Patient Daily Living

Why Seniors Don't Wear Hearing Aids

By Chris Iliades

Presbycusis is the medical term for hearing loss that is due to the aging process and is the most common cause of hearing loss in the elderly. In the vast majority of cases this type of hearing loss is not curable or treatable and the best solution is a hearing aid. According to a recent article published in the ENT—Ear, Nose & Throat Journal, presbycusis occurs in 50 percent of seniors between the ages of 75 and 84 and increases to 95 percent by age 94.


Presbycusis is the medical term for hearing loss that is due to the aging process and is the most common cause of hearing loss in the elderly. In the vast majority of cases this type of hearing loss is not curable or treatable and the best solution is a hearing aid. According to a recent article published in the ENT—Ear, Nose & Throat Journal, presbycusis occurs in 50 percent of seniors between the ages of 75 and 84 and increases to 95 percent by age 94.

“They key to getting the most out of a hearing aid is starting with a good medical exam and then finding a hearing professional that will work with you before, during, and after your purchase.”
Despite the significant handicaps imposed by hearing loss in seniors, only about 20 percent ever buy a hearing aid and many of those are rarely used. Why don’t people take advantage of hearing aids? If you are a senior struggling with hearing loss, and you have been resisting a hearing aid, you should know that many of the common reasons given for not trying or using a hearing aid don’t make a lot of sense:
  • Association with age. It’s hard to make any concession to age in a culture obsessed with youth. But do you really think having to constantly ask people to repeat themselves doesn’t make you seem old?
  • Difficulty adapting. One of the most common reasons for rejecting a hearing aid is that it is just too complicated. “I’m too old for change—I can’t be bothered” is a common complaint heard by audiologists. Remember when the remote control for your TV seemed complicated?
  • Cosmetics. Manufacturers of hearing aids are aware that their cosmetic appeal is an important factor. That’s one reason why they keep making hearing aids smaller (even though smaller is not necessarily better). Today’s hearing aids can hide inside your ear. But even if your hearing aid is visible, is it really such a big deal? Would you be worried about someone seeing your glasses?
  • Unrealistic expectations. You may have heard from friends that hearing aids just don’t work. In many cases a bad hearing aid experience is due to a poor evaluation and fitting. But even in the best of circumstances your hearing will not go back to the way it used to be. Hearing aids do help, but they don’t cure. That’s why they’re called aids.
  • Cost. Medicaid does not cover hearing aids and they are very expensive. For some people on a fixed income this is a real concern. Diagnostic evaluations are usually covered. A single hearing aid may cost around $2,500, but if properly fitted and worn, your hearing aid can be well worth the investment.

Buying a Hearing Aid

If you have been convinced to try a hearing aid, go about it the right way. Start with your doctor. In most cases you should be referred to an ear, nose and throat specialist. Some causes of hearing loss in seniors can be corrected and the success of your hearing aid depends on getting a proper evaluation. If the specialist thinks you need a hearing evaluation it will be done by an audiologist. An audiologist is a hearing professional trained to measure hearing loss and fit you for a hearing aid.

What to Expect When Buying a Hearing Aid

You should expect your audiologist to custom fit your hearing aid and help you through the adjustment period. Just as you might expect from a car dealership, you should expect to be able to come back with any complaints or service issues. Here is what an audiologist should offer you:

  • A thorough explanation of the type of hearing loss you have and what types of hearing aids will work best for you
  • An explanation of why one or two hearing aids is advisable
  • An explanation of all the charges, including dispensing fee, servicing, repairs and warranty—ask about a trial period
  • Testing after the hearing aids have been fitted while wearing them
  • Instructions on using your hearing aid and on maintaining it

Hearing aids are expensive, but in most cases they do work and they are the best solution for most cases of senior hearing loss. They key to getting the most out of a hearing aid is starting with a good medical exam and then finding a hearing professional that will work with you before, during and after your purchase.

Cautions for Seniors and Caregivers

Although you can purchase a hearing aid from an independent dispenser, federal laws state that you need to see a physician first unless you sign a waiver. Don’t purchase a hearing aid without a medical exam. Hearing aids need to be custom fitted. Never purchase a hearing aid by mail-order. If a senior is complaining about discomfort or a hearing aid is making a squealing noise you need to go back to the audiologist. Wax can build up in the ear canal, and hearing aids need to cleaned and readjusted. A squealing hearing aid needs to go back for a tune-up.



- Written By

Chris Iliades

Chris Iliades, MD has many years of experience in clinician medicine, clinical research, and medical writing. After 15 years in private practice as a board-certified ear, nose, and throat specialist, he helped start a clinical research support company and served as its medical director.