And make sure there is enough information out to give the wearer the self confidence to go back to the audiologist as often as is necessary to work out the kinks and make it suitable for individual settings.
    I have been talking to a lot of people who are losing some of their hearing due to age. Who likes to admit their frailties? And so, the hearing aids gets bought because everyone tells them that they need them, and land in a drawer. Because using them is painful, uncomfortable and they do not feel they are able to go back and admit this to the audiologist…And yes, its our right to have this machinery work so that it is suitable for our lifestyle! Perhaps that needs to be said more often…

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    • You make many good points. But hearing aids should not be uncomfortable. If they are it’s because they’re not properly fit and the audiologist should send them back to the manufacturer. Also the audiologist should make it very clear that there is a 30-60 day return policy on new hearing aids, and that it is important to bring the aids back in if they’re not comfortable or if they’re not working well for you. You may need a different brand or a different style. All this is one good reason to buy your hearing aids from an audiologist — whether in private practice or at Costco — and not on line. You need that relationship to help you make the most of your hearing aids.
      Thanks for writing!

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      • I did not mean the actual mold or such, but the way sounds sound. And the way one has to hear with them. It is simply different from your naked ear. The pathways to listening need to be relearned when you wear a hearing aid. Ands that takes time and patience. And you need to feel strong and self confident enough to approach the audiologist with all the little details of hearing comfortably and well. The machine has to be fitted for you individually. And again that takes time and patience.
        I appreciate you trying to teach people about the benefit of the hearing aid, but I would like to restate my actual point: You have the right to have those machines work for you! And the self confidence needs to be encouraged.

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