The Alzheimer's/Hearing Aid Paradox: In Search of Sanity

By Robert C. Keefer PhD

The facts are staggering. Scientific studies have shown that people with hearing loss have up to a five hundred percent higher risk of dementia (including Alzheimer’s), as well as serious falls and clinical depression. Today, around six million Americans have Alzheimer’s—a number that is only expected to increase and overwhelm the healthcare system in the next five to seven years.
In a groundbreaking presentation, Dr. Robert Keefer relies on thirty years of experience in the healthcare industry and the results of his meticulous research to offer insights on how to correct outdated Medicare policies, improve US hearing healthcare, and ensure well-performing hearing aids for everyone in need. After detailing why people with hearing loss don’t use hearing aids, he leads us on a journey into the world of these tiny medical devices, the US hearing healthcare matrix, the technology, and costs surrounding hearing aids, stories of those with hearing loss, wisdom from audiologists in their own words, and ways to advocate for changes that save hundreds of billions of dollars in healthcare expenses.
The Alzheimer’s/Hearing Aid Paradox shares insights and facts from a hearing aid industry insider that point the way to lowering the risk and cost of Alzheimer’s by providing hearing aids for everyone in need.

“With this book, the author has gifted us with a practical but ground-breaking way to reduce loneliness — and thus the risk of Alzheimer’s — by helping millions of Americans access high-performing hearing aids.”
—George Vradenburg ,Chairman and Co-Founder, UsAgainstAlzheimer’s

“This book presents a practical, no-nonsense way to better understand hearing loss and dementia and navigate hearing aid treatment options.”
—Dr. Brian Taylor ,Senior Director of Audiology, Signia Hearing, Editor of Audiology Practices, Co-Author of Fitting and Dispensing Hearing Aids, 3rd Edition

• Language: English
• Publisher: Archway Publishing
• Release date: Apr 4, 2023
• ISBN: 9781665733205

Robert C. Keefer PhD

Robert C. Keefer earned a PhD is in biochemistry from the University of Nebraska Medical School and has worked for over thirty years in the international medical device, pharmaceutical and diagnostics industries acquiring FDA product clearances and approvals, marketing and business development.

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Copyright © 2023 Robert C. Keefer, PhD.

All rights reserved. No part of this book may be used or reproduced by any means,

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any information storage retrieval system without the written permission of the author

except in the case of brief quotations embodied in critical articles and reviews.

This book is a work of non-fiction. Unless otherwise noted, the author and the publisher

make no explicit guarantees as to the accuracy of the information contained in this book

and in some cases, names of people and places have been altered to protect their privacy.

Portion of sales of this book are being donated to

Dementia Alliance of North Carolina (formerly Alzheimer’s-NC)

Hearing Loss Association of America

Archway Publishing

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expressed in this work are solely those of the author and do not necessarily reflect the

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ISBN: 978-1-6657-3321-2 (sc)

ISBN: 978-1-6657-3319-9 (hc)

ISBN: 978-1-6657-3320-5 (e)

Library of Congress Control Number: 2022920968

Archway Publishing rev. date: 4/3/2023

This book is dedicated to my family and all those who believed

that I could do this long before I ever did. That includes mom,

Mark and Dotti, Sue and Dave, Cathy and Dr. Roger Brainard,

Willoughby, Susie Wright, Glenn Busch, John and Beth

Berryman, Tim Stanton, the Now Hear This® team, Ken Moore

and Darla Yancho, Dan and Sally Bowman, June Williams,

Rosie & family, Chuck Cox, Dennis Burns, Reinhard Merz,

Sue and Ed Weems, Mike and Marjie Hille, Alice Watkins,

and all my compadres at House of Hops and Virgin Cigar.

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And it is to everyone who used to think they have no options

when it comes to hearing loss or their risk of Alzheimer’s.

In Memoriam of

William McConnell (Mac) Jones Jr,

Greatly Loved, Deeply Missed

Words strain, crack, and sometimes break under the burden.

—Poet T. S. Eliot

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CONTENTS

Introduction

Chapter 1   Why People with Hearing Loss Don’t Use Hearing Aids

Chapter 2   A Journey into the World of Hearing Aids

Chapter 3   The US Hearing Health-Care Matrix

Chapter 4   Hearing Aid Technology and Costs

Chapter 5   Stories of People with Hearing Loss

Chapter 6   Audiologists, in Their Own Words

Chapter 7   Advocating for Change

Chapter 8   Resources

INTRODUCTION

This book is for everyone with hearing loss, their families and every other American who will live to sixty-five or older. It is also for those Members of Congress, Medicare officials and insurance executives who still don’t realize how much money and heartache could be saved if we simply got everyone with hearing loss to use hearing aids.

Highly regarded peer-reviewed scientific studies have shown that people with hearing loss have up to an astonishing 500 percent higher risk of dementia (including Alzheimer’s), as well as falls with broken bones, and clinical depression. We already have about six million Americans with Alzheimer’s alone and the total cost of care is about $250 billion per year. This is expected to increase to $1 trillion per year in five to seven years if changes aren’t made.

This book is timely because, as it was going to press, the Food and Drug Administration (FDA) established a new class of over-the-counter (OTC) hearing aids that can be sold online and in stores without the need for a medical exam or a fitting adjustment by an audiologist. The FDA established this category of hearing aids because members of Congress and the White House were convinced that the main reason 80 percent of Americans with hearing loss aren’t getting hearing aids is that they are too expensive. Unfortunately, they are mistaken.

Chapter 1 tells you the three real reasons so many Americans don’t use hearing aids. It shows how we could save hundreds of billions of dollars if Medicare and private insurance simply covered the cost of hearing aids that are fitted and adjusted according to the best practices of audiological care.

The book can be used as a convenient, easy-to-read guide to getting (and using) hearing aids that will help you clearly and comfortably hear all the important sounds of life and other people’s voices, even in noisy, busy environments where everyone is talking louder and louder or all at once.

You will learn why it is so important to use audiologists and hearing aid dealers who always use the best practices of their profession and why it is so crucial to your satisfaction with hearing aids. You will also learn that primary care physicians (PCPs); audiologists; hearing aid dealers; ear, nose, and throat doctors (ENTs); national- and state-elected leaders; and regulatory agencies are not doing everything they can to ensure that everyone with hearing loss has access to, and is using, well-performing hearing aids. It shows how the growing availability of cheap, one-size-fits-all OTC hearing aids can create more problems than they solve.

You will learn why getting hearing aids for everyone in need makes financial sense as well. It will be far less expensive than paying for long-term care for the millions of people developing dementia, and the other devastating long-term health issues with proven links to hearing loss. An estimated 6.5 million Americans suffer from Alzheimer’s, and we spend about $250 billion a year caring for those individuals. As mentioned, the cost of Alzheimer’s care is expected to increase to one trillion dollars annually in the next five to seven years unless we do everything we can to stem the tide.

What drove me to write this book was the emergence of two important facts that surfaced over the last ten years and have not received enough recognition. One is that the National Institutes of Health (NIH) reports that about 80 percent of the millions of Americans with hearing loss are not using hearing aids. That is astounding in its own right. The second is that people with hearing loss have up to an astonishing 500 percent higher risk of long-term health issues like dementia, Alzheimer’s, and falls with broken bones. My hope is to increase the use of well-performing hearing aids by everyone in need so that we can reduce the incidence and costs of serious health issues linked to hearing loss. Doing so will also help Medicare, insurers, and American taxpayers save hundreds of billions of dollars at the same time.

I am neither a doctor of audiology nor a licensed hearing instrument specialist. I have not received any compensation from hearing aid manufacturers, insurance companies, or specialty dealers for composing this book. Everything you will read is a product of more than twelve years of research I conducted while working in the hearing industry.

I have a doctorate from the University of Nebraska Medical School, where I got a PhD in biochemistry. I then held a postdoctoral research position in cancer research at Ohio State University before discovering my real career interest is in solving unmet health-care needs through business. I worked for more than forty years with Fortune 50, midsized, and entrepreneurial businesses in several sectors of the international health-care industry. Most of it has been in business development and marketing. I served a four-year term on the national advisory board of