Hearing Aid Guidelines - for reference

King Boo · July 10

A very long time ago, while we were Peer Volunteers, Jo C suggested I write a standing post for reference about hearing loss and hearing aids for the person with dementia.

Untreated hearing loss is a known contributor to cognitive, social, and medical declines. It contributes to social withdrawal, increases fall risk, and auditory deprivation.

As a former caregiver and POA to a parent with dementia, as well as a professional in the area, I share the following.

-The sooner hearing loss is properly fit with hearing aids, the easier it is to get used to them and obtain benefit.

-Never let a physician or nurse tell you “don’t bother, they won’t accept it.” Why?

-because you don’t know until they are properly fit by an experienced clinician who works with dementia patients.

-because hearing is important to staying connected with loved ones.

-it is the last sense to go in the dying process

-even late stage dementia patients benefit from the gift of music.

It’s a confusing world out there. What professionals work with hearing loss?

ENT physicians treat pathology, do surgery. They do not fit hearing aids.

Audiologists – are graduate degreed professionals (Master’s or clinical doctorate) who diagnose hearing and balance disorders, and fit hearing aids.

Hearing Instrument Specialists – fit hearing aids.

Hearing aid fittings:

Are guided by state law. Most states require a return option if the patient/caregiver decides not to keep the hearing aid.

There is usually a return fee specified in the contract and professional services are often separate.

Successful hearing aid use in a nursing facility:

Provide a care kit for your LO’s room and for the nurses station. It should have extra supplies, a cleaning brush, battery tester if not rechargeable, a charger, and written instructions.

A new fitting will require the support of staff – nursing, nursing assistants, therapists, etc. The patient must gradually get used to hearing again.

Hearing aids may be kept on the medication cart at night and inserted for the patient in the morning. This creates a log in/log out process.

All support staff should be inserviced on proper use and care of the hearing aids. A family member may do it, or you can arrange to contract with the audiologist for a fee to come in and do it.

Therapists should be a touch point for hearing aids. Patients should have their hearing aids in for physical and occupational therapy sessions, and for recreational therapy too. Music soothes!

Most hearing aids come in rechargeable form, eliminating the need for battery ingestion precautions. Make sure a charging protocol is in place so they are ready to use in the morning.

Staff should know how to clean the hearing aids. Family should change wax filters as needed monthly when visiting.

Hearing aid retention may be needed to guard against lost. Huggie Catchars which clip to clothing, or Deaf Metal has jewelry options to aid in retention. Some hearing aids come with Bluetooth apps for “find my hearing aid.”

Many hearing aids come with a one time only loss and damage coverage with an accompanying replacement fee. Once this is used, or it expires, you can insure the hearing aid through homeowner’s or a hearing aid insurance company.

An audiologist experienced with dementia patients can modify the test to obtain the best results possible. Bring old evaluations with you to the appointment if possible.

Before going to the appointment, have your LO ears check for and cleared of ear wax. Some states licensure laws permit Audiologists to remove cerumen, others do not. Set yourself up for a successful appointment ahead of time.

The confusing world of Third Party Hearing Aid Insurance

:

-Medicare does not cover hearing aids

-Advantage plans that report coverage are usually through a Third Party. A third party is a company that handles the claims, bills and gets reimbursed by the insurance company – and contracts with hearing aid dispensers and audiologist to provide services for a small fee. A very small fee that often exceeds the cost of doing business. Subsequently, you may have a limited choice of providers to work with

Alternatively, if you are not able to find a good provider – get fit to your benefit with the TPA and max out the services provided under your benefit, then go and find a provider to provide the missing services, and be prepared to pay fee for service. Many audiology practices provide unbundled services and this is a good way to go with a limited TPA benefit. Just don’t expect “free” (which was never really free – you just paid thousands more for it)at the initial purchase).

Companies such as TruHearing, HearPO , Hear USA, Amplifon, United Healthcare Hearing are third party providers.

Benefits vary greatly. Sometimes the cost is low; and sometimes, the cost is in the thousands and you can do better going private pay to a non-par provider. Discount plans that still cost you thousands are often masquerade in marketing literature as a no cost benefit. Research well.

OH MY GOSH – my LO can’t hear in the hospital.

-A Pocket talker can be purchased in a store which allows headphones to be placed on the patient and is attached with a wire to a volume box with a microphone. It’s not a long term solution but is a cheap and quick way to help a patient hear during a temporary hospitalization or when a hearing aid is broken and out for repair. Some families like to own one for emergencies.

-Some practices provide hospice hearing services, where a hearing aid can be rented and fit temporarily.

What about OTC (over the counter) hearing aids?

OTC hearing aids can be a nice, entry level thing to pursue for a cognitively intact person with a vanilla, mild to moderate hearing loss. A true OTC hearing aid is not dirt cheap – so forget those late night TV ads for 39.95 hearing aids.

I would not pursue an OTC for a LOWD because the process will require hearing aid re-programming, extensive learning, counseling and adjustments – all which require the services of an experienced clinician. And no, I wouldn’t rely on the pharmacist for extensive help with this on an over the counter device.

While pharmacists are smart, intelligent and receive some training to accommodate OTC purchases in their store – it’s also far from their area of in depth expertise. Also, our pharmacists are NOT ok. They are stretched too thin by the corporations that own them and multi-tasking on vaccinations, prescriptions, hearing aids, etc.

I hope someone, sometime, finds this post useful.