The Impact of Hearing Loss on Older Adults in North Carolina Study - - PowerPoint PPT Presentation

A Report on

The Impact of Hearing Loss on Older Adults in North Carolina

Study Commission on Aging February 4, 2010 The Division of Services for the Deaf and the Hard of Hearing Jan Withers, Director

Overview

• Report on S.L. 2008-181, Section 12—Studies

Act of 2008

• In March 2008, the Division approached the

Study Commission with an intent to attempt to address issues within the growing older adult hearing loss populations

• Hearing loss is the least understood disability

because of its “hidden” nature

• Unaddressed hearing loss: enormous adverse

economic and public health ramifications

Overview

• Study methodology: a compilation of efforts from

three different sources: – Division staff research – Random survey of Nursing Homes and Skilled Care Facilities’ Directors—543 mailed, 254 returned at 46.7% – Study Group formed consisting of members from varied professional fields—audiologists, hearing instrument specialists, aging, legal, and consumer grassroots groups

• Divided into four groups to study the four areas

specified by the General Assembly

Overview

• Skilled Care Facility Directors’ Survey Results:

– 56% rated themselves less than knowledgeable of hearing loss and the overall impact on older adults – 72% stated no hearing loss professionals visit facilities – 68% were not aware of hearing aid purchase assistance programs – 63% do not provide hearing loss assessments as part of the intake process – 54% consider the facility to be fully accessible for ALL persons with hearing loss – Special notes: Directors requested 1) more information; 2) hearing aid purchase assistance from Medicare and Medicaid for residents

Findings of the Study

• Demographics
• Tangible Impact and Costs

– Severe Adverse Economic Ramifications

• Intangible Impact and Costs

– General Health and Well-Being

• Physical, Social, Medical, Mental effects

Demographics--2008

2008 NC Population age 18 and over

174,867 216,494 5,870,528 631,744 507,724 681,568 1,000,000 2,000,000 3,000,000 4,000,000 5,000,000 6,000,000 7,000,000 18-64 65-74 75 and up

Total Population Total Population with Hearing Loss

Hearing Loss % is derived fromthe 2008 Series 10 report data fromwww.cdc.gov/nchs/nhis.htm P

• pulation data from http://www.osbm

.state.nc.us/dem

• g/countytotals_agegroup_2008.html

(11.61%) (27.68%) (42.64%)

Demographics--2029

2029 NC Population age 18 and over

915,599 7,567,000 1,278,527 428,867 386,371 892,906

1,000,000 2,000,000 3,000,000 4,000,000 5,000,000 6,000,000 7,000,000 8,000,000 18-64 65-74 75 and up

Total Population Total Population with Hearing Loss

Hearing Loss % is derived fromthe average of Series 10 reports from2004 to 2008 fromwww.cdc.gov/nchs/nhis.htm P

• pulation data from http://www.osbm

.state.nc.us/dem

• g/countytotals_agegroup_2029.html

(11.80%) (30.22%) (46.84%)

Demographics

• Population totals do not reflect the facts that:

– Because NC is a retirement haven, the state has a higher percentage of older adult residents with hearing loss than surrounding regional states – Involvement by adult children, family or care givers when misunderstandings occur due to communication issues experienced by older adults only broaden the impact spectrum – End Result: significantly more people are impacted by hearing loss either directly or indirectly

• NC ranks highest in hearing loss population of regional states—

GA, TN, SC, VA

Tangible Costs of Hearing Loss

• Economic Ramifications

– 95% of the hearing loss population can benefit with use of hearing aids – However, only 23% reportedly use hearing aids – High COST of hearing aids is the most frequently stated reason for not seeking hearing aid treatment – Average retail hearing aid costs range from $1400 to $5000 per hearing aid – Consumer Reports cites average mark-up pricing at 117% above wholesale costs; found ranges from 25% to 300% mark-up

Tangible Costs of Hearing Loss

• No mandated insurance coverage from private or

public sources for adult hearing aids; decreasing number of non-profit and civic groups able to help due to diminishing membership and the economy

• Persons with untreated hearing loss are shown to

have approximately $13,000 less income per year than those using hearing aids

• Lost incomes mean lost tax revenues for state
• An estimated lost income of $3.2 billion for NC

citizens equates to lost annual tax revenue of $477.4 million

Intangible Costs of Hearing Loss

• Impact on Health and Well-Being

– In 1999, a study by the National Council on Aging debunked the myth that hearing loss in older adults was a harmless condition – Hearing health care providers have projected hearing loss to be a public health problem due to increase in population – The Centers for Disease Control noted a correlation between the quality of hearing health and the quality of overall health. The greater the hearing loss, the greater the chance that the individual would report poor health.

• 28.9% of those deaf or who have a lot of trouble hearing report
• nly fair or poor health as opposed to excellent or good health

while only 10.5% of those with good hearing report fair or poor health.

Intangible Costs of Hearing Loss

• Strong association of hearing loss with the following:

depression, anxiety, impaired memory, paranoia, reduced coping skills, reduced ability to learning new tasks

• The inability to effectively participate in

communication leads to greater isolation and withdrawal and leads to lower sensory input

• Hearing loss is the 3rd most chronic, but treatable

condition among older adults following arthritis and hypertension

Intangible Costs of Hearing Loss

• Lack of Knowledge by General Populace
• Confused on how to address hearing loss and

possess unrealistic expectations of results of treatment

• Unaware of resources and how to access to them
• Hearing loss is becoming a health care issue

because it is erroneously assumed that many professionals, including medical, have the necessary expertise to address hearing loss issues

• Only 12.9% of primary care physicians perform

some form of hearing screening

Intangible Costs of Hearing Loss

• Ear, Nose and Throat physicians, Audiologists,

Hearing Instrument Specialists are available to help with varied needs of people with hearing loss

• These professionals often do not address the full

spectrum of needs such as coping skills, grief counseling, effective use of assistive technology.

• A comprehensive approach to treatment is critical to

ensuring successful use of hearing aids and other devices

Significant Conclusions to Study

• Hearing loss is widespread among older adult and,

left unaddressed, could have profound and devastating impact on their health and functioning

• Hearing loss is highly varied, complex and very little

understood, even among professionals

• Effective communication is the key to an individual’s

ability to develop and maintain healthy social connections and to independently access and use the services and resources in their own communities

Recommendations

• In order to address these issues and to

enable older adults with hearing loss to achieve effective communication, three recommendations are presented:

Recommendation One

• Establish a task force to assess the feasibility of

developing and implementing a formal system that

• ptimizes consumer capacity to fully evaluate quality
• f hearing aid services prior to and during the process
• f purchasing hearing aids

– Consumer protection tool to prevent costly errors – Enhance awareness and empower consumers, especially

• lder adults, in making informed decisions

– reassure customer of professional integrity at all times – Involve professionals from every aspect of the hearing health care industry in developing solutions

Recommendation Two

• Enact legislation that would require all hearing aid

dispensers provide a minimum of a 30-day trial period with money back guarantee and instruction on the function of the telecoil and its use

– Also a consumer protection issue; two-part recommendation – Part A: Eliminate costly misunderstandings and clarify for the

• lder adult any and all fees associated in the process, with or

without a purchase – Delineate for the consumer responsibilities of both parties including any financial responsibilities

Part B: Provide better use of telephone by removing the electromagnetic interference between the hearing aid and telephone

• -Allow a Hard of Hearing and sometimes Deaf consumer to

receive needed amplification and easier access to sounds from electronic audio equipment including radios, public address systems and assistive listening devices

• -Most consumers are unaware of this beneficial device and

do not inquire about it; likewise, many dispensers do not inform customers the device exists

Recommendation Three

• The General Assembly should consider legislation

requiring hearing aid health insurance coverage for all ages from any private agency providing health insurance and doing business in North Carolina and from any public agency providing medical insurance coverage assistance.

– Hearing aids are expensive and improvements in technology cause costs to rise rapidly – Costs is a primary reason for non-treatment – Currently, health benefits plans rarely include coverage for hearing aids; totally out-of-pocket expense

• -Some older adults seek a last resort purchase via

internet or mail order, which is very risky

• -Maximum benefits to amplification comes from an

appropriate device properly fit and regulated to the individual’s hearing loss

• -(HB 589 / SB 375—children’s coverage)

QUESTIONS?