Baby Boomers and Hearing Loss: A Guide to Prevention and Care
RATING: 5 ears
AUTHOR: John M. Burkey
PUBLISHER: Rutgers University Press
REVIEWER: Mary Anne Pinner, AuD, Department of Communicative Disorders, University of Florida.
SYNOPSIS: Written in essentially layman's terms Baby Boomers and Hearing Loss: A Guide to Prevention and Care describes the function of the hearing mechanism, causes of hearing loss, treatment of hearing loss and preventative measures. The author, John M. Burkey introduces patients and then references the patients throughout the book highlighting the many solutions employed in addition to hearing aids, to enhance communication effectiveness. A thorough explanation of the audiogram and degrees of hearing loss are enhanced by actual audiograms. Examples with explanations are provided to describe the various styles of hearing aids. One excellent chapter discusses satisfaction and dissatisfaction with devices highlighting quality of life issues and extensively citing Sergei Kochkin's research. Another chapter is devoted to non-hearing aid solutions which highlights listening demands in various situations and strategies to employ to enhance the hearing experience in adverse situations. Under the heading of new and future options in Chapter 8, the use of otoacoustic emissions, open ear technology, cochlear implants, BAHA and hair cell regeneration are briefly reviewed. The last chapter pays credence to the consumer complaint of high cost for hearing aids and the lack of insurance reimbursement for aids. Consumer friendly resources are provided.
REVIEW: The introduction makes a compelling case for why all adults, and in particular baby boomers, should be concerned about hearing loss due to its impact on relationships, work, leisure pursuits and safety. Encouraging boomers to take control of their hearing care future should appeal to this age group.
Chapter 1 begins with a patient visit, discussing the patients need to hear well in her employment setting. Unfortunately, the setting is a funeral home which may seem off-putting to some baby boomers that are in denial of their own death. Once past that premise, the overall need to hear soft speech and the real-life consequences of untreated hearing loss in the realms of social interaction, loneliness, reduced independence and fatigue are discussed with research supported conclusions. At the conclusion of the chapter a patient is introduced with solutions specific to her hearing loss.
Chapter 2 discusses boomer specific issues, including the diversity and size of this population in relation to previous generations. Noise induced hearing loss and age related hearing loss statistics are cited. Boomers should enjoy longer lives than previous generations with more years spent working. The need to hear well on the job suggests increasing demand for hearing services by boomers. Boomers will want to "take control" of the hearing loss, educating themselves about prevention and interventions.
Chapter 3 covers external, middle and inner ear functions with explanations of hearing loss types. The author provides a good working explanation of the decibel. Thankfully, a description of severity of hearing loss is contrasted with the lay perception of percentage of hearing loss. Appropriately emphasized in his explanation of the audiogram is the importance of word discrimination scores and word understanding ability.
Chapter 4 discusses causes and treatments for hearing loss in order of preventable, treatable or "surmountable." Noise exposure is covered at length with due emphasis on the deleterious effects of leisure time exposure. Health issues with known links to hearing loss such as smoking, high blood pressure, diabetes and toxic medications are covered. One section provides a good overview of the relationship between chemicals and ototoxicity. Thorough explanations of treatable hearing loss with the advice to seek medical treatment where needed is provided. The chapter concludes with the surmountable hearing losses, primarily sensorineural of either genetic or age related origin. A brief discussion of tinnitus and treatment options would have been helpful at this point. These concluding thoughts segue well into Chapter 5 which covers hearing aid styles, circuits and options. Appropriate amplification rather than style is emphasized. Binaural vs. monaural fittings along with suggested prices are provided. Consumer rights after purchase are reviewed.
A most welcome discussion of satisfaction and dissatisfaction with hearing aids ensues in Chapter 6. The author cites the ten most common complaints about hearing aids and systematically explores each complaint differentiating perception from reality. Approximately five pages are devoted to satisfaction with hearing aids. User factors are given adequate coverage. By the end of the chapter the reader should feel positive about trying hearing aids understanding benefits and satisfaction are clearly two different outcome measures.
Fair time is given to non-hearing aid solutions in chapter 7. Having a plan for hearing better under various circumstances and using non hearing aid tools such as alerting devices are covered. Various telephone strategies and devices are discussed as well as personal FM systems. Provision of this information reinforces the notion that hearing aids alone are not the answer for all of a patient's listening demands.
Chapter 8 is devoted to new and future options with prevention as the introductory topic. Under the heading of prevention, the use of otoacoustic emission testing as a sensitive measure of hair cell function supports the use of this testing even in patients with audiometrically normal hearing sensitivity. Research on medicines to prevent noise-induced hearing loss is briefly covered. Candidacy for cochlear implants and BAHA are reviewed with information on the devices and operation. Future improvements to directional microphones and feedback suppression features are reviewed as well as a brief paragraph on open ear acoustics. Hair cell regeneration research concludes the chapter.
Chapter 9, titled, The Issues that Remain, provides a balanced look at the issues of direct access, the FDA and history behind the medical waiver. Issues surrounding over the counter devices are reviewed in a balanced fashion. Finally, insurance coverage for devices is discussed along with a call to advocacy for hearing research.
CRITIQUE: Using a title of Baby Boomers and Hearing Loss: A Guide to Prevention and Care, John M. Burkey directly entices boomers to read it yet the content serves as an excellent comprehensive guide to hearing topics for all hearing impaired adults. Dispensing audiologists will want to have this book in their patient lending library as it provides excellent explanations of existing technology in generic terms with a final call for consumer advocacy on the topics of insurance coverage and direct access to audiology. One note, though, inclusions of references to payment sources such as Medicaid or the Department of Education, Vocational Rehabilitation Services might have proven useful to consumers.
Hearing aid fitting practices are evolving at a rapid pace in part due to receiver in the aid and receiver in the ear technology. Unfortunately, this technology is not covered in depth. The author can not be faulted though, as most audiologists were unprepared for the rapid advances by manufacturers in this field. The hearing conservation information combined with a wealth of information for hearing impaired boomers make this book a must have for any practice working with boomers or hoping to attract more of these patients.