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I last wrote on this topic about five years ago. Here are some of the more common ways people avoid getting help, and how you, as the patient or the caregiver, can address them.
1. "I can hear just fine." This is the excuse that leads all others. Unless you and your loved one can agree that there's a problem, you'll never get past this starting point in the discussion. Realize that, as a caregiver, you may be fueling the fantasy by repeating things not heard clearly, speaking louder yourself and otherwise acting as a human hearing aid. The best way to open a dialog about the existence of a hearing problem is to get real about it. A hearing evaluation performed by a hearing care professional can provide the objective data that's needed to take the conversation out of the realm of "he said, she said" and move on to a dialog about what can be done. The "I can hear just fine" ploy is really just denial, and is the leading reason people don’t seek help.
2. "It's not that bad. I don't need help." Even though people may acknowledge their hearing loss, their desire to stay independent can ironically steer them away from seeking help. So, instead of using hearing instruments to stay in communication, they rely on you and their wider support network to help them hear. But what they don't realize is that the condition gets worse the longer you let it go. The worse it gets, the harder it is to treat. And the social isolation it creates makes it harder for someone to even seek help. All strong reasons to take hearing loss seriously, get professional help, and be proactive about it.
3. "I'm too young." When you hear this from someone, regardless of their age, what they’re probably really saying is, "I may or may not have a problem, but I am not going to wear something that makes me look like an old man (or lady)." Age-related hearing loss can begin at any age, but it really starts showing up statistically at 45. No matter what their age, people should take comfort in knowing they're not alone. They should also know that many people are able to wear the new, almost invisible hearing instruments that provide a comprehensive set of advanced features without ever tipping off anyone that they exist. I have worn hearing aids for 15 years and my patients rarely notice I have them on.
4. "I'm too old." People who don't believe they're young enough for treatment need to know that managing hearing loss is an important part of aging well. It's not just about enjoying sound and living a more active life. Other aspects of aging: anxiety, depression and dementia like symptoms, are associated with untreated hearing loss. Taking control, staying independent and staying connected to the world around you is a key strategy for fighting the emotional and cognitive effects of aging. So this is really about health as well as happiness. And it gets more important as you get older. My oldest patient was a man who was 103! He drove himself to the appointment in a red Ford Mustang convertible! A man recently who got hearing aids said, "This is really good hearing but I don't know how many years I have to use them." No one knows the answer to that. Another man in his late nineties once said, "Nothing is more precious to me than the sounds of my family's voices. They, the voices, are precious jewels." He knew the value of hearing better.
5. "I can't afford it." Hearing instruments can be a significant investment. The thing to keep in mind is that they are indeed an investment, not an indulgence. The returns on an investment in quality hearing instruments include better performance at work, a deeper, richer social life and more resistance to the anxiety, depression and difficulties associated with long-term hearing loss. Many hearing care professionals offer risk-free trials to make sure you're getting your money's worth, along with low and no-interest payment plans and a variety of choices to match your budget. Most clinics offer 24 month interest free financing. Check your insurance, too. Many plans have benefits now.
6. "They don't work." Most often people come up with this excuse if they've tried a cheap mail- order hearing aid or did not get the care expected after the sale by the dispenser. Often the mail order devices are deceptively packaged and promoted like real hearing instruments, but they are nothing more than poorly designed amplifiers. For someone with hearing loss, the problem isn’t just loudness, it's clarity, and these devices do nothing to fix clarity. Most hearing instruments use dual microprocessors and wireless communication to preserve the clarity of speech, preserve the direction that sounds are coming from and help you focus your hearing on the person you're conversing with -- all automatically and with more natural sound quality. The best way to understand the difference -- and to get real help for hearing loss -- is to visit a hearing care professional for evaluation and fitting with the real thing.
7. "They're too much hassle." Old-generation hearing devices often required manual adjustments made by turning tiny knobs or pushing tiny buttons to switch from one mode to another. Modern hearing technology uses tiny microprocessors embedded in the hearing instruments to automate all of these functions. They are designed to help the wearer get used to hearing with instruments quickly and easily. With new-generation technology, wearing a modern hearing instrument is the closest thing yet to effortless natural hearing. I saw the too much hassle up close and personal. My mom wore hearing aids most of her adult life and couldn't live without them. My dad struggled to hear, constantly asking my mom to explain what was happening on the TV or around him. I provided my mom's hearing aids and would for my dad and at no charge, so the price to him was never the issue. He just refused to consider wearing them because he didn’t want to exert the energy to learn about them and learn to wear and use them. He said each year when I would travel home to Ohio that he did not want the hassle of hearing aids. I found that very sad. I delight in helping folks hear better and my own dad would not allow me to improve his life. He died at age 92 three years ago.
8. "They're ugly." This excuse is often heard from folks who haven't seen a hearing instrument since the days of the transistor, when hearing aids were big, bulky and clinical looking. Today, we are so far beyond the era of the "Big Beige Banana hanging on the back of an ear." Modern hearing instruments can be almost completely invisible, worn far down inside the ear canal. The sleek new receiver-in-the-ear (RITE) models can be worn behind the ear in colors that complement your skin and hair.
9. "They squeal in your ear." Feedback, is the whistling sound made by some hearing instruments and is much less common than it used to be. Digital technology, open-fitting designs, internal software and careful fitting can cancel feedback, minimizing it or eliminating it completely. It's the same with occlusion, that plugged feeling, a booming sound of your own voice caused by hearing instrument designs that completely seal the ear canal. These designs are used rarely today, replaced by digital technology and open designs that minimize or eliminate occlusion. Bottom line, today's hearing instruments are precise, clean-sounding and more comfortable to wear than ever.
10. "Insurance doesn't cover them." In the U.S., there are in fact many private health care plans that cover much of the costs of hearing tests, a hearing aid evaluation and even partial or full coverage of a hearing instrument. You need to check with your health insurance company or your benefits manager at work to find out. If you're retired, although Medicare doesn't cover hearing instruments, many Medicare supplement plans may offer hearing benefits. Medicaid supplements often do have plans for hearing aids and related services for adults, and must cover them for children. By the way, if you are disabled and your insurance has a D-SNP classification on your card, you most likely have $0 co-pay and would get your hearing aids for free. Call the 800 number on the back of your insurance card to find out.
Everyone has their own set of reasons for putting off or denying that they need hearing help. Underlying most of these excuses is a general anxiety about the "new normal" of living life differently. If you’re the hearing loss patient or a caregiver, you need all the help you can get in confronting this basic anxiety, and your best ally will be a hearing care professional. Based on the data gathered from a hearing evaluation, your hearing care professional can guide you through the options available, and answer the questions you may have about the experience. It's the best way to confront objections and excuses. And it's the right way to begin your shared journey to better hearing and a better life. Hearing care is health care. If you have the symptoms of hearing loss let a professional help you find out why. The hearing professional will help you sort out the technology level to meet your needs, your budget and answer your hearing need questions.
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Jeffrey L. Bayliff, NBC-HIS is owner of Hear the Birds Hearing Aid Center in Lock Haven.