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Why don't more people use hearing aids? For most adults, a decline in hearing occurs so gradually as to be imperceptible--except to family and friends who chafe at having to repeat themselves or at being subjected to the blare of a television turned up to accommodate their loved one's poor hearing. Some discover their disability during a physical exam. Fred Smith, 92, a retired San Francisco businessman, got his wake-up call in the Navy. He was taken off sea duty in the Pacific and transferred back to the States during World War II after he failed a hearing test. But only 16% of physicians routinely screen for hearing loss. And even after people realize they are having trouble hearing, many delay--on average 10 years--before seeking help.
Cost is one barrier. Medicare does not cover hearing aids, nor do most private insurers. Hearing aids range in price from $500 to $3,000 or more. "Here's this thing that's the size of a peanut," says Nicolette Toussaint, 49, communications director for a San Francisco nonprofit organization, "and it costs as much as a used car." Toussaint got her first hearing aid more than 15 years ago. It lasted 10 years--until she left it in the pocket of a pair of jeans she threw into the wash. The replacement cost $4,000. For many people the cost is doubled, since audiologists typically advise patients to buy two hearing aids if they have a loss in both ears. But many hearing-aid providers offer installment plans.
Advances in technology cause many to hold out in hopes of getting more for their money. Audiologists caution against waiting too long, however. "It's much easier to get used to a hearing aid when the loss is mild and you're younger," says Susan Rezen, an audiology professor at Worcester State College in Massachusetts and co-author of Coping with Hearing Loss. "If you delay too long, you're taking the chance that your brain may get used to not processing speech."
Another deterrent is fear. Knowing that excessive noise is a major cause of hearing loss, some mistakenly believe that hearing aids, which amplify sound, will cause further damage. Truth is, hearing aids have volume limiters that prevent them from boosting sound to levels capable of causing injury.
Then there's the vanity issue. "I have a real love-hate relationship with my hearing aids. I wear them because I need them. But they're clunky, they're ugly, they look prosthetic," says Battat of SHHH. "I'm longing for Calvin Klein to start designing hearing aids." Many people who have tried hearing aids before the technology surge of the past 10 years found the discomfort and embarrassment of wearing them outweighed the benefit they provided. Bad experience can be contagious as well. "In audiology we say that if someone likes their hearing aids, they tell five people," says Rezen. "If someone hates their hearing aids, they'll tell 20."
Much attention has been paid to improvements in miniaturization. But smaller is not necessarily better. The tinier the aid, the more difficult it is to manipulate the controls and change the batteries. In addition, smaller aids--which fit in the ear, in the canal, or completely in the canal--simply can't pack the power of larger, behind-the-ear or body-aid models.