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The FDA cleared the way for over-the-counter hearing aid devices, intended for adults with mild to moderate hearing problems.

OMAHA — Sometime in mid-October, adults who have what they consider to be mild-to-moderate hearing loss will be able to start buying hearing aids online or in stores without a checkup or prescription from a medical professional.

For older adults used to being able to pick up a $10 pair of nonprescription reading glasses at the drugstore, that may seem like a no-brainer.

But local hearing experts say the advent of over-the-counter hearing aids, while it stands to benefit a lot of people, also poses some questions and concerns, some of which will take time to work through. They’re already hearing many of those questions from their patients.

“The idea is this will open up a whole host of solutions for people who aren’t really ready to try prescription hearing aids and who are having situational hearing difficulty,” said Ryan McCreery, who runs a hearing aid research lab at Boys Town National Research Hospital and serves on the American Academy of Audiology’s ad hoc committee on over-the-counter hearing aids.

Ashton Johnson, a clinical audiologist with Nebraska Medicine, agreed that certain patients will do well with the devices.

Most people, however, aren’t good at judging their hearing loss, she said. Many think they have a mild-to-moderate loss but instead have a more significant deficit, which still will require a prescription device. Patients also may have a medical reason for their hearing loss that could be caught by a hearing test and treated earlier.

“It’s a double-edged sword,” she said. “You can see where the huge benefit is going to be. But you can also see where the problems may lie.”

People who have a sudden hearing loss, McCreery said, or a hearing loss that comes with symptoms such as dizziness or ringing in the ears, should see a doctor or an audiologist to make sure they don’t have another medical condition or a buildup of wax in the ear.

The change comes as a result of a new Food and Drug Administration rule that was finalized in mid-August. The regulation creates a new class of hearing aids that don’t require a medical exam or a prescription.

The move, mandated by the bipartisan Over-the-Counter Hearing Aid Act signed into law in 2017, is expected to increase competition and eventually lower costs. Among the measure’s sponsors were Sens. Charles Grassley, R-Iowa, and Elizabeth Warren, D-Mass.

McCreery, Boys Town hospital’s vice president of research, said age-related hearing loss generally starts when people reach their mid-50s, although most won’t get a hearing aid until they’re much older, in their 60s or even later.

The FDA estimates that nearly 30 million people could benefit from a hearing aid, although only about one-fifth use them.

The potential consequences of not hearing properly go beyond just not being able to catch some of the dialogue on a favorite TV show. Untreated hearing loss, Johnson said, can lead to cognitive decline, isolation and depression.

“This may increase the access for some people and help with some of the issues hearing loss leads to, which would be really great,” she said.

Currently, cost is an obstacle for prescription devices.

McCreery said the average out-of-pocket cost for prescription hearing aids is about $3,000. The devices are not covered by traditional Medicare, and the over-the-counter devices won’t be, either. Some Medicare supplement plans and some private insurance plans do cover prescription devices. Hearing tests also may not be covered by Medicare.

Hearing experts aren’t yet sure what the over-the-counter devices will cost. But they predict they will range from very low-cost items such as personal sound amplification products that are on the market to devices that come with added features and exceed the cost of prescription hearing aids.

If the cost of the over-the-counter devices approaches that of prescription hearing aids, Johnson said, patients may be better off paying a little more and getting the fitting that comes with prescription devices.

The over-the-counter devices are not intended for children, McCreery said. 

Staff in McCreery’s clinic recently saw a patient who came in with a pair of personal amplification devices. The patient’s hearing loss was on the edge of moderate. But hearing tests indicated she could hear better without the devices than with them. She was frustrated because she had spent upward of $700 on the devices.

Ideally, McCreery said, people who suspect a hearing loss will have their hearing tested before they purchase devices. At Boys Town, if a person is found to be a candidate for an over-the-counter device, the staff will let them know. “We want them to have help when they need it,” he said.

In the best-case scenario, people who test as candidates for over-the-counter devices will use them until their hearing loss progresses to the point that they need prescription devices. “That would be a segment of the population that we’re not currently serving,” McCreery said.

Johnson said her clinic has not set a policy on how it will handle over-the-counter devices. But her inclination is to recommend them to patients who aren’t candidates for prescription devices.

If people do purchase over-the-counter devices and aren’t doing well with them, she said, they can get a hearing test to tell them whether they truly are candidates. Clinic staff can do a test to measure the devices’ output in the ear canal.

McCreery and Johnson said they’re also eager to see what type of trial periods and return policies makers of the over-the-counter devices offer.

Prescription hearing aids, McCreery said, come with trial periods so people can wear them and bring them back if they don’t like them. They also come with replacement policies for lost or damaged devices, as well several years of coverage for repairs.

Still, McCreery said he is excited to see what the new devices mean for the technology. Currently, five companies make most of the devices sold in the U.S. and conduct most of the hearing aid research. Leading consumer electronic companies that already are in the sound business, including Apple, Bose and Samsung, are investing in the products.

“There’s a lot of excitement that this could drive innovation in the technology that’s available across the board,” McCreery said.

This report contains material from The Associated Press.

Jannine Liska, BSN, RN, an emergency room nursing supervisor at Memorial Hospital in Seward, had a desire to help people at a young age. Influenced by family members who worked in the medical field and aspiring to have similar experiences, she pursued a career in nursing. Jannine said working in a critical access hospital is rewarding for her because she provides cares to the people in her community at a time when they are at their most vulnerable. “The CAH setting has afforded me a lot of diversity in my profession,” she said. “I’m able to work in many different areas of the hospital, sometimes all in one day.”

Jannine was selected for her commitment to excellent patient care, a quality that was recognized even more during the recent pandemic. “She has worked long hours, cared for patients on ventilators that couldn’t be transferred, gone along on transports when a nurse was needed, the list goes on and on,” her nominator said. “She is an excellent nurse who always has the best interest of the patient in mind.”

Angie Gaughen, BSN, RN, is a charge nurse for the children’s rehabilitation unit at Madonna Rehabilitation Hospital. She was drawn to the profession when her older sister, Abby, was attending nursing school. “I always enjoyed talking to her about everything she was learning, and I found it all so interesting,” said Angie. Around the same period, she was involved in a serious car accident and spent a length of time in the hospital. It was after that experience that Angie knew for sure she wanted to be a nurse — so she could help others in the same way they had helped her. She earned her certified nursing assistant license in high school and ultimately received a bachelor’s degree in nursing from the University of Nebraska Medical Center.

The opportunity to help others is Angie’s favorite part of nursing. “Each patient has their own story, and being able to witness and be part of their recovery is very rewarding,” she shared. For new nurses entering the field, Angie encourages patient-focused care and an understanding of how this care impacts a person’s life. She expressed that a simple smile can really make a patient’s day. “Through all of the changes we’ve faced over the past couple of years, Angie has led with positivity and encouragement,” her nominator said. “She takes joy in her patients’ accomplishments, especially when they meet and exceed their goals.”

Elaine Van Volkenburg, RN, BSN, a retired nurse who worked for 41 years at Gateway Manor, said the most enjoyable part of her occupation was the people — the many nurses, staff and patients she met along the way. “It’s a good profession; there is always a need for nurses,” she commented. “You have to have empathy towards helping people. You have to go with the flow and be able to take whatever is thrown at you.” Elaine said two of the hardest things she ever did as a nurse were transitioning from manual charting to computers and giving up her nursing license after 60 years. For her, nursing was a way of life.

Nominated for the outstanding contributions she made to her profession, as well as to the health, welfare and happiness of so many, Elaine wants those nurses who are just starting out to know that while it’s hard work, it’s very rewarding. “She is an example worthy of emulation by those beginning a career in nursing,” her nominator said.

Registered nurse Carol Burk recently retired after 50 years in nursing; however, she continues to work as a charge nurse on the night shift at Lancaster Rehabilitation Center. Growing up in a small rural community in southwest Nebraska, Carol knew she wanted to be a nurse even before starting kindergarten. “To me being a nurse is my reason for being, and this is why I’m who I am,” she said.

After graduating from West Nebraska General Hospital School of Nursing in 1972, she continued at the hospital for six years, first providing care to surgical patients and then transitioning to pediatrics. Carol moved on, working in long-term care positions and eventually settling in Lincoln, where she began employment with Lancaster Rehabilitation Center. She expressed her love of caring for people, hopefully making them comfortable and improving their quality of life — whether they are rehabilitating or near the end of life. “She loves nursing and has embraced the changes through the years,” her nominator said. “She puts her heart into taking care of her patients.”

Teri Feit, RNC-NIC, a nurse in the neonatal intensive care unit at Bryan Medical Center East, served as a hospital candy striper in high school after her dad encouraged her to start volunteering. She went on to earn a bachelor’s degree from South Dakota State University and has been working as a nurse for nearly 26 years. Teri started in the cardiac progressive care unit at Bryan, where she continued for more than 12 years before transitioning to the NICU. In her current role, Teri cares for the youngest and most vulnerable patients. “The babies are born sick or tiny, tiny, and I get to be a part of the journey with the families and teach them how to take care of their babies when they go home,” she said.

Teri’s nominator got to know the nurse during the 159 days her twin grandchildren spent in Bryan’s NICU. Working the night shift frequently throughout this time, Teri calmly explained the different procedures and encouraged the grandmother to read to the twins. “She made some of the hardest moments so much easier,” her nominator recalled. “I knew she was fighting for them as hard as we were.”

Jenny Hoyt, RN, a nurse with the Dialysis Center of Lincoln, grew up with a mother who struggled with addiction. As the oldest of three children, she became a caregiver for her two younger sisters — one of whom suffered from cerebral palsy. Jenny enjoyed caring for her siblings. With the support of her foster family, she earned her certified nursing assistant license in high school, and more recently received a registered nurse diploma. She expressed that evolving and learning new things are her favorite parts of nursing. Jenny advises new nurses to be flexible, learn and try a field of nursing that may seem scary.

She has previously worked in wound care and hospice care, and also as a correctional nurse for jails in Nebraska, Kansas, Iowa and South Dakota. “You have the opportunity to plant nuggets,” said Jenny. “You leave little nuggets, whether it be education or encouragement, and hopefully not negativity.” Providing encouragement was an especially important part of her role with prisoners. “Some of those people are genuinely at their lowest and want to do better, but don't believe they can,” she expressed. Her nominator stated that Jenny treats every patient with kindness and cares for them.

Vicki Coffin, RN, BSN, a faculty member at Southeast Community College, originally wanted to be a teacher. But first she earned her licensed practical nursing diploma and began working as a nurse, with the intention to obtain her teaching degree at a later time. She fell in love with nursing. Now she works as a nurse who teaches and says she is living out her dream. Vicki’s favorite thing about nursing is the opportunity to advocate for patients when they can’t advocate for themselves and to care for them no matter their ages or circumstances. The person who nominated Vicki, describes her as being generous with her time and having a wonderful spirit.

Vicki tells her nursing students who are close to completing the program to start a file with the notes, drawings and thank you cards they receive from patients. “When these nurses are having a tough day, they should open that file and it will remind them of the good they do and the good they have in their hearts,” she said. “It will reinforce that they are exactly where they need to be.”

Jennifer Smith, RN, BSN, a nurse at Madonna Rehabilitation Specialty Hospital, became interested in nursing during high school. Her best friend’s parents were both nurses, and she was inspired after learning about their professions. Holding a bachelor’s degree in nursing and an associate’s degree in biotechnology, Jennifer likes the science of nursing and the fact that no two shifts are ever the same. “You really have to be able to roll with it. Things are constantly changing; your plan is always evolving,” she said. In her role at Madonna, Jennifer enjoys watching patients heal. “You see them later when they come back to visit and you’re like, ‘no way, you’re the same person?’”

Nominated for her strength and dedication, Jennifer continued to care for others as a bedside nurse while receiving intensive treatment for a rare form of leukemia. “When COVID hit hard and nurses were in short supply, she stepped up and enrolled in a staffing incentive to ensure patients continued to receive excellent care,” her nominator said. “She is an inspiration to all who know her.”

Jeanine Worley, RN, is a nurse in the neuro trauma intensive care unit at Bryan Medical Center West. Always interested in medical TV shows, she originally hoped to become a paramedic. This led Jeanine to join the Ambulance Explorer program in Lincoln, and she began riding along in an ambulance once a week. Ultimately, though, she wanted to get to know her patients and decided on a career as a bedside nurse. Jeanine said she loves nursing because it’s a challenging and rewarding profession, and she can make a difference in someone’s life. “Sometimes it’s a happy ending and sometimes it’s a sad ending, but I feel like I can be a part of their journey,” she said. In her role as a nurse, she says, it’s important to be compassionate, empathetic and a good listener.

The person who nominated Jeanine received care from her after being critically injured in a car accident. “She went above and beyond the call of duty to keep me comfortable and content during the scariest time of my life, and when I was in the most indescribable amounts of pain,” her nominator said. “She also assisted my family in getting me to the next level of care when I was ready.”

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