Ask HN: My father is starting to lose his hearing. What should I do? | Hacker News Reader

Ask HN: My father is starting to lose his hearing. What should I do?

16 pointsedtech_dev24 comments

My dad is in his mid 70s. He is otherwise very healthy, but has started showing signs of hearing loss. What steps can we take to prevent, reverse, or correct this issue?

Seeing our family doctor and getting a hearing test, and perhaps a hearing aid seems like the obvious next step. But as great as modern medicine can be, there are gotchas because of incompetence or greed that you have to watch out for - for e.g. dentists pushing for unnecessary procedures to fund their next car or doctors prescribing nasal sprays that do more harm instead of treating the root cause etc. I am just trying to be cautious of going down the wrong path with this stuff.

Given how insightful this community is, I thought I'd try posting here. Does anyone have any experience in this subject? What kind of a doctor/specialist/institute should we see? What are the best aids?

Note: I'm in Canada

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Recently there has been an explosion in hearing aids from new manufacturers and the rules for selling them have been loosened so there is more competition than ever.

My understanding is that, unlike dentists, audiologists are pretty honest, but hearing aids have been crazy overpriced for a long time.

See https://hearingreview.com/hearing-products/hearing-tech-inno... and https://www.bloomberg.com/news/articles/2023-12-06/hearing-a...

People losing their hearing due to old age often have difficulty believing that they have a problem. They often blame others for not speaking loudly or clearly enough. Proceed with care and understanding. It can be a good idea for both parents to get tested together. That can tend to relieve resentment and doubt without embarrassing them both.

Getting them tested together is a good idea, thanks!

See a general practice doctor first, they will refer you to an audiologist if it's more complex than needing ears syringed (common!). If the audiologist thinks it's anything sinister or unexpected they will refer you to a specialist.

Any specialist treatment for age related hearing loss beyond a hearing aid will cost much more than a hearing aid from even the most money grabbing hearing aid sales person.

Ask your father what he wants, he probably wants to ignore it but get a hearing test anyway. They will immediately try to sell a hearing aid so be prepared to say you'll come back for that later.

There are relatively few reversible/preventable causes at that age. This is just life. What he can probably do is eliminate nearly all practical impact from this problem.

To do that, get an audiologist-administered hearing test, then discuss the results with an otologist/ENT. Often this is done in the same office visit.

Among other things, the audiologist will test where the loss is occurring (Google "Rinne and Weber tests" or bone vs. air conduction), and at which frequencies. Get hearing devices tailored to those frequencies. The otologist will recommend options. These aren't likely to be all that expensive.

There's no real opportunity for greed or snake oil here. If the otologist's advice works, the results are literally audible.

This is not a difficult problem to almost completely solve, and it makes a huge difference in quality of life and healthspan: https://www.hopkinsmedicine.org/health/wellness-and-preventi... (Update: apparently this study was retracted - see reply)

> it makes a huge difference in quality of life and healthspan: https://www.hopkinsmedicine.org/[...]

I agree with everything else, but:

That study you cited has been withdrawn for fraud:

https://www.thelancet.com/journals/lanpub/article/PIIS2468-2...

Recent discussion:

https://news.ycombinator.com/item?id=38894636

Medicare in the US doesn't cover hearing "devices" unless you need cochlear implants.

Most people have mild hearing loss. They shouldn't need to spend thousands for a pair of hearing aids, which deliver little relative to their price. Miniature electronics have improved markedly over the past couple of decades, but for some reason FDA approved hearing aids have not participated in those gains in usability and cost reduction.

> Medicare in the US doesn't cover

Thanks for the correction. I removed that sentence.

Is there Costco in Canada? Everyone on my mom's side is half deaf, and one of her brothers swears by Costco's hearing aid situation. You could get fitted and tested there for not much money, or you could see a doctor and pay 50x more. Secondhand information, anyway.

Yes, someone I know just got the hearing test and hearing aids (made by Philips) all at Costco (we're in Canada). Very good experience all-around and now this person can hear us like never before. The Philips-made hearing aid can be controlled via bluetooth, smartphone app that allows changing to different presets (for instance going to "comfort mode" when in a loud environment). No clue what that all means if you don't have a smartphone, but figured I'd mention. I've tried to convince others I know to undergo this process.

As for actually treating/helping the hearing loss, it all depends on "why", there are of course many different reasons for hearing loss so I can't comment on that aspect.

BTW in Canada, hearing aids are an eligible medical expense you can include as a tax writeoff: https://www.canada.ca/en/revenue-agency/services/tax/individ...

Makes me realize that my mom does not have nor wants a smartphone so hopefully hearing aids with non-app controls exist.

Yes there is, and I have been reading good things about Costco too when it comes to hearing correction. I wasn't sure if I should see a proper doctor/audiologist first before going to something like this.

>Is there Costco in Canada?

Costco's world headquarters are in Canada. They are a Canadian company.

Oops. Should have googled it first.

ThePowerOfFuet should have googled it. Not sure where they got the idea that Costco is a Canadian company.

Oh yeah... founded in Seattle and still headquartered in Washington [1].

[1]: https://en.wikipedia.org/wiki/Costco

IF his hearing problem is simple volume loss, and do get a professional audiologist to evaluate his hearing, then AirPods can help at considerably less cost.

Here are some articles on the matter.

https://www.ncoa.org/adviser/hearing-aids/airpods-hearing-ai...

https://www.forbes.com/health/hearing-aids/airpods-hearing-a...

https://www.techradar.com/how-to/how-to-use-your-apple-airpo...

If the problem is diagnosed to be complex, follow the doctor's advice. I can't speculate on how to evaluate/compare different prescription options that may be offered.

I have AirPod Pros. Two generations of them.

In my experience, they are useless. Not only don't they amplify external sound, they provide no compression and insufficient treble boost. Meanwhile, my $400/pair aids work pretty well.

Apple has all the hardware and software to solve this. But they don't, for some reason.

Hearing aid wearer here. There's a certain element of salesmanship that happens at hearing aid centers, but audiologists do use science to evaluate your hearing levels and they should be more than happy to show your hearing charts to you. You can take that chart to someone else and get a second opinion, if you really want to.

I don't frequently get upsell attempts by my audiologists, but they will lay out some options. They'll say "This one is what you need. If you want Bluetooth, this one works better for most people. This one over here has a really great iPhone app but doesn't work well with Android." I never have had someone say "You absolutely must use this one, because I said so."

TL;DR: Take your dad to an audiologist, get a professional opinion, get a second opinion if you want to. I would recommend getting your hearing aids from an audiologist and not a "Hearing Aid Center."

Good luck to your father! Hearing loss is tough, but treatable!

Thanks! What do you use? Are you happy with it?

I have an Oticon. I forget the exact model, but it's the most powerful of the models. (My hearing loss is very bad and I'm classified as "profoundly deaf" which as close to totally deaf as you can get and still use a hearing aid.)

My model is about 2 years old, but the Bluetooth integration is a game changer, and I use it pretty constantly at work and on my phone.

My only concern with that Bluetooth feature is that some apps are very loud and will cause bigger hearing problems down the road like constant ringing in the ears.

The volume is easily controllable, and the hearing aids themselves come with a noise ceiling that prevents sounds from getting too loud, although this is adjustable by the audiologist on a case-by-case basis. I can go to a bar or a concert and actually hear _better_ than those around me, because the hearing aid is actually keeping the sounds from being too loud.

Occasionally when the waveform flattens against the ceiling, it sounds pretty strange, but not disturbingly so.

Anyway, I've never had this problem and I've worn a hearing aid since the 80s, so I suspect it's not as big of a concern as you might think.

That's an interesting feature. I didn't know that audio technicians and scientists solved this problem. My father-in-law started wearing a hearing aid a year ago (before Biden made it easier so It had a hefty $4k price tag). It was hooked up to his phone. I don't think he was very savvy with the volume button. Often times he didn't know if the sound was coming thru bluetooth or the phone directly. Now he has a ringing problem that keeps him at night. And he needs a white noise maker to tone it down.

I will take a trip to the audiologist at Costco to get more insight. I hope it is as good as you say it is.

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