Depression and Hearing Loss

young-depressed-man-cartoonThe National Council on the Aging has published a study emphasizing the need for treating hearing loss, no matter how “minor”. Dr. James Firman, the President and CEO of the National Council on Aging reports that untreated hearing loss can lead to serious consequences.

According to Dr. Firman, “The survey of 2,300 hearing impaired adults age 50 and older found that those with untreated hearing loss were more likely to report depression, anxiety, and paranoia and were less likely to participate in organized social activities, compared to those who wear hearing aids.”

Dr. Firman further states, “This study debunks the myth that untreated hearing loss in older persons is a harmless condition.” This is not new information to audiologists who regularly see patients with untreated hearing loss. Many first time hearing aid users report an increase in socialization and family interactions. Being able to be part of a conversation is refreshing and relaxing. Family members report a renewed interest in outside activities once their loved one is fit with hearing aids.

There are over 38 million Americans with hearing loss. Hearing loss is just not for older Americans. About 7% of American teens have permanent hearing loss due to noise exposure. Fortunately, many teens are “turning the volume down” on their personal listening devices. But, for some the damage is already done.

Also, fortunately, Baby Boomers are recognizing the need for hearing tests and the necessity for hearing aids. Physicians are requesting patients have a baseline hearing test at age fifty. Many Baby Boomers are finding the need for understanding conversations in meetings and social situations. They are finding that with a high frequency hearing loss they are having trouble understanding speech in a noisy situation. They often report they are withdrawing socially because it is too difficult to follow the conversations.

Depression is real. Hearing loss is real. See an audiologist and have a hearing test. If you need hearing aids, find a way to purchase them. Do not let a treatable problem rule your life.

Written and Submitted by Loleata Wigall, M.S. CCC-A, FAAA

President of Atlantic Audiology, Inc.

781-246-0305

lwigall@gmail.com

 

 

 

Why WE Follow Best Practices

Audiology of Nassau County adheres to Best Practices
Audiology of Nassau County adheres to Best Practices

The landscape for hearing health care has changed dramatically over the past 35 years. This ever evolving profession has undergone legislative changes that prior to 1978 would not permit qualified audiologists to fit hearing aids for their patients, to laws, decades later, requiring that all audiologists entering the field hold a doctorate degree.  And while the profession has seen many positive changes that have augmented the professional scope of the practitioner resulting in better hearing and improved lifestyle for more patients, there is also a vagueness regarding hearing care standards that baffle both patients and some physicians.

One possible explanation for the confusion about hearing care and hearing health is a general lack of awareness about the auditory system, its effect on cerebral health, and the role of amplification and aural rehabilitation in the care of hearing impaired patients.  Another explanation for general befuddlement is the seeming overabundance of hearing care facilities.  Many facilities run aggressive advertisement campaigns that focus on “selling” and of course “discounting” hearing aids.  Sorting through the confusion of big box store proclamations, marketing gimmicks (see post Marketing Predators: The EAR-ie Truth), and too often hurried fittings by some audiologists both in private practice and those employed by otologists, often leaves patients vulnerable to making decisions that may not have the best outcomes for their hearing rehabilitation.

Hearing aids are prescribed to improve communication, increase brain stimulation and overall to improve quality of life. Yet, often hearing aids are not appropriately fit, verified nor measured for their success, nor accompanied by a systematic process to ensure that the fitting goals are met.  This logically can affect not only the patient’s satisfaction with the instruments, but with the quality of life improvement as well. It is therefore of critical importance that patients, and families who are ready to begin the journey toward better hearing, understand that there are industry standards in place to ensure best outcome.  These standards are called best practices, and by following best practices, there is a system available to ensure best outcomes both from an acoustic perspective but also from a quality of life perspective.

A recent article by Sergei Kochkin published earlier this year by the Hearing Review compares outcomes for hearing aids purchased by users through direct-mail hearing aids and those who opted for a more traditional route. The results indicate that patients are “significantly more satisfied if all best practices are employed by the hearing professional in the clinic or office. Satisfaction from direct-mail purchases exceeds that from offices where best practices are not followed.”  This study and others similar, and the organizations that guide our profession outline and emphasize the importance of the use of best practices as a tool to provide best care for patients.

For patients and their families looking for hearing care and for physicians seeking the best referrals for their patients, best practices format makes it easy. It demystifies so much of the hearing care process.  Indeed, hearing health care is a process, not a device.  Educate yourself, your patients, and your loved ones about the standards that should be expected for best hearing outcomes.

Download our best practices “shopping guide” (available soon) on our website that can be used to compare process and procedures from one facility to another.  Best practices are the gold standard for hearing health care and regardless of the location, these methods should be applied. The savvy patient will use this guide as a tool, and ask targeted questions when interviewing a practitioner. Better hearing health begins with knowledge. The power is yours.

Hears to better hearing and better health!

Stefanie Wolf, Au.D.

 

Doctor of Audiology

Audiology of Nassau County

165 North Village Avenue

Suite #114

Rockville Centre, NY 11570

(516) 764-2094

www.audiologyofnassau.com

 

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What’s the Buzz About?

imagestinnitusAn estimated 37 million Americans suffer from ringing, buzzing, humming or hissing in the ear known as tinnitus. Tinnitus, by definition is the conscious perception of sound in the absence of an externally generated sound source. Tinnitus can be a combination of sounds and for many people may vary in tone, character and loudness. It may remain consistent and persist or may subside or at times seem to disappear. For some, stress and diet exacerbate it. Others have difficulty determining what makes it better or worse.

And while tinnitus is perceived in the ear, and may, in some cases be generated in the middle ear space, most scientists will agree that in most cases, the sound perceived in the ear is occurring in the brain. Yes, that’s right, tinnitus is perceived in the ear, but occurs in the brain. This explains why many patients with severed auditory nerves will lose all ability to hear from the severed nerve ear, but will still experience tinnitus.

Scientists disagree over the causes, origins and models for how tinnitus originates and becomes weaved into the neural pattern, but what they do agree about is the fact that many different types of tinnitus exist. A popular theory suggests that damage to the peripheral auditory structures send disrupted, abnormal neural signals to the brain which subsequently causes persistent abnormal activity in the central auditory pathway (Nageris, et al., 2010; Jastreboff & Hazell, 1993).

While tinnitus can occur for individuals with normal hearing, 85% of those with tinnitus do have some degree of hearing loss. (Simpson & Davies, 2000). This makes sense when we think about how damage to the ear can result in disrupted and abnormal signals to the brain.

For many patients, simply acknowledging the presence of the tinnitus and understanding that it is a result of damage to the auditory mechanism is enough for them to accept the noise intrusion. Others find their tinnitus more debilitating and seek other avenues for help.

For many tinnitus sufferers with hearing loss, a properly fit hearing aid will help to reduce the perception of tinnitus in over 60% of cases. Some find that use of amplification can suppress tinnitus. But for most, decreased awareness of tinnitus is either a result of a complete or partial masking of the sounds or a reduced contrast between silence and the tinnitus, or because of a more structured neural pattern, among other possible occurrences that contribute to diminished awareness of the presence of tinnitus.

For others, amplification alone will be insufficient to help deal with the effects of tinnitus. Stress management and counseling or cognitive behavioral therapy is often extremely useful when used alone or in conjunction with amplification therapies.

Certainly, one with tinnitus should know that there is help. An appointment with an audiologist can help identify whether there is hearing loss, need for medical referral and design an approach for dealing with tinnitus.

Hears to Healthy Living!

Stefanie Wolf, Au.D.

Doctor of Audiology
Audiology of Nassau County
165 North Village Avenue
Suite #114
Rockville Centre, NY 11570
(516) 764-2094
www.audiologyofnassau.com

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Sources

Jastreboff, P., & Hazell, J. (1993). A neurophysiological approach to tinnitus:
clinical implications. British Journal of Audiology, 27, 7-l7.

Nageris, B., Attias, J., & Raveh, E. (2010). Test-retest tinnitus characteristics in patients with noise-induced hearing loss. American Journal of Otolaryngology–Head and Neck Medicine and Surgery, 31, 181-184.

Simpson, J., & Davies, E. (2000) A review of evidence in support of a role for 5-HT in theperception of tinnitus. Hearing Research, 145, 1-7.

Hearing for the holidays and life

family-meal-free-clip-artIt’s that time of year once again. The days are shorter, the air is colder, we shop too much, we eat too much, and we make plans for more. For most of us the best part of the season aside from the delightful treats and seeing little ones open their presents, is reconnecting with family and friends. Gathering around a table or a fireplace reminiscing, recollecting and sharing is what the holidays are all about.

Yet, for the 48 million Americans that have some degree of hearing loss, the holidays may be a time of great struggle. For those with untreated hearing loss, get togethers with friends, family and colleagues in noisy party settings is often stressful and uncomfortable. Conversation connects us with people and even a mild hearing loss affects the ability to converse in the presence of background noise.

Untreated hearing loss can also lead to social isolation and depression. People decline invitations because they feel like they can’t participate in conversation in a meaningful way. Many feel that they look “stupid” if they can’t properly answer a question (it’s difficult to answer a question that you can’t hear). Depression can result from prolonged isolation.

Many are in denial about their hearing loss, often because it is a gradual process and are truly unaware that there is a problem. Others are concerned that admitting to a hearing loss will make them look “old.” The alternative, which is suffering in silence as the world whirls about is it really is painful for the person with hearing loss and their loved ones.

The silver lining is that hearing aids DO HELP. Most hearing losses can be assisted with hearing aids that are discrete and have a remarkable ability to process sound clearly and naturally. Don’t spend another holiday season in silence. Motivate yourself or your loved ones to have a hearing evaluation. There is little more precious in life than enjoying the company of those we care about. Make the most out of your time together. Hearing enables us to connect and is too precious a sense to be ignored.

Take care of your health, hearing and enjoy the spirit and sounds of the holiday season!

Stefanie Wolf, Au.D.
Doctor of Audiology
Audiology of Nassau County
165 North Village Avenue
Suite #114
Rockville Centre, NY 11570
(516) 764-2094

Baby Boomer, Audiologist, Grandma, Hearing Aid User…

 

grandmareadingFor decades as a hospital based and later a private practice audiologist, I had been counseling my hearing impaired patients about the benefits of amplification. Most were receptive, but for a small group of resistive die-hard “denial-ers” I would attempt to motivate them to take steps toward better hearing by quoting scientific research, sharing success stories of the “non deniel-ers” and demonstrating the effectiveness of the latest in amplification technology.

And as a younger, normal hearing audiologist I was empathetic to the concerns of my hearing impaired patients, but on some level I couldn’t completely relate to their daily struggles of living with hearing loss. Until one day, I was one of them!! I too needed some hearing improvement and in 2006 I bit the bullet and fit myself with my first set of hearing devices. Suddenly, I had creds!

As a hearing instrument user, I was able to share my joy, not just my knowledge and professional experience, at hearing the birds chirping, listening to my classical music selections, enjoying movies and my favorite English TV programs that had previously eluded me. Hearing devices, I proclaimed, were giving me an improved quality of life that I was able to share with all of my patients, including the “denial-ers”. And they listened. Hurray!

BUT, as the old infomercials would proclaim, “but wait… there’s more,” I soon unearthed my own amazing discoveries…..experiences I didn’t find in a text but rather from my daily exposure to the sounds around me. I detected the police sirens and ambulance sirens (not that I didn’t hear them before I became a user) when they were further away enabling me to make a maneuver in a timely fashion. I was now a safer driver! I burned fewer dinners because I heard the timer ringing when I was in an adjacent room. I had dryer window sills and floors because I heard the rain against panes and managed to close windows before the deluge. You can imagine how these little improvements reduced the number of spousal complaints.

AND then there was the BEST discovery of all. I have three grandchildren and I no longer protest that they talk too softly or mumble. Grandchildren are the dividends in life’s journey, and if you can’t share or connect with them, a whole segment of the wonderments they bring to the table are lost and never recaptured.

So to all you drivers, cooks, TV viewers, but especially you grandparents of any age, give yourself a gift that brings a whole other world to your doorstep….try to improve your hearing. Find an experienced, well regarded audiologist near your hometown and get started. It will be a journey you won’t regret!

Barbara Rosen, Au.D.

Director of Audiological Services
Audiology of Nassau County
165 North Village Avenue
Suite #114
Rockville Centre, NY 11570
(516) 764-2094
www.audiologyofnassau.com

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[avatar user=”Barbara” size=”thumbnail” align=”center”]

 

Hearing Loss and Driving: Safety on the Open Road

 

While an estimated 43% of adults over the age of 65 have hearing loss, roughly only 25% wear hearing aids. Many are in denial about their hearing loss, often because it is a gradual process and are truly unaware that there is a problem. Others are concerned that admitting to a hearing loss or assisting it with amplification will make them look “old.” Although, untreated hearing loss has been known to lead to social isolation and depression and recent studies have correlated a decrease in auditory stimulation to dementia, untreated hearing loss poses safety issues as well, especially for drivers.

The open road is a dangerous place. Anyone getting into a car and turning on the ignition has a tremendous responsibility; the life of the driver, passengers, pedestrians and other motorists is in many senses in a heighten state of vulnerability. Careful driving requires engagement of visual and auditory senses to make informed often, very quick decisions to navigate safely.  Hearing loss can greatly impair an individual’s ability to hear important safety cues such as a horn honking, a siren, or another vehicle accelerating nearby.   Street noise outside the car and the hum of traffic can make it difficult for normal hearing drivers to detect signals, for those with hearing loss, background noise presents an even greater challenge.

Hearing loss alone provides significant safety concern on the road.  Hearing loss combined with the ordinary distractions of driving makes for an even riskier environment.  A study of older adults with hearing loss published in the Journal of the American Geriatrics Society entitled Hearing Impairment Affects Older People’s Ability to Drive in the Presence of Distracters found that there was a significant correlation between hearing impairment and driving performance in the presence of distracters. The study concluded that older adults with hearing loss had greater difficulty driving safely in the presence of distracters than older adults with normal hearing.  Because distractions such as conversation, reading street signs, listening to the radio, using a mobile phone or navigation system are a present day reality for all drivers, those with hearing loss face an even greater challenge when confronted with distraction.  This study, which references similar studies of adults with hearing loss suggests that the additional effort of listening to a degraded auditory signal detracts one’s resources from other cognitive tasks, making it more difficult to attend safely to the road.

Good hearing is essential to good driving. But drivers with hearing loss needn’t necessarily hang up their keys, instead they should seek help. If you suspect you or a loved one has a hearing loss, see an audiologist for an audiologic evaluation.  If you have a diagnosed hearing loss, see your audiologist annually to monitor for changes. If hearing aids are prescribed, they should always be worn when driving.  Finally, make responsible decisions; if your senses are impaired, your driving ability can suffer, especially for older adults.  When on the road, be smart, be courteous, and remember, your safety and that of others is at stake.

Stefanie Wolf, Au.D.
Doctor of Audiology
Audiology of Nassau County
165 North Village Avenue
Suite #114
Rockville Centre, NY 11570
(516) 764-2094

Hickson L, Wood J, Chaparro, A, Lacherez, P, Marszalek, R. Hearing impairments affects older people’s ability to drive in the presence of distracters. Journal of the American Geriactrics Society, 2010; 58:1097-1103

 

Marketing Predators: The EAR-ie Truth

I wish I had a nickel for every time a patient came to my office with a mailer they received promising a vacation, a kitchen appliance, or even a Thanksgiving turkey as a gift for trying a hearing aid. Mailers like these are nothing new. Such inducements have become common practice in condo time shares and car dealerships, but they have no place in health care.

 

These mailers are sent by hearing aid dispensers or audiologists who purchase a list of specific demographic targets in order to lure prospective patients to their offices with promises of gifts and discounts.  These practices expect that, in order to receive their “gifts”, the patients will book an appointment and splurge for hearing aids. The mailers will often arrive in an 8 x 10” envelope marked “urgent” with the appearance of an authorized document, with emboldened warnings such as “time sensitive information” and “for recipient only.” Others state that the recipient has been “selected to be part of a special test market.” These mailers are often outsourced and arrive from a third party marketing company to present the appearance that it is not the practice’s own marketing. Is it legal, yes. Is it ethical, who knows. Is it tasteful, definitely NO!

While there is nothing wrong with advertising a clinic – after all, how else will people be made aware of the practice – I have a particular distaste for letters and publicity designed to mislead people. What is particularly troubling is that most of those who are targeted for these mailers are over the age of 65. A December 2012 article published on NPR’s website entitled Why It’s Easier To Scam The Elderly reported findings from psychologist Shelley Taylor at UCLA. Her study suggested that older adults have decreased activity in the area of the brain that detects risk and danger, making them more susceptible to respond to unsavory types of marketing. The article also reports a finding from AARP that the average age of fraud victims is 69, and states that this age bracket is “most inclined to believe those too-good-to-be true promises.” A more recent article, entitled Psychological Vulnerable Older Adults Are More Susceptible to Fraud,  published by Science Daily in April 2013, suggests that psychologically vulnerable individuals, characterized by depression and ”low level of social needs fulfillment”, were most likely to become victims of fraud. Because hearing loss is so pronounced in this age demographic, and because untreated hearing loss leads to social isolation and depression, the inevitable obvious conclusion is that the target audience for the hearing aid gimmicks are those who are most psychologically vulnerable.

To our patients who are disgusted by these mailers, I want to say “Thank You” for reading between the lines. To our colleagues who remain committed to avoid this path, it’s wonderful to see so many taking the high road to preserve the caliber of our profession. To our professional organizations that have not yet sanctioned these tactics for being unethical, hopefully soon you will reach the same conclusion that I have and re-evaluate your ethics standards and guidelines.

Most importantly, to recipients of these mailings, please remember for yourself and for your loved ones – especially the elderly who may not be able to read the subtle cues or fine print – that there really isn’t a special prize, special discount or special test audience, as advertised. These are simply devices to get people intrigued. The gifts for valentines chocolates aren’t REALLY chocolate, rather a $15 online certificate where you have to spend a certain amount to activate the coupon. If a practice promises $500 off a price of a hearing aid, more often than not, the price is first INCREASED $500 so the spender can feel good about using their coupon. Or, my personal favorite is the 50% off the manufacturer’s suggested retail price, which of course is artificially doubled by the practice so that it can be cut in half. Read carefully, be smart, and advise those you care about to do the same.

When it comes to your hearing, which is an integral component of your overall health, choose a hearing care professional who is patient and caring and provides counseling and aural rehabilitation to facilitate the adjustment to hearing instruments. Hearing aids are a process, not a product, and the relationship you build with your audiologist should be meaningful and built on a foundation of trust. Certainly professionals who use tricks to get you to their door could be initiating a relationship that prays on your vulnerabilities. Don’t let yourself or your loved ones fall victim to marketing predators. Isn’t it better to find honest professionals and buy your own Thanksgiving turkey?

Stefanie Wolf, Au.D.

Doctor of Audiology
Audiology of Nassau County
165 North Village Avenue
Suite #114
Rockville Centre, NY 11570
(516) 764-2094
www.audiologyofnassau.com

“Like” us on Facebook!
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http://www.npr.org/blogs/health/2012/12/06/166609270/why-its-easier-to-scam-the-elderly
http://www.sciencedaily.com/releases/2013/04/130425132441.htm