We know you’ve heard us loud and clear talking about the delicate matter of hearing loss.

We each have our own way of dealing with this deficit. Most of us are in complete denial. We avoid dealing with it because:

1. We despise the look of hearing aids stuck behind our ears.
2. Hearing aids shout loudly to those who see us—there’s an old person.
3. The price tag sends our blood pressure soaring.

The reality is we must face our aging demons and hearing is a biggie.

It’s hard to pinpoint how our hearing went south. Often these kinds of things happen in unnoticeable shifts. Was it when we went to a Bruce Springsteen concert, the music was blasting and blew out our ear drums?

Was it when our significant other yelled at us for burning the roast and we decided to tune them out? Who knew it might be permanent.

Was it when we turned 70 and were officially old?

Is it genetic? Seems so. Both of Margaret’s parents needed hearing aids. Barbara’s mother needed them but refused saying, “Your grandfather had them and they never worked.” To which Barbara replied, “Today’s hearing aids are not my grandfather’s version.”

We’re frustrated and sad, of course, when trying to have a phone conversation if one of our children finally calls us back. The stress of trying to hear them and then asking, “What?” too many times, is annoying for both of us. It’s happening more often with Barbara and her grandchildren.

After too many, “Could you please repeat that?” or “Could you spell your name or place of business since I’m not sure I heard it properly” or asking someone watching TV or a movie with us to share what happened because we couldn’t hear the dialogue, understand the accents or lip read, we know it’s time.

And then there are all the conversations on zoom or in person when each of us asks to have something repeated numerous times. If too embarrassed, we simply miss out. There is no closed captioning for our conversations.

There were more signs, some even laughable, which are pushing us over the edge. Barbara was told emphatically by her 5-year-old frustrated grandson, “You’re not listening to me!” He was right on but for the wrong reasons. She was hiding the fact that she couldn’t hear him and was hesitant to share, “I’m old and can’t hear as well.” Her daughters were each thrilled that there was more pressure on Mom to do something about this loss.

Or Margaret was doing a phone interview and thought she heard the person say, “cheese station” when, in fact, he said “tea and coffee station.” Whoops, fortunately she caught the mix-up before it went into print.

The very act of going for a hearing test and buying the aids, marks a milestone: nothing will ever be like what it was. We have officially joined the contingent of those who need replacement parts and enhancements.

At least we have company. Our friends are starting to buy aids, too. Why shouldn’t we follow their example? One has grown her hair longer, so the aids aren’t as visible. Another puts them on only when she must absolutely hear what’s going on. Margaret, who likes to wear hair bands to cover her ears which get cold when she’s walking around NYC, is concerned this will block whatever aid the hearing the aids will bring.

The tipping point for Margaret was an item on the digital homepage of the New York Times (Saturday, Oct. 29, 2022). It offered a truncated hearing test, of sorts, that Margaret quickly took and failed. She read simultaneously, that hearing loss can cause dementia. She called an ENT. Made an appointment with her and an audiologist in her office.

Barbara decided for the new year she would make an appointment with a painting friend Glen Datres, an audiologist, who suggested doing a baseline test of her current hearing ability and then testing again six months later to see if it had worsened. She was reluctant to tell him, “Let’s just go right to the counter and choose which aids. My hearing is terrible, which you’ll quickly find out.”

There is a silver lining, we reason. Today, they’re less expensive than they were in our parents’ and grandparents’ elder years. They are also smaller and less noticeable. And the best place to purchase hearing aids for a good price is Costco or your local Walgreens or CVS. Yes, they are now OTC.

In the meantime, there is something called replacement denial. It’s what has enabled us to keep up as our hearing has declined. Ironically, our hearing deficits have heightened other senses: our eyesight, sense of smell and touch, to compensate.

Yes, we know we speak loudly and blast our TVs. We say, “What’d you say?” too much. In reality, life could be worse we know. But we don’t want to be isolated by not hearing what others say when we’re together or chatting on the phone. Yes, we’re inching closer to doing something about this.

Here’s what else is important to know, according to Datres, Au. D., Doctor of Audiology at Millbrook Audiology in Millbrook, N.Y.

What are the signs that it is wise to make an appointment with an audiologist? 

You have greater difficulties with not just hearing but understanding conversations in certain environments. Some of the time honest friends and family members will tell you that you are not hearing them. You may turn the TV up louder than others prefer. Certain individuals may be more difficult to hear. If someone turns their back and walks away while speaking, you no longer understand them. You begin to avoid certain situations because you cannot hear.

How do you pick an audiologist besides by word of mouth?

Referrals from your primary care provider are a good start or through the American Academy of Audiology by your ZIP Code.

Are appointments covered by any insurance?

Most of the time hearing evaluation is covered when you see an audiologist unless you have an unmet deductible. This is why hearing aid dealers advertise free testing because they are unable to bill.

Are aids covered at all and how good are the ones now offered over the counter?

For some individuals, their healthcare insurance covers at least a portion of hearing aids. Over-the-counter hearing devices have a wide range of simpler technology. Some are simple amplifiers. They can’t be programmed, adjusted, repaired or updated by an audiologist. The customer has to do everything, even adjust them, possibly via an app on their phone. (It’s really self-service so the less tech-savvy or people with any physical or visual issues may not be successful.) They’re also by design just for mild to maybe moderate hearing loss.

Is there a huge price range?

There is a very large price range of real/prescription hearing aids available through an audiologist ($1,200 to $3, 000 each). We often look at lifestyle and an individual’s daily communication needs when helping a patient choose what might work best.

There is always an exchange or return policy with patients getting most of their money back if not satisfied.  In my audiology offices this includes programming of hearing aids based on testing we have done, follow up adjustments and fine-tuning, warranties that include repair, damage and loss, connection to an app on your phone and assistance with that, counseling on proper use, adjustment, maintenance, cleaning, etc. Average “real” hearing aids have a five- or six-year life span.

Tell us where most aging people lose their hearing…at what decibel level, low or high?

For clarity, the decibel level is the loudness, the frequency means low to high pitch, as in going up the piano scale from bass to treble. So, to answer the question, people lose their ability to hear soft or low decibel sounds first and more typically higher frequency/high sounds or treble first.  Over time they lose more sounds in the lower frequency range, making speech less and less clear. You often first lose high frequency soft or voiceless consonants sounds, like f, s and the first.

How do you make a smart choice in an aid or what to consider?

Do some research before meeting with an audiologist, talk to friends and family members who may already have hearing aids, make sure the audiologist you meet with is happy to discuss details without pressure to purchase so you can ponder and sleep on your options.

How much technology is involved in using them? 

The technology is huge yet built into the hearing aids so that doesn’t mean the consumer needs to understand all of it, as much of it is automatic. Yes, there may be some adjustments that you can make to the sound, volume or quality as well as other factors that you can control such as microphone directionality, Bluetooth connection, etc. There are many individuals who are happy to merely remove their hearing aids from a charger in the morning, place them in their ears and go about their business.  Period. At my office—as at others, this is all set up for you.

Do we need an app on our smartphones?  

Smart phone apps and Bluetooth connections, as well as rechargeable options, are part of most hearing aids. But that does not mean you have to have a smart phone to use hearing aids and have them sound fine.

Are there a variety of brands, sizes, shapes and materials to choose among?

Yes, this is the start of the discussion following evaluation of your hearing abilities—including style, size, color, technology, options, cost. What a customer wants depends on all the particulars of their hearing loss. These are individualized choices.

How’s it best to use them? All the time or only in crowded places?

Use them full-time or don’t buy them. Your brain is where hearing occurs and as your brain starts to acclimate to the new, often forgotten sounds, depending on your hearing loss, your performance will improve but only with full-time use. This becomes your new normal sound/auditory environment.  It takes time. If someone uses hearing aids part-time, each time they put them on they are starting all over to adapt to this new level of sound.

Do they need cleaning or servicing periodically?  

They require regular checks and at least simple cleaning by the wearer (or a friend/family member if not possible due to low vision, arthritis, neuropathy, etc.) There are often only a couple of simple parts such as a wax guard that needs to be changed maybe every two to three months. Things like this are part of almost every hearing aid on the market and new over-the-counter choices will be no exception. Patients should also expect an office visit to thoroughly clean and check the hearing instruments every six to 12 months, or as needed.  Then, have your hearing retested and the aids reprogrammed yearly.

Do they wear out after X number of years?

Average hearing aid life is five to six years. But we certainly see some instruments that are still functioning well at six, seven and eight years. Technology changes rapidly, but this doesn’t mean you need new hearing aids, any more than you need a new cell phone or laptop before five to six years.

What else do we need to know to make a good choice?  

Have your hearing professionally evaluated. Schedule an appointment to review these results and what hearing aid options are available for your particular hearing loss.  Ask about possible free two-week trial periods to “test drive” a pair of hearing aids. Sometimes, it’s a bit amazing when you see (hear) what you’ve been missing: birds, beeping of microwave or coffee pot, what your grandchild is saying, a clock ticking, the purr of your cat, sweet whispers from a loved one, etc.

And… know that hearing aids won’t be a perfect solution. Nothing can replace the original equipment! Repairs are to be expected.  One cannot expect to wear a miniature highly technical, digital, electronic device on your body with perspiration, wax, weather conditions, etc. with flawless function.

We both announced to our children that we made or are making hearing appointments. To which one of our children said : Bingo! We never thought we’d see (or hear) the day.  We are so proud  It can be just like old times, to which we replied, “We don’t think so.”