A select committee of the National Academy of Sciences,
Engineering and Medicine has identified a BIG problem for Americans as we age:
hearing aids are not a covered medical expense in Medicare, and Congress has a
history of resisting changing that.
Costs average at least $5000/pair and research indicates that at least
half of us who need this help try to do without, with results that vary from
uncomfortable to disastrous.
Sociologists, social workers and medical researchers have long linked
hearing loss to increasing social isolation in elders. If you can’t hear, you can’t keep your social
networks strong, which in its turn is closely linked to poorer physical and
mental health. Now Alzheimer’s researchers,
including Dr. Frank Lin at Johns Hopkins, part of the committee, say that an
aging brain that is over-tasked with trying to discern language from faint,
muffled sounds is a brain that is deprived of the power to maintain cognitive
tasks. In other words, if you need a
hearing aid and don’t get it, you are making cognitive decline inevitable.
The obvious answer, for those who can’t
afford a $5000 set themselves, nor the Medicare Gap policies that can cover them,
is to do without. As the Boomer generation
continues to swell the elder ranks, this is becoming a public health
problem. In addition to the purely
humanitarian aspect, adding to the ranks of dementia is not in the best
interests of the nation. Some members of
the committee want the FDA to make hearing aids an over-the-counter purchase to
help drive down the cost, while other members caution that hearing aids require
careful tuning so the comparison with OTC reading glasses doesn’t really
fit. The committee also asked for more
consumer information, including forcing vendors to tell buyers if the product
can only be tuned by a particular provider (locking you in if you don’t like
the service) and forcing vendors to unbundle the product and services, so that
people can determine how much fitting and tuning they want (or really “can
afford”.)
The committee also had specific suggestions for helping an
elder who needs hearing assistance and can’t afford a hearing aid: speak more
slowly and distinctly, not more loudly; face the listener; reduce background
distraction noises, so meeting in a library is better than a crowded coffee
shop; turn off the radio and TV; rephrase, rather than repeating yourself. The latter is particularly important. If the person can’t hear certain sounds well,
using different words will be more likely to lead to comprehension. And do your best to get Congress to change
its mind…. Which will undoubtedly require a new Congress, one focused on
improving the lives of ordinary Americans.
No elder should be forced to slide deeper and deeper into an isolating
silence because they lack the financial resource to both hear and eat.
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