Seated in a soundproof room, 67-year-old Dale Fowler listened carefully for tones coming through his earphone inserts.
In an adjacent space during this October appointment, audiologist Barbara Peregoy conducted a hearing test for Fowler at the University Hearing and Speech Clinic in Spokane, Washington.
“Basically, we’re going to run through various frequencies we use for speech,” Peregoy said. “Vowels are lower in frequency; the consonant sounds are high frequencies. Boomers definitively lose hearing in the high frequencies first, so they start missing the consonant sounds in the words.”
About 37.5 million Americans of all ages have some degree of hearing loss, Peregoy said, and boomers make up about 20 percent to 25 percent of that population. The American Speech-Language Hearing Association recommends that people age 50 and older have a hearing test every three years.
Fowler wanted to know if he needed hearing aids, a check suggested by family members. He has to strain sometimes to hear others speaking, especially in noisy places. “If I’m in a cafeteria and it’s loud and echoey, I really have to pay attention to make sure I’ve heard someone,” said Fowler, a retired harbor master.
Peregoy gave directions to Fowler through a microphone as she controlled an audiometer, which has a control panel with multiple knobs and distributes a range of frequencies.
Fowler responded with a “yes” when he heard different frequencies, first in the left ear, then the right. “We work hard to find the lowest-intensity level per frequency,” Peregoy said.
After about 30 minutes, she found in Fowler’s hearing range what she says is common among boomers: He had some minor hearing loss at high frequencies in one ear, but it wasn’t enough to warrant a hearing aid. Peregoy also checked both of his ears for any physical problems, and she asked common screening questions such as past noise exposure. She ended Fowler’s session with tips for improving communication skills, from requesting face-to-face dialogue to turning off the TV.
Boomers tend to fall into that gray area of minor hearing loss, Peregoy said. “As an audiologist, I’d say they have enough hearing loss to have some communication difficulties. Baby boomers probably have been exposed to noise either from work or recreation, sometimes both, but they’re also getting older, so they have noise-induced hearing loss and the aging of the auditory system.”
For those who have a more severe hearing problem, hearing aids are recommended both for better understanding of verbal speech and also for brain activity, she added. “Hearing loss can definitely lead to cause a person to be more isolated, which is also a risk factor for dementia. People stop going to restaurants with friends, for example.
“As we age, use of hearing aids can help keep the brain active. Hearing loss is a risk factor for dementia. We think nothing of vision correction, yet people kind of hem and haw about correcting hearing. It’s just as important, both for hearing and to keep the brain active.”
In hearing tests, she checks how well people understand spoken words, screening possible issues with how the brain is processing words. With Fowler, Peregoy used a comfortable tone of voice to recite words loaded with high-frequency sounds, and he repeated each one back to her correctly. “People come in and say, ‘I can’t hear my grandchildren, or I can’t hear my spouse,’ ” she said.
Five years is the average length of time in the United States between when someone is told they need hearing aids and the point they actually go get them, Peregoy said. Some reasons for such a delay may be cost, denial, vanity or even fear.
“It’s called the hearing-aid effect,” she said. “They’re afraid they’ll start feeling old, or people will start treating them like they’re old. People are getting better at accepting and getting treated for hearing loss. I think the trend is starting to turn that way.”
Cost for the devices depends on the level of technology and the outcomes a patient desires, she added. “You can fit someone as inexpensively as $800 per ear,” Peregoy said. “But it’s going to be extremely basic, just a generic amplifier. You can spend as much as $2,000 per ear for a hearing aid.”
Higher-end hearing aids can help people cope with tinnitus, which is ringing in the ears, or filter out background noises so the wearer can focus on individual speakers. Certain hearing aids also can stream cellphone conversations.
Some people ask Peregoy if they can get the smallest hearing aids possible, so they don’t show. She often tells those clients about a favorite quote: “Hearing loss is more obvious than the hearing aid.”
“We want people to come in to hear better and get the best technology, but sometimes people come in and say they’d rather spend money on a hearing aid that doesn’t show; they worry more about that,” she said. “Yes, they are designing hearing aids that are more aesthetically pleasing. It’s been that way for a while.”