Symposium Wrap-Up – Considerations In Hearing Aid Fitting for Older Adults

Lorienne Jenstad, Ph.D., clinical audiologist at the University of British Columbia, gave a presentation at the ReSound Symposium on the barriers to hearing aid uptake.  Here’s what she had to say.

Is there a difference between what older and younger adults want and need from a hearing aid?
Do older adults look for different things in hearing aids?  When a sample of older adults were asked about the importance of various attributes, their answers were very similar to those given by a younger group.  One attribute that older adults did rate more important was “ease of handling”.

Some features that can make handling easier.  For example, an ITE is easier to manipulate than a BTE.  Automatic processing can also reduce the need to switch programs, manually switch to directional mode, find the t-coil setting, or fiddle with the volume control wheel.

While older adults look for similar features in a hearing aid, their actual hearing needs are different.  The three main characteristics of age-related hearing loss are:
–  Thresholds
–  Temporal Processing
–  Speech Processing

Temporal processing, on many different tasks, is impaired with age independent of hearing threshold. The relationship between temporal processing & speech recognition is still not fully understood, but these deficits may explain some poor speech recognition.

What are the barriers/facilitators to hearing aid uptake?
9 females between 60 and 75 were interviewed.  They had previously been told that they would benefit from amplification. 5 had made the decision to obtain hearing aids or were current hearing aid users and
4 had decided not to obtain hearing aids or were undecided.

As a result of the interviews, the following 5 factors were identified as important in the hearing aid consideration process:

Self-reported hearing loss
Is hearing loss interfering with activity participation and quality of life?  Acknowledging their own hearing loss is the first hurdle to overcome.

Stigma still remains a barrier despite advances in technology and increased cosmetic appeal.

Degree of hearing loss
The worse the hearing thresholds, the greater the likelihood of hearing aid use.

Personality and psychological factors
People who seek hearing aids have different personality characteristics than the general public.

Cost of hearing aids
It’s important to clarify whether “it costs too much” means that they can’t afford it or they just don’t think it’s worth the cost.

What seemed to have the biggest impact on a decision to try a hearing aid was the influence of others: family members/friends, other people with hearing loss and hearing care professionals.

“My son has been bugging me for years, but he’s just really a sarcastic bug, so I sort of negated anything that he said.”

“When I first had my testing done at [the hospital], the audiologist there told me, she said, ‘well, you’re kind of borderline, you might benefit from it but,’ she said, ‘if you go to a place that dispenses hearing aids,’ she said, ‘they’re going to want to sell you a hearing aid, so bear that in mind.’ So I just, I didn’t do anything at that point.” 

“I have another friend that I play golf with and she doesn’t wear her aids and I realize now how tiring it is for someone. I would tell her something and then she was constantly saying, ‘what did you say? what did you say?’ It’s just really tiring.”    

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