Category: Blog

The most common service-connected disabilities for American Veterans are hearing loss and tinnitus, which is a ringing or buzzing in the ears. An estimated 3.6 million Veterans receive compensation for hearing loss or tinnitus.¹ And this impacts Veterans from every war from World War II through the Korean, Vietnam, and Gulf Wars, as well as those who served during peace time.

Compared to the general male population, 11% fewer male Veterans have good to excellent hearing while 10% more have at least moderate trouble hearing.²

Both hearing problems and tinnitus can impact quality of life and communication. Both also contribute to isolation, frustration, and even depression without intervention.

We sat down with audiologist Stephen DeMari, who is also Sorenson’s director of business development and education, to talk about Veterans and hearing loss due to military service.

Why talk to Stephen about hearing loss in Veterans?

Stephen has more than 30 years of experience in the audiology and hearing aid industries. He earned his master’s degree in audiology from Syracuse University. He then completed a clinical and research audiologist fellowship at the Department of Veterans Affairs Medical Center in Long Beach, California. He’s a member of both the American Academy of Audiology and the American Speech-Language-Hearing Association.

Q: Do Veterans have different types of hearing loss than the general population? 

A: No. There are different types of hearing loss. Conductive hearing loss occurs in the outer and/or middle ear. It can be caused by debris, excess ear wax, disease, or trauma.

Sensorineural hearing loss (SNHL), results from noise exposure, age, disease, or a combination of these. It involves the inner-ear and/or auditory nerve. It’s usually the result of damage to the hair cells in the inner ear. Severity of SNHL can be mild to profound.

SNHL is the most common type of hearing loss for Veterans and non-Veterans. Veterans most commonly suffer from high-frequency SNHL, which means they struggle to hear high-pitched sounds.

Q: What are some of the causes of hearing loss for Veterans? 

A: Hearing is a complex mix of three parts of our ears. Sound waves vibrate tiny bones in our ears and those vibrations create waves that interact with hair cells in our ear and create an electric signal that the brain interprets as sound.

That’s a very basic and abbreviated description. The complexity of it creates a number of opportunities for aging, noise exposure, disease, and heredity to affect hearing. Still, the most common cause of hearing loss is loud noise.

Hearing loss for service members results from gunfire, aircraft, tanks, bombs, and trauma from blast explosions. With noise-induced hearing loss (NIHL), the longer the exposure and the more intense sound, the greater the damage that occurs.

A lawn mower has a decibel level of about 95, while military guns range in the 150 decibels. Grenades and louder explosives can exceed 170 decibels.  Anti-tank fire can approach 190 decibels. A single grenade or tank blast can cause immediate and permanent hearing loss. Anything over 140 decibels instantly damages nerves. Exposure to 130 decibels can cause permanent damage with as little as 30 minutes of exposure.
Q: What are some of the symptoms a veteran may experience with hearing loss or damage? 

A: Symptoms depend on the severity of impact. Tinnitus isn’t hearing loss but a sensation of ringing, buzzing, clicking, or even roaring in one or both ears. It can seem like an engine or appliance is always running nearby. For some people, it’s loud and persistent enough to be debilitating.

A feeling of fullness in the ears can be a symptom of hearing loss. It can feel something like needing to pop your ears when you go up in elevation. Other symptoms of general hearing loss include:

• Asking people to repeat themselves or misunderstanding what they say
• Needing the television volume louder than normal
• Difficulty understanding speech, especially in the presence of background noise
• Fatigue after conversation, which results from struggling to listen
• Missing the phone or doorbell ringing

With high-frequency SNHL, Veterans might struggle to hear consonants. Speech will sound like mumbling.

Often, it’s the people a veteran interacts with who first notice a change in a veteran’s hearing.

Q: Does hearing loss only affect older Veterans? 

A: Hearing loss can affect Veterans of any age. It can also affect them while still actively serving. As I mentioned, exposure to a loud enough sound, such as tank fire, can damage hearing immediately and permanently. And as we grow older, our cognitive ability to understand speech naturally declines, as does our hearing sensitivity.

If exposed to sustained, unprotected noise levels during combat or training, a service member can experience hearing loss and/or tinnitus. High-frequency SNHL is the most common form among Veterans, old and young.

Q: Are there things Veterans and active-duty service members can do to prevent hearing loss? 

A: The only preventative methods are avoiding the noise and wearing hearing protection when possible. Ear plugs offer 30 to 40 decibels of attenuation (sound reduction). The military does buy and provide a lot of ear plugs. Earmuffs — like the headphones you see naval servicemen wearing — are another option. Some helmets also have built in hearing protection. Over time though, even with hearing protection, loud noise can damage hearing.

These devices help during active duty, but a veteran exposed to loud noises who didn’t have these options has likely already suffered damage. And even though they may not yet have symptoms of NIHL, their hearing may have been damaged. Options there include Veterans Health Administration (VHA) programs that offer further NIHL prevention and aural rehabilitation services to optimize remaining hearing.

Definitely, any inactive veteran should take the same precautions to protect their hearing as everyone should by avoiding loud noise and wearing hearing protection when using power equipment.

There are a variety of things anyone can do to naturally protect their hearing.
Q: What can vets do if they’re experiencing symptoms of hearing loss and/or tinnitus? 

A: It’s important to see an audiologist. A vet can do that through their local Veterans Affairs Medical Center (informally called the VA). The U.S. Department of Veterans Affairs website is a great place to start if you don’t know your local VA yet.

In some cases, the effects of tinnitus can be alleviated by a hearing aid or tinnitus program.

Q: Can a vet just see their non-VA doctor or audiologist?

A: Vets can see any doctor they choose. If they qualify for the Veteran’s Choice Program, their care for a covered non-VA doctor is covered under their VA benefits. The potential advantage of using a VA medical facility is that those practitioners specialize in helping Veterans with issues, including hearing loss, due to military service.

Q: Are VA audiologists licensed professionals? 

A: Yes. Each of the over 1,000 audiologists employed by the VA must hold a state license and participate in continuing education according to state regulations. And the Veteran’s Health Administration (VHA) operates the nation’s largest audiology program with audiologists at 400 locations.  So, whether a vet chooses their own provider or a VHA provider, they have access to excellent care.
Q: How do Veterans get a hearing test with the VA? 

A: Once enrolled for medical services at a VA facility, they can arrange for an audiometric test. If they’re deemed eligible for hearing aids, they’ll be scheduled for a fitting as well.

Many hearing aids can be adjusted remotely through the VA’s live video conferencing service, VA Video Connect. Veterans can contact their nearest VA audiology clinic to see if telehealth visits are available in their area.

Q: Do VA benefits cover hearing tests, hearing aids, and cochlear implants?

A: They do if the hearing loss is related to military service. Vets can get their hearing aids, hearing aid batteries, and related appointments covered under their VA benefits.

The VA also covers cochlear implants, which are devices that are surgically placed in the skin and used with an external device to transmit sound directly to the auditory nerve. Cochlear implants are sometimes the only option when hearing loss is significant enough or beyond the scope of hearing aids.

If a vet’s hearing loss is deemed to not be service-connected, Medicare may pay for hearing aids for older vets.

Q: Does the VA provide the latest hearing aids and cochlear implants? 

A: Yes. For eligible vets, the VA dispenses hearing aids from the top six manufacturers, GN Resound, Oticon, Phonak, Siemens (Signia), Starkey, and Widex. The devices provided by the VA are actual premium devices that sale for the highest prices in the non-veteran sector.

They also offer cochlear implants from three FDA-approved cochlear implant manufacturers, Cochlear Corporation, Advanced Bionics, and MedEl.

Q: Does the VA offer other hearing solutions for vets?

A: Yes. The VA also offers FM systems, which are frequency modulated (FM) systems. With such a system, someone speaking wears a small microphone that is transmitted to a receiver worn by the person with hearing loss. The transmitter can even be attached to a hearing aid.

Vets also have access to TV amplifiers and transmitters, remote microphones, and internet protocol (IP) captioned telephone service through the VA and other programs and based on their needs.

A TV amplifier works like an FM system but with a TV.

Q: What else can Vets do about hearing loss?

A: There are a variety of tools available to anyone with hearing loss. There are smartphone apps designed to assist with hearing loss, including captioning apps. [*Some no-cost apps have user eligibility standards].

Captioning apps are available. And captioned telephone service uses either a specially designed phone or a smartphone to turn spoken phone conversations into readable captions. Captions on a TV or show can also help. Studies have shown that captions can help with comprehension, even when someone wears hearing aids.

There are also aural rehabilitation programs, including some offered by the VA, designed to help reduce or compensate for hearing loss.

Support groups and organizations are also available to help Veterans with hearing loss, including HLAA Veterans Across America Virtual Chapter (VAAVC).

Whether a vet has symptoms of hearing loss, practicing good hearing hygiene is always a good idea as well.

Q: How can Veterans get captioned telephone service for hearing loss? 

A: Sorenson and other providers offer captioned telephone service to vets and others with hearing loss that requires they have captions to use the phone effectively.

Sorenson offers both CaptionCall and CaptionCall Mobile app by Sorenson to help vets with hearing loss stay connected. CaptionCall transcribes phone conversations using a specially designed phone with a screen for captions. CaptionCall Mobile is a smartphone app that captions calls on a mobile phone.

Vets can ask their audiologist about this no-cost service or visit Sorenson — Global Communications Solutions for People, Businesses, and Enterprises to learn more.

Request CaptionCall by Sorenson for your home

Download the CaptionCall Mobile app

Q: How do Veterans qualify for captioned telephone service? 

A: Captioned telephone service is available at no-cost to anyone with hearing loss that necessitates the use of captioned telephone service to use the phone effectively. Vets who meet this eligibility requirement can access the service through their audiologist by self-certifying they need it when they enroll.

Q: Do Veterans need to have internet access to use CaptionCall or CaptionCall Mobile service? 

A: No. Anyone who qualifies, including Veterans, can get captioned telephone service without internet access on select phones. And all that’s needed to use the CaptionCall Mobile app is a Wi-Fi connection or mobile (cellular) data connection.

by Rupa Balachandran, PhD, CCA-A

The key principles of patient-centered care for hearing health require understanding the emotional and physical needs of the patient while developing a solution that addresses their daily lifestyle. Best practices for patient-centered care go beyond excellence in diagnostic services. Understanding the attitudes, concerns, health literacy needs, and priorities of individuals with hearing loss are key to determining the right treatment options.

What is patient-centered care?

The Institute of Medicine (IOM) defines patient-centered care as “providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient’s values guide all clinical decisions,” (IOM, 2001). The Picker Institute further divided the principles of patient care into eight categories.

These principles, when applied to hearing health care, provide valuable insights into the areas where hearing health providers can develop and enhance our current practices. Applying these principles to hearing health care improves accountability and helps gather information on how well we’re serving the needs of  patients.

In this article, I dig deeper into these eight person-centered principles of health care as they apply to hearing health.

1. Respect for the patient’s values, preferences, and expressed needs

Patients value health care providers who create a positive and supportive environment. Acceptance and adjustment to a diagnosis of hearing loss only happens in an environment where a patient receives information in an empathetic manner.

Interviews with patients about the adoption and use of hearing aids indicated that patients were more likely to pursue the use of hearing aids and overcome challenges in adapting to hearing aids when they perceived consideration, warmth, and empathy from their health care provider (Blazer et al., 2016).

A review of first-time consultations with audiologists in Australia found that patients perceived a lack of empathy and a gap between their needs and the goals of the audiologists’. For example, when the audiologists delivered the diagnosis, two-thirds of them directly transitioned into a recommendation for hearing aids, without allowing the patient time to react or ask questions about the diagnosis and without discussing other available treatment options. For example, hearing assistive technologies, communication programs, and support groups (Ekberg et al., 2014).

When the encounter with the professional creates a negative perception, the individual often delays taking action, resulting in putting off opportunities to improve quality of life and well-being (Clements, 2015).

A patient-centered care model involves going beyond understanding the needs of the patients; it includes measuring if those needs were met. Requesting feedback from patients about whether they were treated respectfully, felt their values were taken into consideration, and whether they felt their needs were met during their encounter with the provider, provides information that can be used to improve on existing clinical services.

Patient satisfaction surveys sent to a patient after an appointment can help a practice hone its patient-centered care efforts. These surveys can be easily administered electronically with web-based survey tools.

2. Information and education

The first consultation with an audiologist or other hearing health care professional can have a long-term impact on decision-making and outcomes (Clements, 2015). In the hearing health care space, discussion of different treatment options and opportunities for social and emotional support lead to a comprehensive solution for patients.

In addition to a  recommendation for hearing aids, written information about the following resources can  help people with hearing loss.

Assistive-listening devices

Other options for treating hearing loss  include assistive listening devices and technologies that give situation-specific help to people with hearing loss. Technologies such as captioned phones, amplified phones, amplified wireless headsets for television, and other audio streaming can be part of an amplification strategy.

Smart phone applications also provide options for amplification and captioning speech in real-time.

Community support

Providers should include information on community-based education programs, such as speech-reading classes and aural rehab groups.

Patient-centered care can also include providing information on support groups for people with hearing loss, such as the Hearing Loss Association of America and hearing-impaired professionals groups that are available both locally and online. These groups not only provide additional support, they help people with hearing loss develop a sense of acceptance and shared community.

Ongoing device support

Health care providers need to offer patients regular updates on the use, operation, and maintenance of hearing aids and hearing assistive technologies after the initial fit. Links to videos and tutorials on care and maintenance of devices, along with a newsletter on what devices can do are a helpful reminder of how people with hearing loss can benefit from different technologies available in their devices.

These additional avenues of support help create an environment where individuals with hearing loss can understand and accept their hearing abilities and achieve positive outcomes with amplification. This in turn strengthens the provider-patient relationship.

3. Access to care

Improving access to care involves providing easy access to the hearing health care provider and addressing the national shortage of hearing health care providers.

With the expected increase in the aging population and market factors keeping the supply of audiologists fairly low, there’s an expectation that new avenues need exploring to improve access to hearing health care (Marquardt et al., 2017). Clinicians today have access to multiple technologies that reduce the need for in-person visits.

Online technologies and patient management portals

Web-based technologies make requesting appointments easy for clinicians and patients. The ability for patients to select the day and time of their appointment themselves; timely appointments; short waiting time in the office; and timely response to emails and telephone calls can be accomplished with the use of a customized patient management portal.

Tele-audiology

The global pandemic  forced practices to transition quickly to tele-audiology, which enables remote appointments that increase efficiency and productivity for the patient and provider. Remote appointments also increase access for patients who can’t get to — or from — the office without transportation assistance. Every provider has had instances where a patient waited in the clinic long after their appointment for a transport to pick them up.

Hearing health care doesn’t reach everyone who needs it. Residents of rural and low-income urban areas are at a particular disadvantage in accessing care.

Tele-audiology holds the key to increasing access for patients who also live several hundred miles away from their provider. Increasing the infrastructure to support a variety of tele-audiology appointments goes a long way toward alleviating the lack of providers in remote areas.

4. Emotional support to relieve fear and anxiety

Despite technological advances, the psychosocial concerns of adults with hearing loss continue to have impact on the decision to seek help for their hearing loss and rehabilitation. Patient attitudes towards amplification are critical influential factors driving consultations for hearing device adoption (Meyer, 2014). Patients experience a variety of emotions when adjusting to a diagnosis of a hearing loss. These include sadness, disappointment, fear, and worry.

Clinician response to patients during this time is an important aspect of patient-centered care. For a lot of patients, the recommendation of a hearing aid triggers an unpleasant association. They may equate hearing aids with old age and lack of independence (Claesen & Pryce, 2012).

When a patient raises these issues with the provider, it’s important that they feel their concerns are heard. A clinician’s interpersonal skills, along with active and empathetic listening, can facilitate more positive associations with hearing aids and foster a strong therapeutic relationship (Grennes et. al 2015). Setting aside time within the appointment to listen to the patient’s concerns and validate them is a critical step towards a strong patient-centered hearing health care model.

5. Involvement of family and caregivers

The National Quality Forum’s National Priorities Partnership characterizes patient-centered care as health care that “honors each individual patient and family, offering voice, control, choice, skills in self-care, and total transparency, and that can and does adapt readily to individual and family circumstances, and to differing cultures, languages, and social backgrounds” (NPP, 2010). For family, friends,  and other caregivers of adults with hearing loss, their contributions fall into two categories:

1. Functional assessment: Family and caregivers can add their perspective on how the hearing loss affects the everyday activities for the person with hearing loss, including their ability to communicate with those around them.
2. Treatment efficacy: They can weigh in on the benefits or challenges associated with the different treatment options for the patient. This information helps the provider make the most suitable recommendation for managing the hearing loss.

Patient-centered care is more than just agreeing to whatever the patient wants. It involves identifying issues that are meaningful in the patient’s life and tailoring a solution that works with the patient’s values. It involves respect for their feelings and emotions along with buy-in from their family, caregivers, and loved ones.

This provision of patient-centered care is complex and time-consuming, and requires broad involvement of the patient, the family, and the care team to consider all  issues that affect the patient’s care.

6. Continuity and secure transition between healthcare settings and coordination of care

Often hearing health professionals are required to share information with other key healthcare providers and work as a part of a team to provide appropriate care for their patient. Timely sharing of health information, appropriate referral to specialists, and keeping the primary care physician informed of the care plan are all key components of patient-centered hearing healthcare.

Working with a HIPAA-compliant electronic health record alongside secure transmission channels of health records is essential. Creating workflows within the administrative office that give patients easy access to their test results and nimble coordination between different providers and insurance go a long way toward building patient confidence and trust in the healthcare provider.

7. Physical comfort

In a hearing health care environment, care must be taken to ensure that the person is in a physical space that feels safe and secure and promotes participation. Ways create a safe and secure environment include:

• Room lighting that reduces glare
• Increasing visual contrast in walkways and doorways
• Having furniture that’s solid and not prone to shifting when the person sits down or stands up
• Signage that’s clear and easily understood
• Providing marketing materials that reflect and respect the patient’s cultural beliefs
• Making pocket talkers and amplifiers available for patients to use during appointments

These techniques help create an office where the patients feel that their values are respected and that the care they receive is comprehensive, competent, and delivered by professionals who care about their well-being.

8. Support for HCP in patient-centered care environments

A comprehensive discussion of patient-centered care needs to include support for those who provide the care. For most practices, patient-centered care requires a significant investment of time and resources.

Many providers are overwhelmed by decreasing reimbursements and encroaching threats to their scope of practice. With a healthcare industry undergoing significant transformations, there’s a need to identify mechanisms that support the provider in reaching the goals of patient-centered care.

Best practices in patient centered care are those that also take into account sustainability from a practice standpoint. Conversations around patient-centered care must include adequate reimbursement for the provider through appropriate billing codes and consideration of fee-for-service models.

Conclusion

Implementation of patient-centered care has very clear benefits for both the patient and the provider — better treatment outcomes, better health outcomes, stronger therapeutic relationships, and improved financial outcomes for the practice.

About the Author

Rupa Balachandran, PhD, CCA-A

Martinez VA Medical Center
150 Muir Road
Audiology Section 126
Martinez, CA 94553-4668

Email: [email protected]
LinkedIn: linkedin.com/in/rupa-balachandran

Sources

1. Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, Audiologists, on the Internet at Audiologists
2. Claesen, E., & Pryce, H. (2012). An exploration of the perspectives of help-seekers prescribed hearing aids. Primary Health Care Research & Development, 13, 279–284. doi:10.1017/ S1463423611000570
3. Clements, C. (2015). Why do older adults delay in seeking help for hearing loss. Journal of Otolaryngology-ENT Research, 3(4), 00070.
4. Ekberg, Katie, Caitlin Grenness, and Louise Hickson. “Addressing patients’ psychosocial concerns regarding hearing aids within audiology appointments for older adults.” American Journal of Audiology 23.3 (2014): 337-350.
5. Gerteis, M. (1993). Through the patient’s eyes: understanding and promoting patient-centered care.
6. Blazer DG, Domnitz S, Liverman CT, editors. Hearing Health Care for Adults: Priorities for Improving Access and Affordability. Committee on Accessible and Affordable Hearing Health Care for Adults; Board on Health Sciences Policy; Health and Medicine Division; National Academies of Sciences, Engineering, and Medicine; Washington (DC): National Academies Press (US); 2016 Sep 6. 3, Hearing Health Care Services: Improving Access and Quality. Available from: NCBI - WWW Error Blocked Diagnostic
7. Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C., & Davidson, B. (2015). The nature of communication throughout diagnosis and management planning in initial audiologic rehabilitation consultations. Journal of the American Academy of Audiology, 26(1), 36-50
8. Grenness, C., Hickson, L., Laplante-Lévesque, A., Meyer, C., & Davidson, B. (2015). Communication patterns in audiologic rehabilitation history-taking: Audiologists, patients, and their companions. Ear and Hearing, 36(2), 191-204.
9. Institute of Medicine (US) Committee on Quality of Health Care in America. (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press (US).
10. Marquardt et al 2017. Supply and Demand of Audiologists in the US | Hearing Health & Technology Matters . Meyer, C., Hickson, L., Lovelock, K., Lampert, M., & Khan, A. (2014). An investigation of factors that influence help-seeking for hearing impairment in older adults. International Journal of Audiology, 53, S3–S17. doi:10.3109/14992027.2013.83
11. NPP (National Priorities Partnership). Patient and family engagement. 2010. .
12. Picker Institute: Principles of patient-centered care.

More than 60 million Americans over age 12 have some level of hearing loss.¹ Losing your hearing can be inconvenient, and frustrating. It may even lead to isolation, which can contribute to cognitive decline.² Luckily, as with most things, there’s an app for that — an app for living your best life with hearing loss, that is!

Let’s take a look at 9 of the best smartphone apps for hearing loss. Many are great for Deaf individuals too.

Included here:

CaptionCall Mobile  |  Live Transcribe  |  Live Transcribe and Notification  | Talk to Deaf  |  Sound Amplifier (iPhone)  |  Sound Amplifier (Android)  | Subtitles Viewer! (iPhone)  |  AudioCardio Hearing & Tinnitus  |  Shazam: Music Discovery

1. CaptionCall Mobile call-captioning app

Cost: $0 if you self-certify that you have hearing loss and need captioned calls to effectively use the phone, the cost of captioning is covered by federal funds. The service is unavailable otherwise.

If you have hearing loss and need captions to understand phone calls,  CaptionCall offers two great options for connecting to our call-captioning service. One is a specially made home phone with a screen that shows captions. The other is a mobile app that turns your smartphone into a captioning screen.  CaptionCall offers both services at no cost and requires only that you self-certify you have hearing loss and need captions to effectively use the phone.

Captioned calls work like closed captions on your TV. A captioning service converts spoken words into captions or text that appear on your phone’s screen in real time, so you can read along and keep up with the conversation.

CaptionCall Mobile captions calls using speech-recognition technology. It displays the captions on your mobile phone screen instantly. This is different than using the built-in captioning on your phone. It gives you faster, more accurate captions.

Of the available mobile captioning apps, CaptionCall Mobile is our favorite, not because it’s a Sorenson product, but because it works in real-time. There’s no lag or delay between what your caller says and seeing the caption text on your phone screen

Rating on Google Play

4 out of 5 stars

Rating on Apple App Store

4.8 out of 5 stars

Get CaptionCall Mobile for your mobile phone

2. Live Transcribe

Cost: Free basic version, optional monthly subscription for more features

Live Transcribe from Mighty Fine Apps is one of the best apps available for Deaf and hard-of-hearing individuals. It transcribes voice to text for any speech in range of your phone’s microphone. You can even set it to start transcribing the moment you open the app.

One advantage compared to a standard transcription app is that it lets you make the text as big as you want. You can even have the text fill the entire screen. It also offers captions in more than 70 languages and even lets you filter out profanity.

You can also save transcripts of conversations to a messaging app or note-taking app on your phone.

A small disadvantage of Live Transcribe is that it’s only available for iOS.

Rating on Apple App Store

4.6 out of 5 stars

Download from the App Store

3. Live Transcribe and Notification

Cost: Free

Live Transcribe and Notification from Research at Google gives you both live transcriptions of spoken conversation and sound notifications.

Live Transcribe turns spoken conversation into fairly accurate written captions in real-time and supports more than 70 languages.

Unique features include the ability to add your own frequently used words, such as names and household items. You can also use it to set your smartphone to vibrate when someone says your name.

Unlike Live Transcribe above, Google’s version doesn’t automatically save transcripts, but it does give you the option to save them manually. It will also only save them for three days. To keep them longer, you can copy and paste them into another program.

The notifications part of Live Transcribe and Notifications lets you choose custom sounds, flashing lights, or vibration mode to alert you to stove timers, smoke alarms, baby monitors, sirens, and more.

Rating on Google Play

3.8 out of 5 stars

Install from Google Play

4. Talk to deaf for Android

Cost: $6.99 annually

If you don’t want or need notifications, Talk to deaf from Kickdata is a good option. It does come at an annual cost of $6.99 but has a solid 4.1 average rating.

Talk to Deaf quickly translates spoken language into text displayed on your phone screen. You can customize the font and size for easier reading. You also have the option to save your conversation history.

A disadvantage of this app — or maybe a benefit depending on your needs — is that you must press the microphone button to capture speech.

Rating from Google Play

4.1 out of 5 stars

Install from Google Play

5. Sound Amplifier

Cost: Free

Another app from Mighty Fine Apps, Sound Amplifier boosts the volume on your surroundings.

This app uses your phone’s microphone to pick up sounds and increase the volume up to 100x through your connected headphones, while also minimizing background noise and taking advantage of its voice isolation feature.

Use it to amplify conversations, TV shows, movies, lectures, and more. While this app packs a serious punch, its built-in loudness protect feature still protects your ears by preventing the volume from getting dangerously high.

One disadvantage: this Sound Amplifier app is available only for iOS.

Rating on Apple App Store

4.6 out of 5 stars

Download from the App Store

6. Sound Amplifier

Cost: Free

This is Google’s take on the Sound Amplifier app. Just like other sound amplification apps on this list, Sound Amplifier uses your device’s built-in microphone to pick up sounds in your environment, then filters, augments, and amplifies them through your connected headphones.

Sound Amplifier doesn’t just turn up the volume on all noises — you can personalize your listening experience by boosting low frequencies, low frequencies, or even quiet sounds. It can help you enjoy everything from conversations and lectures to movies, TV shows, and plays.

If you have a compatible device, the app’s Conversation Mode can focus in on a speaker’s voice for even clearer sound.

Sound Amplifier is only available for phones running Android 8.1 or later.

Rating on Google Play

3.7 out of 5 stars

Install from Google Play

7. Subtitles Viewer! for iPhone

Cost: 3 free subtitles, more than 3 requires credits acquired through in-app purchases

Subtitles Viewer! by Craig Grummitt turns your iPhone or iPad into a personal subtitles screen. The app loads subtitles from a large database of crowdsourced subtitles and syncs with the action on your TV screen or even at the movie theater.

Rating on Apple App Store

4.4 out of 5 stars

Download from App Store

8. AudioCardio Hearing & Tinnitus

Cost: Free trial, basic plan for $9.99, or Pro+ plan for $14.99 a month, $64.99 every 6 months, or $99.99 annually.

AudioCardio Hearing and Tinnitus from AudioCardio is one of the apps we mention in our post on improving hearing loss naturally. It is a unique app that may help some users improve their hearing.

The app offers personalized sound therapy based on a hearing test you take when you open your account. AudioCardio then uses these results to develop daily one-hour sound therapy sessions for both of your ears. Sticking to the schedule and using it every day may help protect your hearing.

According to the app’s description, its technology is clinically proven by researchers — including Stanford University.

Rating on Google Play

3.2 out of 5 stars

Download from Google Play Store

Rating on Apple App Store

4.3 out of 5 stars

Download from the App Store

9.  Shazam: Find Music & Concerts

Cost: Free

Shazam is a popular music-discovery app designed to help you identify music you might hear in your everyday life. Whenever you hear a song that you’ve never heard before or can’t quite place, pull up Shazam and it’ll use your phone’s microphone to listen to the music and identify the song.

Not only is it great for finding and remembering new music, but it can help you enjoy your old favorites, too.  If hearing loss makes it hard to understand the lyrics of the music you love, this app displays the lyrics of all your favorite songs while you listen. You’ll never miss out on the joy of music — or singing along — again.

Rating on the Google Play

4.8 out of 5 stars

Download from Google Play Store

Rating on Apple App Store

4.9 out of 5 stars

Download from the App Store

Sources

1. Hearing Loss Statistics 2025: More Common Than You Might Think
2. https://www.ncoa.org/adviser/hearing-aids/hearing-loss-statistics/
3. Hearing Loss and Cognition: What We Know and Where We Need to Go - PMC
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC8920093/

Say what? If you find yourself asking, maybe you’re having trouble hearing. And you’re not alone — nearly 15% of people in the U.S. over 12 years old have hearing loss in both ears. If you’re among them and are wondering how to improve hearing loss naturally, there are things you can do.¹

In this post, we break down common types of hearing loss and natural remedies you can use to help protect and improve your hearing.  

Before we dive in, let’s talk about the basics of hearing loss. 

Types of hearing loss 

There are three main types of hearing loss that each affect different parts of the ear. 

Conductive hearing loss comes from an obstruction in, or damage to, the middle or outer ear. The damage or obstruction prevents sound from reaching the auditory nerve. Conductive hearing loss can be temporary or permanent. 

The most common type of hearing loss is sensorineural hearing loss. We hear when sound waves move the hair cells (cilia) in our inner ear, and that movement creates electrical impulses that travel to the auditory nerve in our brains. Damage to our auditory nerve or cilia results in sensorineural hearing loss. 

Mixed hearing loss is a combination of sensorineural and conductive hearing loss. It happens when a blockage or damage in your middle or outer ear makes your sensorineural hearing loss worse. 

Causes of hearing loss 

Several things cause hearing loss.  

While age itself doesn’t cause hearing loss, 33% of people over 65 have hearing loss.² Age-related hearing loss, known as presbycusis, is a slow loss of hearing in both ears that results from changes in the inner ear as we age. 

A variety of factors can cause hearing loss, including:

• Genetics: age-related hearing loss tends to run in families 
• Exposure to loud noises:
  • Noises above 85 decibels (dB), the sound of a gas lawnmower, can damage your ears and hearing in a few hours³
  • Noises above 120 dB can immediately damage your ears and hearing³
• Smoking: smokers are more prone to hearing loss than nonsmokers 
• Medical conditions, including diabetes 
• Some medications, including chemotherapy drugs for cancer treatment 

Knowing what type of hearing loss you have can help you determine if it’s possible to improve it at home, or if you need the help of a doctor or hearing specialist.    

Whether you have hearing loss now or want to avoid it in the future, there are things you can do to protect and improve hearing loss naturally.  

How to improve hearing naturally 

If you’re experiencing hearing loss, there are things you can try to improve it, including natural remedies for hearing loss.  

The best thing is to prevent hearing loss in the first place. And many of the ideas here can help. 

Note that the methods here are not intended as medical advice. Before trying anything at home, talk to your doctor. And if your hearing gets worse, we advise you to see a doctor about it. Know that some hearing loss is permanent and may require assistive devices. 

Clean out the wax 

Built-up earwax is one of the leading causes of conductive hearing loss. It prevents sound waves from reaching your inner ear.  

The good news is that you can safely remove earwax. If you do it regularly, you can help maintain hearing.  

When you clean your ears, keep in mind that they’re delicate. Don’t put cotton swabs, earwax candles, or sharp instruments in your ears. Instead, follow this home remedy for cleaning your ear canal naturally:

1. Soften the wax: Put a few drops of baby oil, mineral oil, glycerin, or diluted hydrogen peroxide in the ear canal. 
2. Flush with warm water: Once the wax softens (usually after a day or two), gently squirt warm water into your ear canal. The warm water should flush out the softened wax and clear the blockage. Tip: Tilt your head to the side, so the water drains out of your ear. 
3. Dry your ear: After removing the wax, gently dry your outer ear with a soft, clean towel. 

Your doctor can also remove excess earwax for you or recommend an over-the-counter ear drop or removal kit. 

Exercise your brain 

A study by the Perelman School of Medicine found a possible connection between hearing loss and grey matter atrophy. Grey matter is the part of the brain that handles sensory perception (including hearing).  

While the study suggested a link between hearing loss to grey matter loss, it may also work the other way: grey matter atrophy may also lead to hearing loss.   

Exercising your brain — and body — can protect your grey matter. Solving puzzles is a great mental workout to get the blood flowing in your brain and improve brain and hearing health. 

Consider the following games to keep your brain and hearing sharp:

• Crossword puzzles 
• Word searches 
• Sudoku 
• Jigsaw puzzles 
• Card games 

Exercise your body 

Cardio exercise, like jogging, biking, hiking, and walking, can help improve your overall health, your brain health, and your hearing.⁴  

Just as working out your brain increases blood flow to it, working out your body increases blood flow to your brain and ears. And like the rest of your body, the tiny hairs in your ears responsible for most of your hearing are more likely to stay healthy and fully functional with good blood flow.

Do yoga 

Yoga won’t get your heart pumping as much as jogging, but it improves blood flow. Some studies show that it may improve sensorineural hearing loss too.⁵

Nix the nicotine

A study in 2013 found that smokers have a higher risk for hearing loss, particularly sensioneural hearing loss.⁶ It also found that the more someone smokes, the higher their risk.⁶ That holds for the number of cigarettes smoked a day and the number of years someone smokes. The older a smoker gets, the greater the chance of hearing loss.⁶  

Smoking can also cause tinnitus.⁸ Tinnitus isn’t hearing loss. It’s a noise or ringing in your ear. And it’s a problem for 90% of people with hearing loss and a nuisance for anyone dealing with it.⁸ 

Bottom line: If you smoke, cut back, or quit altogether to protect and improve your hearing. 

Turn down the volume already 

Listening to loud sounds, such as music or power equipment, can damage your hearing. The longer you listen, the higher the risk of noise-induced hearing loss.   

Everyday noises, even at lower volumes, can lead to some form of hearing loss over time. 

To protect your hearing and prevent further damage, avoid loud, prolonged noises. And if you can’t avoid the noise, use hearing protection. 

Hearing protection devices won’t reverse existing damage but can protect and preserve the hearing you have left. 

Earplugs 

Loud noises contribute to roughly 15% of hearing loss cases.⁹ Using earplugs can reduce the volume of loud noise. Earplugs decrease the number of sound waves entering your ear canal.  

When using earplugs to preserve your hearing:

• Find a pair that fits snugly in your outer ear canal. 
• Consider custom-fit earplugs if you work in a job with regular exposure to loud noises.

Also, turn down the volume when using headphones to listen to music or the TV. 

Earmuffs 

Earmuffs function like earplugs, but protect the entire ear, not just the outer ear canal. You want earmuffs that form an airtight seal around your ear for the best results. You can also use earmuffs with earplugs for up to 15 dBs of added hearing protection. 

Feed your nutritional needs with vitamins and minerals 

Studies aren’t conclusive, but vitamins and minerals may help hearing health.¹⁰,¹¹ They have other benefits too. 

Always talk to your doctor before adding any supplement to your diet. 

Folate 

Folate, or Folic acid, is one of the B vitamins. One study found that men over 60 who take more folate have a lower risk of hearing loss.¹² Other studies have also found correlations between low folate intake and hearing loss.¹³

Foods high in folate include:

• Peanuts 
• Beans 
• Sunflower seeds
• Dark green leafy vegetables 
• Liver 
• Seafood  

Many common foods are also fortified with folic acid, such as bread, flour, pasta, rice, and cereal. 

Potassium 

Potassium may help balance the natural fluid in the inner ear and in the part of the brain that translates noise into recognizable sounds. Research suggest higher potassium intake might lower the risk of hearing loss.¹⁴

The best way to add potassium to your diet is though foods. Potassium-rich foods include:

• Potatoes 
• Spinach
• Lima beans
• Tomatoes 
• Raisins 
• Bananas 
• Oranges 
• Yogurt 
• Milk  

Remember to check with your doctor before taking supplements. Also follow their instructions if they’ve told you to restrict your potassium intake. 

Omega 3 

Omega 3s are known for their anti-inflammatory and anti-aging properties. They may also promote brain function and communication between the brain and the ear, which might improve your hearing.¹⁵ Studies have shown Omega 3s may reduce the risk of age-related hearing loss.¹⁶

Omega 3-rich foods include:

• Mackerel 
• Salmon 
• Cod liver oil 
• Herring 
• Oysters 
• Flaxseed 
• Chia seeds 

Investigate herbal remedies 

Some herbal remedies show promise for treating hearing loss naturally. Traditional Oriental Medicine (TOM) has used herbs to treat hearing loss for centuries.  

Again, ask your doctor before adding any supplement to your diet. 

Promising herbal options as natural remedies for hearing loss 

One study found that 25 herbs and 40 compounds used in TOM might help with sensorineural hearing loss and tinnitus caused by noise, aging, ototoxic drugs, and diabetes.¹⁷ Ginkgo biloba, Panax ginseng, and Astragalus propinquus showed particular promise to improve hearing in patients with sensorineural hearing loss and to reduce symptoms of tinnitus.¹⁸ 

A year-long study found that 10 mg of Vinpocetine (VPC) three  times a day might improve acquired sensorineural hearing loss.¹⁹ Study participants reported their hearing loss not only stopped progressing but reversed. 

Another study found that Coenzyme Q10 (CoQ10) holds promise for treating sudden-onset sensorineural hearing loss.²⁰

There’s an app for your ears 

Technology isn’t necessarily natural, but it does offer helpful, do-it-yourself ways to improve hearing. Playing these apps and programs for just a few minutes a day might maintain or improve your hearing health. 

AudioCardio hearing & tinnitus 

AudioCardio is an app for hearing and sound therapy. After an initial test, the app creates a therapy session for each ear. You can complete daily sessions while you do other things. 

The app is clinically proven to “maintain, protect, and strengthen hearing.” Find AudioCardio in the app store. 

LACE (Listening & Communication Enhancement) auditory training and aural rehabilitation 

LACE is designed to train your hearing to keep up with conversations in noisy environments. The online trainings use artificial intelligence to adapt to your hearing level and keep you on track for improved comprehension.   

While LACE can’t improve your hearing as far as how your ears function, it may improve your brain’s ability to comprehend what you do hear. Find LACE online. 

Offline hearing exercises 

If you don’t want to use apps or computer programs, you can train your hearing at home, offline, with auditory training exercises. 

Start by enlisting a friend or family member to:

• Have a conversation in a noisy environment (turn up the TV or radio) and focus on the conversation to train your brain to cut through the noise. 
• Have someone move around you while your eyes are closed so you can practice identifying the direction and distance of the sound. 

When alone (or not), sing. One study found that singing helps people with age-related hearing loss better perceive speech in noisy environments.²¹

Don’t shun assistive devices 

If you find you still don’t hear as well as you’d like, talk to a doctor. Your doctor may suggest an assistive device, such as a hearing aid or a cochlear implant. You can also try captions on your TV or captioned calls on your own. 

Using assistive captioning improves perception, memory, and comprehension, which helps you and your brain.  

You may qualify for captioned calls at no cost if you have hearing loss that requires call captioning to effectively use the phone. Sorenson offers call captioning on a specially designed phone with a captioning screen and through the CaptionCall Mobile app for your cell phone.

Sources 

1. Quick Statistics About Hearing, Balance, & Dizziness
2. Age-Related Hearing Loss (Presbycusis)
3. About Noise-Induced Hearing Loss
4. Cardiorespiratory Fitness and Brain Volumes
5. Improving Hearing Performance through Yoga
6. The Effect of Smoking on the Hearing Status–A Hospital Based Study
7. The Link Between Smoking and Hearing Loss
8. Tinnitus — Symptoms and causes
9. Noise-Induced Hearing Loss
10. Interplay between Nutrition and Hearing Loss: State of Art
11. A prospective study of vitamin intake and the risk of hearing loss in men
12. A prospective study of vitamin intake and the risk of hearing loss in men
13. Folic Acid for Hearing Loss
14. Association between a High-Potassium Diet and Hearing Thresholds in the Korean Adult Population
15. Consumption of omega-3 fatty acids and fish and risk of age-related hearing loss
16. Fish and fatty acid consumption and the risk of hearing loss in women
17. Traditional oriental medicine for sensorineural hearing loss: Can ethnopharmacology contribute to potential drug discovery?
18. Traditional oriental medicine for sensorineural hearing loss: Can ethnopharmacology contribute to potential drug discovery?
19. Evaluation of vinpocetine as a therapy in patients with sensorineural hearing loss: A phase II, open-label, single-center study
20. Coenzyme Q10 in combination with steroid therapy for treatment of sudden sensorineural hearing loss: a controlled prospective study
21. Short-Term Choir Singing Supports Speech-in-Noise Perception and Neural Pitch Strength in Older Adults With Age-Related Hearing Loss  

More than 63% of the world’s population uses the internet every day. It’s the go-to tool for everything from banking and shopping to filling prescriptions and connecting with friends and family. Most captioning services and phones also use it. But you can get closed captioned telephone service without having home internet access. 

A captioned telephone uses the internet and Internet Protocol Captioned Telephone Service (IP CTS) instead of the traditional phone network to provide call captioning over the phone. IP CTS is a type of telecommunications relay service (TRS). But you don’t necessarily need home internet service to use call captioning. 

Before we dig into having call captioning with no home internet service, let’s review what call captioning is and when you want it. 

What is call captioning? 

Call captioning transcribes one or both sides of a phone conversation into easy-to-read captions. The transcription is virtually real-time and uses a live captioning agent and/or automated speech recognition (ASR) or another voice recognition technology.  

If you have a captioning app on a smartphone, you see captions on your phone’s screen. You can also use a captioning service at home with a specially designed captioning phone with a built-in screen. 

You can get call captioning service and a home phone with a captioning screen at no cost if you have hearing loss and need the service to effectively use the phone.  

Captioned calls over IP CTS are a critical tool if you’re hard of hearing. Its dependence on the internet can be a challenge, but newer phones and cellular data can help keep you connected. 

"It’s a marvelous invention. One of the best things that could happen to people with hearing loss."

— Lou

Not everyone has internet access

For people on a fixed income or living in a rural area, access to internet service with at least 25 Mbps download and 3 Mbps upload speeds continues to improve, but still falls behind access for other groups. In its last Annual Broadband Report, the FCC reports that 14.5 million Americans lack reliable high-speed internet access.  

Pew Research Center reported in 2021 that 43% of households with incomes below $30,000 annually lacked home broadband service.  

In another 2021 survey, the  Pew Research Center found that 7% of the general U.S. adult population doesn’t use the internet, but of the population over 65, 25% doesn’t use it. 

Even for people who have internet service, outages can knock out service for minutes, hours, or days. And Wi-Fi requires a power connection. So, if the power goes out, so does your internet. 

You don’t want to be in a situation where you need to make a call, especially during an emergency, and find that you can’t.  

Why a closed caption phone without internet is important

If you have hearing loss, call captioning empowers you to effectively use the phone. It’s a convenience and even a lifesaver. Especially when you’re in an isolated area or can’t reach out via online communication tools, a captioned phone or mobile phone with a captioning app keeps you connected.  

How to get captioned telephone service without internet access

Select call captioning phone services can give you closed caption phone access without an internet connection. Some use an analog-only connection, and some include a built-in access point, giving the phone the ability to create its own internet connection without the need for home internet service.

You can also get caption telephone service on your mobile phone. All you need is a captioning app and a smartphone with Wi-Fi or a cellular mobile data connection. 

Note that Wi-Fi connections depend on having internet service, especially at home. Some merchants, public libraries, and government offices do offer free public Wi-Fi access.  

Almost all cell phones offer a mobile data connection. Just be aware that you might have a limited data plan that caps the amount you can use each month. If you go over your cap, you may pay extra. Ask your mobile phone provider for details about your plan or how to get a plan with unlimited data. 

A mobile data connection also uses the internet over a cellular connection. If you’re in “dead zone,” you won’t be able to make a call. But 95% of the world’s population now has mobile broadband access. Chances are, you won’t hit dead zones too often. 

Whether your use a mobile phone or a landline home phone, you don’t need home internet service to make captioned calls.  

Here’s how to get a closed caption phone without internet 

Whether you have Internet service or not, you can get a closed caption phone at no charge to you, a family member, or friend.  

If the phone user has hearing loss that makes captions a necessity, they qualify for service and a phone from CaptionCall by Sorenson, the CaptionCall Mobile app, or similar products from other providers. As long as they qualify, there’s no cost for either service or the caption phone.  

Call captions without internet with CaptionCall by Sorenson 

If you, your family member, or friend live in a rural area, on a fixed income, or don’t have internet service, a CaptionCall captioning phone includes technology to create its own internet access point (that only the CaptionCall device can use) so you can connect without home internet service.    

Call 1 (833) 691-1600 to find out about no-internet call captioning solutions, or visit the CaptionCall page on the Sorenson website to learn more and sign up for an account.

Captioned calls without internet on your cell phone with CaptionCall Mobile  

You, your family member, or friend can also get captioned calls on a cell phone anywhere you have Wi-Fi or a mobile data connection. CaptionCall Mobile is a call captioning app available for phones with Android or IOS operating systems. 

Call +1 (800) 359-3186 or visit the web page to learn more about CaptionCall Mobile or download the app.