Higher Medical Bills for Those Who Don’t Treat Hearing Loss

The cost of hearing loss treatment is far less than the cost of not treating.

Higher Medical Bills for Those Who Don’t Treat Hearing Loss

Two new studies point out the serious consequences of untreated hearing loss.

In one, researchers at the Medical University of South Carolina found that middle-aged adults with untreated hearing loss had substantially higher medical bills compared with those without hearing loss. A second study from Johns Hopkins University found that moderate to severe hearing loss in those age 70+ was associated with a 54 percent higher risk of death.

The South Carolina study, published online April 7 in the journal JAMA Otolaryngology — Head & Neck Surgery, examined some 562,000 adults ages 55 to 64 drawn from a national health care claims database. They were matched in terms of age, employment, the presence of a variety of chronic health conditions and other factors. Most had private, low-deductible health insurance with at least 18 months of coverage.

SIGNIFICANTLY HIGHER MEDICAL BILLS.    The study found that over 18 months, those with diagnosed hearing loss had 33 percent higher health care costs than those without hearing loss. Those with untreated hearing loss spent $14,165, while those without hearing loss spent $10,629. The study did not suggest a cause-and-effect relationship between hearing loss and higher health costs, merely a statistical association.

The study also found that of the 280,882 study subjects with hearing loss, just 36,323, or 13 percent, had received hearing services. That’s even lower than the federal estimate that only 20 percent of those who could benefit from a hearing aid actually use one.

The study’s lead author, Annie N. Simpson, an assistant professor of Health Care Leadership and Management at the Medical University of South Carolina, emphasized that the important finding was that the patients in the study were middle-aged, not 50+. The study shows, she said in a statement, that the negative health-related effect of hearing loss “may manifest earlier than is generally recognized and may affect use of health care across the continuum of care.”

The reason for the higher bills, said Simpson in an email to AARP, could be because hearing difficulties cause some patients to avoid seeking timely medical care due to the stress of “trying to communicate with medical providers.” Putting off going to the doctor could lead to problems becoming worse, she said, resulting in “a sicker patient who needs more care.”

In addition, communication barriers could also affect how well those with hearing problems followed directions for taking medication or recognized “symptoms that signal the need to seek care.” The isolation that often results from hearing loss may “reduce necessary communications about health problems to health care providers and family members,” she added.

EARLIER STUDY SHOWED INCREASED MORTALITY.     Hearing loss expert Frank Lin, M.D., and colleagues at the Johns Hopkins University School of Medicine found a 54 percent higher risk of death among those age 70+ with moderate to severe hearing loss in another study published in JAMA Otolaryngology — Head & Neck Surgery.

Co-author Kevin Contrera, a medical student, said in a statement that the findings don’t answer “the big question” — whether hearing aids and other therapies could offset this negative effect.

Both of these studies are wake-up calls about the health (and financial) consequences of untreated hearing loss.

People with hearing loss — as well as insurers, including Medicare, and the hearing industry — need to pay attention to the consequences of doing nothing about hearing problems. The cost of treatment is likely to be far less than the cost of the consequences of not treating.

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

 

Photo: IStock

The Shared Experience of Music

I’ve written often about music, just a few weeks ago in fact, and how much I’ve missed it since I lost my hearing. I recently wrote this post for Psychology Today and want to repost it here, because I came to a different understanding of my sadness about losing music: the loss of shared experience.

“In international surveys, people consistently rank music as one of life’s supreme sources of pleasure and emotional power,” Natalie Angier wrote in the New York Times recently. “We marry to music, graduate to music, mourn to music.”music-notes-on-staff-clipart-dt6xgz8t9

The inability to hear and appreciate music is one of the most frustrating aspects of hearing loss. I was never a musician but I was a music lover from my teenage years until my early 60’s, when I lost most of my hearing.

The joy of a glorious piece of music could bring me to tears. It might be something as exalted as Beethoven’s Ode to Joy, or a Verdi duet, a Puccini aria, a Mahler symphony. Otis Redding, Bruce Springsteen, Emmy Lou Harris — all have enormous emotional impact for me. For others, it may be something completely different. But the loss is the same.

Making that loss even more painful is the fact that music is so often a shared experience. Music heard in a place of worship, the opera house, the concert hall, the outdoor arena is intensified by the shared experience.

Like many people, I suffered from serious depression when I lost my hearing, and I think a large part of that was because I could no longer hear music.

If you are a therapist working with a patient who is losing their hearing, it’s important to recognize the magnitude of that loss. Not only the loss of a sense, the loss of easy communication with others, but the loss of music, “one of life’s supreme sources of pleasure and emotional power.”

I’ve written elsewhere about tips I’ve learned through personal experience and from others to learn to listen to music again. Those tips and other practical advice about living with hearing loss can be found on my personal blog at katherinebouton.com.

I refuse to give up on music, so I accept it even with compromises. It’s far better than no music at all.

Trouble Hearing in Your Book Club?

Are you in a book club? If you’re hard of hearing, the answer may be no. Even a hearing book club member may miss a lot of the discussion.

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Book clubs generally have 10 to 20 members.

An estimated five million Americans are in book clubs,some of them are in more than one. I know people in couples’ book clubs, mother-daughter book clubs, all female or all male book clubs, history book clubs, biography book clubs. You name it.

Book clubs average anywhere between five and twenty members, a size that poses a difficulty for most people with moderate to severe hearing loss. Even with hearing aids or a cochlear implant, it may be difficult to hear in a group this size. But there are strategies and tools that can help you participate fully.

Here are some tips.

*Seat yourself near the center of the group, remind people of your hearing loss, and ask them to speak one at a time. Remind them when they forget. Then remind them again. And again.

*Establish a group leader. In my book club, that person designates herself the “Conversation Monitor.” (She actually refers to herself more crudely, but you get the idea.) Her role is to make sure that people speak one at a time, that no one dominates the conversation, that the group doesn’t roam too far off topic.

*Choose your own personal interpreter. Have a pen and paper available: You write: “She did what?” your interpreter answers: “She married him” You may have been pretty sure you’d heard “she buried him,” but figured it was an unlikely plot twist.

*Voice to text software. Examples of this, which is sometimes called speech recognition software, include Siri and Dragon Dictation. A new app, called Ava, shows great promise in using voice-to-text software to help those with hearing problems follow a conversation. Some friends and I were beta testers and used it successfully with four people, although it can be used for a group of six to eight. The app assigns each person a color, and each time they speak, their color-coded words plus their photo or the first initial of their name show up on every participant’s phone. The app can be restarted with a whole new group the next time you want to use it.The app’s founder says it’s still several months away from being on the market. When it is, it will be available on the Apple Store and Google Play.

There’s a reason five million Americans are in book clubs. They’re fun, they’re educational, they’re a great way to socialize and do something constructive at the same time. Don’t let hearing loss deter you.

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Dogs, Debates and Doorbells

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. 

Reflections on Hearing Loss

KB in Seattle copyInterview with Stu Nunnery, After hearing loss, Katherine Bouton finds new purpose in life. This paragraph about HLAA is just one part. Click on the link to read the whole interview.

Stu: Hearing loss has many side effects short and long term and most troubling to many of us is the isolation, depression, and other long term health issues.

Katherine: This is why I advocate for HLAA. Joining your local chapter of HLAA is the best way you can find others like you. It doesn’t mean you give up your hearing friends or your hearing life, but you meet new friends. And because many HLAA meetings have Communication Access Real Time (CART) capability, you can actually comfortably “hear” in these meetings.  I’ve learned a huge amount in casual conversation with my HLAA friends, and even more from the structured programs we sponsor. That said, in contrast to the very culturally vibrant deaf community, outside of HLAA (and maybe ALDA) there isn’t a hearing-loss community at all, much less a vibrant one. I think active HLAA members do have a vibrant community, but it’s hard to get people interested.

 

Source: After hearing loss, Katherine Bouton finds new purpose in life

The Elusive Sound of Music

Hearing aids and cochlear implants are designed to maximize speech comprehension, which is as it should be. But for many of us, this means compromising on one of life’s joys, music.music-notes-on-staff-clipart-dT6XGz8T9

As Natalie Angier wrote in an article in Science Times last week, “In international surveys, people consistently rank music as one of life’s supreme sources of pleasure and emotional power. We marry to music, graduate to music, mourn to music.”

She also noted that Americans listen to music four hours a day.

The inability to hear and appreciate music is one of the most frustrating aspects of hearing loss. While hearing aids and cochlear implants are designed to maximize our speech comprehension, they are inadequate to the task of reproducing the fidelity of the human ear when it comes to music.

Part of this has to do with digital versus analog hearing aids. Audiologist and author Marshall Chasin, director of auditory research at the Musicians’ Clinics of Canada, has explained that the old-fashioned analog hearing aid was nowhere near as good as the newer digital hearing aids for speech, but it was better for music listening.

It also has to do with the wide range of sound in music. “Human speech is generally between 30 decibels and 85 decibels, giving it a range of about 50 decibels,” says Lisa Packer, a staff writer for Healthy Hearing. “Music, however, has a range of about 100 decibels. Hearing aids simply aren’t designed to efficiently process such a wide range of sound.”

So what can you do? Chasin has this practical advice for hearing aid users:

  • For recorded music, turn down the volume on the source and turn up your hearing aid. Turning up the volume on, say, a car radio just causes distortion of the incoming signal.

  • Use an FM system, and plug it into the direct audio input jack. This also helps reduce the distortion that results from turning up the source of the sound.

  • In a live-music venue, muffle the microphone on your hearing aid. Try a scarf or earmuffs over your hearing aid or wear a hat, or you can try Chasin’s trick: Scotch tape. He tells his patients to take several layers of tape and place it over the microphone. This decreases the distortion. “It is low-tech, but it works really well,” he says.

  • Take off the hearing aid. Music is inherently louder than speech, and if you have moderate hearing loss, you may be able to hear without amplification and without distortion.

  • For those with cochlear implants, some of these suggestions might work, although not the last one. Most people have little to no residual hearing after a cochlear implant, so simply taking the device off would leave you with no sound.

From my own experience, a visual component always improves the musical listening experience. For example

  • Vocal music with captions (whether live opera or YouTube) will help you to “hear” the sung words in a way that you can’t without that visual clue.

  • Reading lips is not a solution because singing distorts the mouth, but watching a singer can help with comprehension simply because of body language and facial expression.

  • With orchestral music, the kind most difficult for me to follow live — and impossible to follow as recorded music — I find that if I focus on a key player it helps to make the music a bit more comprehensible. This is easier with an instrument where you can see the player’s hands and body movements — a piano or cello, for instance. I can’t follow the fingering of a flute or piccolo in any useful way.

I refuse to give up on music, so I accept it even with compromises. It’s far better than no music at all.

Is Hearing Aid Insurance Worth It?

You undoubtedly have insurance for your important valuables. So should you get insurance for your precious hearing aid? The answer is yes, but not right away.

New hearing aids come with a warranty from the manufacturer. The length of the warranty, usually up to three years, is based on the device’s level of technology, according to Terrence Williams, assistant director of the Berelson Hearing Technology Center at the nonprofit Center for Hearing and Communication (CHC) in New York.

Warranty

When you purchase your hearing aid, be sure to find out the length of the warranty. It should cover both replacement and repair. Replacement includes loss, but this is a one-time offer. Once the manufacturer replaces a lost hearing aid, the warranty is no longer in effect.

When the warranty runs out, you’ll probably want to buy insurance. Coverage cost is based on the level of technology of your hearing aid as well as its age, says Williams. For a higher-end device, the price averages about $300 a year (per aid). That may seem expensive, but with the average cost of a hearing aid about $2,300, according to thePresident’s Commission on Science and Technology, it’s probably a wise investment. You can usually insure for replacement or repair, or both.

CHC works with three providers of hearing aid insurance: Ear Service Corporation (ESCO), Midwest Hearing Industries, and Starkey Hearing Technologies. Starkey works with the hearing-aid provider, not directly with the consumer. Ear Service and Midwest offer comprehensive coverage for all types of hearing aids and will replace a lost or damaged hearing aid with the same model. If the model has been discontinued, they’ll offer a comparable model. Starkey, which also manufactures hearing aids, will cover all manufacturers’ products, but it will replace a lost or damaged hearing aid with a Starkey device.

Before you buy this extra coverage, check with your homeowner’s or renter’s policy to see if your hearing aids are covered and what your deductible is. If you’ve chosen a high deductible to save on premiums, the deductible may be far more than the cost of the hearing aid.

The best thing, of course, is not to lose your hearing aid in the first place. Here are a few hints for holding onto that valuable object:

  • Before bed, put it in a Dri-Aid or other dehumidifier to get rid of excess moisture and keep it secure during the night.
  • Never put it on the table or your plate at a restaurant, as some people do when the room gets too loud. One of the titles I considered for my book Shouting Won’t Help was The Man Who Ate His Hearing Aid, based on a friend’s experience. Enough said.
  • Carry a small case for your hearing aid in your purse or in a secure pocket where it won’t get lost or damaged.
  • Never leave the hearing aid on the dresser or a bedside table at night. It can get accidentally knocked off or, worse, swallowed by a pet. In that case, you’d not only be replacing the hearing aid, you’d also be stuck with a veterinarian’s bill.
  • If you have upgraded to a new hearing aid, be sure to keep the old one to use in case the new one gets lost.

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

This post first appeared on AARP: Conditions and Treatments.