JustCare

Tag: Hearing

  • Earwax can cause hearing loss, if left untreated

    Earwax can cause hearing loss, if left untreated

    If you have a problem hearing, it may stem from excess earwax. Kaiser Health News reports that earwax can cause hearing loss in older adults, if left untreated. Excess earwax is more common in older people than in younger people.

    In addition to conductive hearing loss–preventing sound waves to reach your inner ear–excess earwax can cause tinnitus or ringing in your ears, because earwax blocks the ear canal. It can also cause vertigo, and even cognitive decline. And, it can increase your risk of falling.

    What is earwax? It is a sticky substance that mixes with dirt and dust in the air, which protects your ears. For about three in ten older adults, however, it can block the ear canal, posing serious risks. People in nursing homes are particularly likely to suffer from this blockage or impaction.

    Many people try to remove excess earwax on their own. That can can bigger problems, pushing the wax deeper into the ear canal. Experts suggest leaving the earwax alone. The National Institute on Aging recommends mild treatments, such as mineral oil, baby oil, glycerin, or commercial ear drops to soften earwax.

    Here’s more from Just Care:

  • Hearing loss common for older adults

    Just about everyone experiences hearing loss as they age.  In fact, the National Institute on Deafness and Other Communication Disorders reports that half of people over 75 have difficulty hearing. I want you to know that hearing loss happens naturally and often can be treated.

    If you work or worked at a job and were exposed to repetitive noise, you’re likely to have hearing loss.  Not surprisingly, if you’ve gone to a lot of rock concerts or have blasted loud music regularly at home or in your headphones, there’s also a good chance you have hearing loss.

    But, many people do not realize they have hearing loss.  And, many people who do realize it do nothing about it. There are lots of signs of hearing loss.  You might feel like sounds are muffled or you might have a hard time figuring out what someone is saying in a loud space. I once had a patient, whose wife thought his memory was going because he wouldn’t remember things she had said to him. As it turned out he just couldn’t hear her!

    For both your happiness and your safety, when you notice that your hearing is changing, and it is harder to hear things as well as you did before, you should see a hearing specialist. Your hearing loss can’t be reversed, but your hearing can be helped.

    If you go to the doctor, make sure you explain all your symptoms as well as any medical history that is ear-relevant, such as occupational noise or a history of ear-infections. Additionally, veterans tend to have a higher exposure to noise from the duties while serving.

    To determine how much hearing loss you are suffering from, the doctor will generally perform a hearing screening test and discuss your options for hearing aids. You might also get a referral to an audiologist to help work with you to create the best course of treatment.

    Seek help if you notice changes in your hearing before it continues to get worse.

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  • Tips for driving safely

    Tips for driving safely

    As you get older, it can become increasingly challenging to drive. A variety of health conditions can affect your ability to drive. If you are concerned about whether you or someone you love is a safe driver, talk to your doctor. Don’t risk hurting yourself or others. Here are tips for driving safely from the National Institutes of Health.

    If your joint and muscles are stiff, you may have difficulty turning your head to see oncoming cars or responding to a situation where you need to turn the steering wheel or brake quickly. In these situations, you are likely better off driving an automatic car with power steering and brakes and big mirrors. And, you should exercise so that you are as strong and flexible as possible.

    If your vision is not what it used to be, you may have trouble seeing people and things in front of you as you drive. You also might struggle to see at night. Visit the eye doctor to ensure your vision is as good as possible. You also might consider stopping driving at night.

    If your hearing is failing, you may not hear horns and sirens and may not be warned when you need to get out of the way. Make sure to have your doctor check your hearing. Also, consider keeping the radio off while you are driving so that you are better able to hear outside noises.

    If you have mild dementia, you may continue to drive. But, you want to stop when your memory weakens and you are unable to remember where you need to go. You may not appreciate the challenges of driving.

    As your reflexes slow down, you may not be able to respond as quickly as needed while you are driving. Try to not to get too close to the car in front of you, brake sooner, and, if possible, stay out of rush-hour traffic. If you need to drive when the roads are busy, try to keep to the right lane.

    If you are taking medicines, be sure to note whether the warning label includes side effects like drowsiness or lightheadedness.  If so, driving can be unsafe, and you should not be driving. Be sure to check the warning labels on your medicines and discuss them with your doctor to see whether you should be driving while taking them.

    To be safe, try not to drive when the weather is bad and at night and avoid highways, if possible. Here are helpful tips on how to help someone you love decide when to stop driving.

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  • Free and low-cost ways to address hearing loss

    Free and low-cost ways to address hearing loss

    While our hearing is likely to weaken with age, there are things we can do to address hearing loss.  Hearing aids can be very expensive—as much as $3500 for a single hearing aid and most people need one for each ear.  Batteries are also expensive—as much as $150.  So, you want to be sure you really need them.  If you do, here are ways to keep your costs down.

    If you think you need hearing aids, these resources may help keep your costs down.

    • Get a free annual wellness exam with Medicare.  Medicare covers an annual wellness exam in full so there’s every reason to make an appointment. During your visit, make sure that the doctor checks you for hearing impairments as well as your likelihood of falling.  While Medicare will not pay for a hearing aid, the doctor can tell you whether you really need one.
    • If you qualify for Medicaid, check the Kaiser Family Foundation web site to see whether Medicaid covers hearing aids in your state.  If you’re a Vet, the VA may cover your hearing aids depending upon the degree of your hearing loss or the cause of your hearing loss.
    • Help America Hear provides hearing aids to people with limited financial resources.
    • Starkey Hearing Foundation may help pay for hearing aids. Contact Starkey’s Hear Now program at 800-328-8602. Through the Starkey Hearing Foundation, Hear Now might be able to provide you with good hearing aids at low cost.
    • The Lions Club’s Affordable Hearing Aids project also might be able to help you get low-cost hearing aids. Contact the Lions Club to see if the Lions Club has a project in your state.
    • Sertoma, a civic, service organization, whose mission is hearing health, offers a list of organizations that help people who need hearing aids.
    • The Better Hearing Institute offers a free Guide to Financial Assistance for Hearing Aids, providing 47 different resources for securing help.
    • State assistive technology programs may loan you equipment, loan you money to buy equipment, or offer information and referral services. To learn about your state’s programs, contact the Center for Assistive Technology Act Data Assistance.

    Note: The price of hearing aids should be coming down. The FDA recently has approved the sale of hearing aids over the counter, without a prescription. Experts believe that once you can get hearing aids without a prescription, costs should come down significantly.

    Here’s more from Just Care:

  • Hear better with over the counter hearing aids

    Hear better with over the counter hearing aids

    New research published in JAMA finds that low-cost over-the-counter (OTC) hearing aids may help more than 20 million people with mild to moderate hearing loss hear better. These hearing aids, recently approved by the Food and Drug Administration, can be bought in a pharmacy without a prescription.

    These hearing aids are called Personal Sound Amplification Products (PSAPs). They are not so different technologically from the prescribed hearing aids that cost several thousand dollars.  And, at far lower cost than traditional hearing aids, they may be worth trying.

    Since Medicare does not cover hearing aids, millions of people with hearing loss end up going without any hearing assistance. As few as one in seven of them get a hearing aid, according to the National Academies. People with Medicaid may have coverage for hearing aids, depending upon the state they live in.  In 34 states, hearing aids are covered, according to the Kaiser Family Foundation

    The researchers found that participants’ hearing improved by 11 percent with one of the PSAPs, Sound World Solutions, which retails for $350.  By comparison, a prescription hearing aid, which cost $1,910, improved hearing by 12 percent. Participants studied had mild to moderate hearing loss.

    There are less expensive PSAPs than Sound World Solutions. But the researchers found that the MSA 30X, which retails for $30, worsened people’s ability to hear.  Consumer Reports did its own independent testing and reached the same conclusion. It found that the Bell and Howell Silver Sonic also did not have much benefit and potentially could cause hearing damage through overamplification.

    If possible, consult with an audiologist before buying a PSAP. And, if you do buy one, make sure it is properly fitted.

    Senators Elizabeth Warren and Charles Grassley have introduced a bi-partisan bill in Congress that would make it easier for people to get over-the- counter hearing aids of different varieties. A similar bill was introduced in the House.

    Here’s more from Just Care:

  • Medicare should cover dental, vision and hearing services

    Medicare should cover dental, vision and hearing services

    A new paper in JAMA, by Amber Willink, Cathy Schoen and Karen Davis, explains why Medicare should cover dental, vision and hearing services. Right now, these three services, along with long-term care, are the biggest gaps in Medicare coverage. Lack of coverage for these services may lead to unnecessary hospitalizations and can push older adults into bankruptcy. Expanding Medicare to cover these services would benefit older adults, people with disabilities, health professionals and the Medicare program.

    A survey of people with Medicare in 2012 reveals that most people with Medicare end up going without needed vision, dental and hearing care. Three-quarters of people surveyed reported hearing difficulties and more than four out of five of them (84 percent) did not have a hearing aid.

    About 11 million people with Medicare (about 20 percent) said that they had trouble eating because of problems with their teeth, but seven in ten of them had not seen a dentist in the last year. (Here are some tips for getting free or low-cost dental care if you have Medicare.)

    Another 20.5 million people with Medicare reported problems with their eyesight, yet more than half of them (57 percent) had not had an eye exam in the past year. (Here are four things to do to protect your eyesight.)

    Cost is the primary reason people do not get these services. Hearing aids alone typically cost $4,700 for both ears. (That said, low-cost hearing aids may be available soon.) On average, people who received services spent $927 for dental services, $715 for vision services, and $1338 for hearing services.

    Not surprisingly, people with incomes under 100 percent of the federal poverty level were far less likely to get these critical services than people with incomes over 400 percent of the federal poverty level.  In most states, Medicaid does not pay for much if any vision, hearing or dental care.

    People who forego this care are far more likely to be hospitalized or to need emergency care than people who receive treatment for their vision, hearing and dental needs. There are currently two bills in Congress that would cover these services, but for now they appear to be going nowhere.

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  • Avoid using Q-tips

    Avoid using Q-tips

    You may have heard this before, but it bears repeating: Avoid using Q-tips inside your ears. For as long as I can remember, my father, a physician, would dry out his ears after his shower with Q-tips. Recently he had to submit to a rather painful extraction of globs of dark, hard wax from both his ears by an ear-nose-throat (ENT) physician.

    The doctor found that my father also had an infection in one ear, behind the wax. An infection can be a complication of a wax build-up and can damage the eardrum. Any blockage to the ear canals of course also impedes hearing, and older adults have enough trouble with hearing loss without the addition of something preventable like wax build-up.

    Our ears make wax for a reason. It actually helps move dirt and other impurities out of our ears. Sticking things like Q-tips into our ears just pushes old wax in, and doesn’t allow the ear canal to do it’s normal sweeping up.

    Just use a towel to dry the outside of your ears and let the rest air dry. As in other parts of our body, like the gut, we have a whole microcosm of microorganisms that, under normal circumstances, help to keep us healthy. They like a certain level of acidity, for example, that can be disturbed by putting things in your ears.

    A recent study in JAMA, a top ENT journal, showed how many other Americans don’t listen to the oft-repeated advice to “never put anything into your ears.” Medicare spent over $46 million to “disimpact” wax or cerumen from the ears of 1.3 million people in 2012, the year the study examined data on the topic.

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  • Medicare and Veterans’ benefits: Vets can have both

    Medicare and Veterans’ benefits: Vets can have both

    If you’re a Vet and also have Medicare, you may be entitled to health care benefits through both Medicare and the Veterans Administration (V.A.). Many would say that the V.A. offers some of the best care in the U.S. through its network of more than 1,400 care facilities, including hospitals and clinics. And, Medicare offers coverage from most doctors and hospitals anywhere in America. So, there’s value in having both. When you’re deciding whether to get your health benefits from the Veterans Administration or through Medicare, here are four things you should know.

    1. V.A. and Medicare benefits work independently of one another. You can’t use your Medicare benefits at a V.A. hospital.  And, you can’t use your V.A. benefits at a non-V.A. hospital.
    2. All Vets are eligible for V.A. health benefits, so long as you served in active military service for 24 continuous months or the full term  for which you were called to active duty, and you were not discharged or released under dishonorable conditions. You can apply by phone at 1-877-222-VETS (8387), Mon-Fri between 8 am and 8 pm, EST or online here.
    3. It’s generally also wise to enroll in Medicare Part B when you become eligible, even if you have V.A. benefits.  Medicare Part B will give you coverage for care from doctors and hospitals outside the V.A. system.  If you do not enroll in Part B when you are first eligible, you can enroll later. But, if you delay enrolling, you will likely have to pay a premium penalty for late enrollment.
    4. Depending upon your service as a Vet, your V.A. benefits may include coverage for hearing aids and over-the-counter drugs that Medicare does not cover.  The V.A. also covers care from doctors and hospitals in the V.A. system. And if you get your prescription drugs from the V.A., your cost generally should be far lower than anywhere else.

     

  • How to prepare for a visit to the audiologist

    How to prepare for a visit to the audiologist

    You’d think with all the advances in modern medicine and technology these past 50 years, you’d be able to go get a hearing aid and presto — the world’s sounds would come into focus. That’s not the case. Among the millions of seniors who have significant hearing loss — that’s one in four age 65 to 74 and half of those age 75-plus — too many still have trouble hearing. And that can lead to health issues that include dementia.

    It’s not just the cost of hearing aids that’s to blame, though that’s a big roadblock. Many of us don’t exactly know which type of technology would work for us based on our listening needs. I didn’t. I just got handed my hearing aid and went home with it. That’s because audiologists I saw never evaluated me for my individual needs. And that’s after spending $2500, which was supposedly a big bargain at a university audiology department.

    Turns out my audiologist wasn’t doing his job very well. He was just selling me hearing aids.

    Why Getting the Right Hearing Aid Is So Tricky

    Helping people hear well is much harder than helping them see well. Unlike simple vision problems, hearing loss is sneaky. It varies according to the setting you’re in, so you might not even realize you have a problem. For example, you may hear fine in a quiet place and at close distances when facing the speaker, but if you have high-frequency hearing loss — the most common type as we age — you’ll have a hard time hearing in a noisy room, because the noise interferes with your better lower-frequency hearing.

    Unless your specific type of hearing loss and your individual needs are addressed, you might end up still not being able to hear, even with hearing aids.

    What’s more, even today’s hearing aids don’t always help us distinguish between certain words that sound alike. And hearing aids still do not give you natural hearing, although they’re getting closer.

    “Consumers have been taught by professionals and by the hearing aid industry to think that hearing aids are the solution to hearing difficulties,” says Dr. Cynthia Compton-Conley, an educator and consumer advocate who specializes in needs assessment and hearing assistance technology. “But while hearing aids can definitely lead to improved communication, they’re not perfect.”

    This means you have to buy a hearing aid that suits your particular needs and you might have to add some bells and whistles to make it work better.

    Assistive Listening Devices

    So, what’s the answer? According to Compton-Conley, you may need an Assistive Listening Device or ALD along with your hearing aids, or an ALD instead of hearing aids, depending on how bad your hearing loss is and how well you recognize words.

    What are assistive listening devices? “Think binoculars for the ears,” Compton-Conley says. An assistive listening device helps you hear in certain challenging situations — in a place with bad acoustics or where there’s lots of background noise, for instance, or when you’re far from the sound source.

    Assistive listening devices include telecoils, personal amplifiers and microphones. Here’s a link explaining the different assistive listening device options.

    A version of this article was first published on SeniorPlanet.org as “What you need to know before you visit an audiologist.” Click here, to read the full article on Senior Planet and learn what to expect from the audiologist and how to advocate for yourself at the audiologist’s office.

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  • How can you help someone you love decide when to stop driving?

    How can you help someone you love decide when to stop driving?

    Getting older does not mean that you cannot continue driving.  But, the last thing you want is for people you love to hurt themselves or others.  As people age, they can lose mental and physical functions that enable them to drive safely.  The National Institute on Aging has several tips for helping people decide whether they should continue driving or rely on other forms of transportation.

    Responsible driving depends upon good reflexes. And, good driving is often about making snap decisions. So, if people you love have trouble seeing, turning their head, climbing stairs, responding quickly, or confuse the brake and the gas pedals, those are signals that driving might put them and others at risk.  Similarly, if driving makes them anxious, stressed or tired, those could be indicators that it’s time for them to stop.

    People who have trouble keeping up with the flow of traffic, seeing when cars are coming at them, making sense of the traffic signs on the road or staying in the proper lane should likely also not be driving.  They will know whether they are having problems if other drivers are honking at them, if they had minor accidents or have been pulled over by a traffic officer.

    For sure, once people you love lose their vision, hearing, reflexes or have had a stroke or another serious condition, you should advise them to take a driving test every three years. If they continue to drive, encourage them to stay home in bad weather and, if possible, take alternate routes on quieter roads that are less stressful.  For more information, click here.