[Speaker 1] (0:02 - 1:18)
I'm Dr. Joan McCormick with Atlantic Hearing Care, and this is Dr. Taylor Shabbat, and we want to thank the SwampScot for All Ages Committee for giving us the opportunity to do this talk about town to give you some updates on healthy hearing. Hearing has been in the news a lot, and we want to go over some of the things that our patients have been talking about and asking us questions about. So, certainly one of the most important things is treating hearing loss early, the relationship between hearing loss and other health conditions.

We'll talk a little bit about over-the-counter hearing aids, which have been in the news a lot lately, and insurance coverage. And then we'll also talk about some unique help for hearing loss through our non-profit, the North Shore Hearing Foundation. I opened Atlantic Hearing Care a little over 15 years ago to be able to provide hearing care to our local community.

We've grown, and we now also include Lisa Alwell and Taylor. They are the co-directors of Atlantic Hearing Care. Taylor's going to talk a little bit about how common hearing loss is.

Great.

[Speaker 2] (1:18 - 3:15)
Thanks, Joan. So, we're here to talk about healthy hearing because we know that hearing loss is the third most common health condition for adults in the United States. We know that about one in three people over the age of 55 and about two in three people over the age of 70 are affected by a hearing loss.

That equates to about one person in every four households will have a member of that household experiencing a hearing loss. We know that hearing loss can often go undetected. Many primary carers in the United States do not screen for hearing loss as part of their routine evaluation.

Only about 10% do. And we know that it's often considered an invisible condition, as in it does not show on a physical examination during their yearly physical. Hearing loss often comes on gradually, so it can sometimes go undetected until it's a bit more pronounced in an individual.

We're going to now talk about some common conditions or symptoms you may notice with a hearing loss. If you feel like speech is muffled or people often mumble to you, if you notice you're having difficulty hearing in groups or crowds or when you're in an area where there's a lot of background noise, if you find yourself frequently asking for repetition or if you're turning up your television often at home, if you experience any ringing or buzzing in your ears, often called tinnitus or tinnitus, or if you experience fatigue at the end of the day. A lot of times hearing, if you have a hearing impairment, you can be putting a lot of additional effort into listening and understanding, which can cause fatigue. We're now going to talk about some of the consequences of leaving a hearing loss untreated and why it's important to stay on top of getting routine baselines for your hearing.

Joan's going to speak to you about some of those consequences.

[Speaker 1] (3:16 - 8:51)
So certainly we know that untreated hearing loss creates communication problems. There's no question that you have difficulty hearing family, friends, and loved ones. But you might not be aware that there are some other consequences, really importantly that you can have much higher health care costs.

I think part of that is because it's hard to be able to follow maybe what your physician is saying, to be able to remain engaged in some of your health care needs. There also is a much higher risk of developing dementia and memory problems, and I'm going to talk a little bit more about that in a minute. Certainly having untreated hearing loss can put you at risk for depression if you're not connected, you're not doing some of the same activities that you've been doing for years and years.

Hearing loss also can put you at risk for falling. Part of this is the fact that without having good hearing, you really can't hear some of the environmental cues as you're walking around. And certainly we know that the health care cost is also related to people with untreated hearing loss will have a much higher number of hospital stays.

I'm going to talk a little bit about a very large study that was published in the British journal Lancet a couple of years ago, where they looked at what are some of the potentially modifiable factors, things that you and your doctor can do to help reduce your risk of dementia. What was found was that hearing loss was the single most effective modifiable risk factor for dementia. That means that if we were able to identify and treat hearing loss early, we could reduce the risk of developing dementia by as much as 9%.

Then when you also add the fact that when you have hearing loss, you can have depression and social isolation, combining all these things together and treating hearing loss early could reduce your risk by as much as 15%. I want to talk a little bit about what the mechanism is, we think, that is creating some of this risk factor. We know that when you have hearing loss, you're focusing really, really hard.

Taylor said one of the symptoms was that you may be really tired at the end of the day because you've just been working so hard. And so when you're using all of your cognitive resources to figure out what's going on and follow conversation, you just may not be making as many memories and able to process that information as easily. That's one possible explanation as well as we know about the social isolation and being depressed.

Those are also risk factors for dementia. There was a study done a number of years ago looking at over 3,500 adults over the age of 65, and they found that people who were wearing hearing aids had the same rate of cognitive decline as their normal hearing peers. But people that were not using hearing aids that had untreated hearing loss had the greatest risk of cognitive decline.

So our conclusion from that is that wearing hearing aids are almost like a little vitamin for your brain. They certainly can reduce your risk of having cognitive decline and to keep you more involved and engaged with what's going on. A lot of times people will ask us, well, when really should we come to see an audiologist?

When does it make sense? And so certainly anybody who's had a hearing screening, we do provide hearing screenings at the local senior center, and in fact we'll be at the Swampscot Senior Center December 1st. We also go to Marblehead.

Anybody that has symptoms of hearing loss, that list that Taylor went through, including tinnitus, the ringing, or the buzzing. People that may have some mild cognitive impairment, also called MCI, we really want to make sure that we rule out hearing loss as contributing to that. You know, it can look like you're confused, but maybe it's just that you're not hearing things clearly and so you're not responding appropriately.

We certainly want to monitor people that are on medication that is damaging to their ears, some of the cancer medications. A lot of times we see folks who have known hearing loss and they just want to be tested every year or two to keep an eye on it. In the same way, we do a baseline for people that want to monitor their hearing because they're exposed to noise, either recreationally or at work.

People with a family history of hearing loss should have it evaluated. We know that as much as 30% of hearing loss is considered to be genetic, so it's always good to get it checked out. And then finally, if you're someone who uses hearing aids from another provider and you just want to have them checked, you want to have them adjusted, it's always reasonable to check in with another audiologist and we're always happy to see people who had purchased their hearing aids elsewhere.

Taylor's going to talk a little bit about sort of the new buzz about something that's happened recently with over-the-counter hearing aids.

[Speaker 2] (8:51 - 15:39)
Great. Thank you, Joan. So, over-the-counter hearing aids are a new development in the hearing healthcare platform.

We know that hearing aids are a medical device and as we've discussed earlier, they're essential to your health and well-being. However, hearing aids are often not covered by medical insurance and therefore there can be a gap of accessibility for hearing healthcare for some individuals. The over-the-counter hearing platform has come out to try and bridge that gap and make hearing healthcare a little bit more accessible.

So these will be called the over-the-counter hearing aids. They're going to be accessible at most pharmacies and retail locations. And then you'll also see hearing aids referred to as prescription hearing aids.

Those will be the hearing aids that we as audiologists have worked with in the past and will continue to work with in the future. Over-the-counter hearing aids, we're going to now talk about how and who they may be applicable for or appropriate for. These are designed primarily for people that are perceiving a mild to moderate hearing loss.

There's no official hearing test or ear check required. It's mostly based on what people are noting for difficulties throughout their day-to-day activities. These are not going to be something that insurance can access.

And they're typically designed to be self-fitting. So that means you would use an app on your smartphone to adjust them to your perceived needs. They may come with a one-size-fits-all type of approach with some popular preset options.

We're thinking of these primarily as, if you use the analogy of glasses, like a reader until you need a prescription glass. You may find that you use an over-the-counter hearing aid for very specific activities throughout your day-to-day routine, such as watching television. But they may not be appropriate and they're not necessarily designed to work in all listening situations you encounter throughout your day-to-day routine.

As such, we do want to make sure that people, if they're testing an over-the-counter hearing aid, ensure that they get one that has a return policy on it. Because it may not be appropriate for your full day-to-day activities and you don't want to be saddled with something that you don't feel you're getting appropriate benefit out of. So you want to be able to test it and return it and try something else if necessary.

We also want to talk about individuals that over-the-counter hearing aids may not be appropriate for. They're really not designed to be used for children. Children need to be seen by an audiologist and have an official evaluation done.

And typically, if they have hearing loss, they're going to need prescription hearing aids to ensure that language and schooling and information of that sort is acquired correctly. They're also not designed for individuals that have significant hearing loss. As we said, it's more of a mild to a moderate perceived hearing loss.

They're not designed for people that may have medical conditions such as tinnitus, that ringing or buzzing in the ears. And they're also not designed for individuals who have ear pain or ear pressure or drainage from their ears, as well as people who experience vertigo or dizziness. You may wonder how over-the-counter hearing aids differ from prescription hearing aids.

So I'm going to give some information on that now. Prescription hearing aids tend to be more catered to the individual's hearing loss. Instead of the one-size-fits-all approach, we will have you come into our office at Atlantic Hearing Care and we'll take a thorough case history.

This will include where you may be noticing challenges with your hearing, what listening situations you may want to preserve or improve upon, as well as a detailed medical history as it pertains to your ears and your hearing. We'll then complete an evaluation in the sound booth. We'll look in your ears and check for any wax or medical challenges.

We'll test your hearing in the soundproof booth with the absence of any interfering environmental sounds. Then we'll take those test results, talk through them with you. And if hearing aids are indicated, we'll talk about what hearing aids are available.

There are varying levels and types of hearing aids, different styles of hearing aids. We'll select those for you and then we use your test results to program the hearing aids specifically to your hearing, to the listening needs we discussed during your intake history, and then we'll also measure those devices on your ears. Hearing aid settings will vary depending on the size and the shape of the ear, even if the hearing loss is very similar from one individual to another on paper.

Your listening needs and your anatomy dictate different settings. At Atlantic Hearing Care, we have a variety of options for hearing aids, as well as a variety of plans for hearing aids and hearing health care. We have our total listening care package, which includes the hearing aid devices, along with all of the services and supplies of our office for five years, warranties, and loss insurance on the devices.

Then we also have our basic listening care package, which includes the devices and the initial fitting and setup of the hearing aids. And then it's kind of an a la carte pay as you go for additional services throughout the following years. This is important because sometimes your listening needs will evolve throughout your life.

Maybe you've retired or you've gone back to work. You have a new member of the family. You've joined a new club.

Those can all be different activities that may change your listening needs from what they once were, even if your hearing remains similar. Or your hearing may change over time, and the hearing aid prescription may need to be updated accordingly. We have a variety of ways that you can finance hearing aids through our office.

We have payment plans available, and we also have a low-interest monthly leasing program available. And then we also have options for people of lower income that still need high-quality prescription hearing aids, and OTCs may not be appropriate there. That's called the North Shore Hearing Foundation, and Joan's going to talk to you a little bit more about that program.

[Speaker 1] (15:40 - 18:17)
Thanks, Taylor. So, I actually started the North Shore Hearing Foundation about five years ago as a way to bridge the gap between people that did not have the insurance or resources for hearing aids, but certainly needed them in their daily lives. And so, the North Shore Hearing Foundation is a 501c3 nonprofit foundation, and our goal is to provide hearing aids and services to children and adults who are of low income or underinsured.

We do use a financial means test. It's 250% of the federal poverty level, and we also have a sliding-scale co-pay. So, the hearing aids are usually not free, but there's a very small co-pay, $50, $100, that helps go to the foundation for the next person.

So, currently in 2022, for a single person, the financial guideline would be about $34,000 a year with limited savings, and for a couple, it's about $46,000 a year. Now, we do have something that we call our circle of giving. We have been asking that people either provide volunteer hours in the community or, of course, during COVID, providing acts of kindness to their family, friends, neighbors.

We really want people to re-engage with the community once they have enjoyed better hearing, and it's also an opportunity to provide some give-back themselves. The foundation itself is really easy to access. You just have to call the office at Atlantic Hearing Care, and we will go over the financial application with you.

We'll do a hearing evaluation, and then we include a year's service going forward, and then when you come in for your subsequent care, it's at a very reduced rate. I want to thank the Swamp Scout for All Ages once again for giving us the opportunity to give you some updates on what's going on with hearing and hearing devices, and I want to encourage anyone that has any questions or concerns to just give Taylor and I a call at our offices, and we'd be more than happy to talk to you. Thank you very much.