Listen up! Pay attention to your hearing

As we get older, we may not notice our senses are gradually diminishing. Cataracts can dim your vision so slowly that you don't realize you're not seeing as well. Your taste buds may not be as sharp, so food doesn't taste as good.

While all five senses are important to our continued well-being, I put hearing at the top of the list. Age-related hearing loss, known as presbycusis, is one of the most common conditions among older adults.

One-third of adults ages 65 to 74 have some hearing loss. Over age 75, it's half of all adults.

Hearing loss is one of the risk factors associated with dementia, so it's not something you should just ignore. We need information coming in through our ears to help keep our brains working.

Causes of hearing loss

Why does our ability to hear diminish with age? One reason is that our inner ears undergo changes as we get older. But a big reason is long-term exposure to noise, whether from all the concerts we went to as teenagers or from our jobs. This is why, if you have grandchildren, let them know that cranking up their headphones so that others can hear their music is already damaging their ears.

Some medications, such as chemotherapy, can affect hearing, as can some medical conditions, including high blood pressure. The nerve pathways that tell your brain what you're hearing can also be damaged.

But if you're like most people, your hearing loss is both age-related and noise-induced. And you're probably having hearing loss in both ears.

Get a baseline test

Even if you're not aware of hearing loss, it's not a bad idea to have a baseline hearing test performed by an audiologist. With this information, you and your doctor can track whether your hearing is worsening. The tests take about an hour. You'll be hooked up to headphones and asked to identify high and low tones and words spoken by people with various tones of voice and volume levels.

Your ears may also be examined with an otoscope to see if ear wax or other obstructions are causing hearing loss.

Employer-based insurance usually covers hearing tests, but Medicare does not. The good news is that many Medicare Advantage plans include some hearing benefits, such as routine screenings.

What should you do?

Mild hearing loss is not necessarily a reason to run out and get hearing aids. But there are some things you can do to live with it.

Tell your friends and family that you're experiencing hearing loss. Ask them to speak to you face to face, and to speak clearly, not more loudly.

It may be harder for you to understand speech if there's background noise, so turn off the TV or radio if you're not listening to it. When going to a restaurant, avoid sitting near busy areas like the kitchen. If the restaurant background music is too loud, ask to have it turned down a bit.

Turn on closed captioning or subtitles on your TV or streaming service. Even people who can hear perfectly well often use closed captioning, particularly when watching a fast-paced movie or when actors are speaking with accents. TV headphones can also help.

If hearing aids are recommended

Hearing aids are big business, and they carry a hefty price tag, usually between $3,000 and $8,000 per set. Why so expensive? Six global manufacturers control 90% of the market, according to AARP.

But the marketplace is changing. In October, the U.S. Food and Drug Administration issued a proposal to establish a new over-the-counter category for hearing aids. The rule would allow hearing aids to be sold directly to people in stores or online without a medical exam or fitting.

Meanwhile, companies are already offering hearing aids online. You can buy a recommended hearing aid from a manufacturer's site, and then have it professionally fitted. But proceed with caution. You may end up buying hearing aids that don't serve your needs. I recommend starting with your doctor and an audiologist's exam before purchasing any hearing aids.

Is Medicare going to step up?

In its 56 years, Medicare has never covered the cost of hearing aids, even though the lives and health of many older Americans would be improved with proper hearing care. The $1.75 trillion social spending bill now under consideration by Congress provides a Medicare hearing benefit for the first time.

The new benefit, together with the FDA's proposal to allow over-the-counter hearing aid sales, could mean millions of Americans hearing better, feeling better and living better. Hear, hear!

• Teri Dreher is a board-certified patient advocate. A critical care nurse for 30+ years, she is founder of NShore Patient Advocates ( She is offering a free, 30-minute phone consultation by calling (312) 788-2640 to make an appointment.

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