It wasn't until his mid-50s that Rick James began to notice that his hearing wasn't what it used to be.
James was having trouble understanding people if he couldn't look at their lips as they talked. He was finding it hard to pick individual voices out of a crowd. And if people were talking behind him, James pretty much wasn't able to hear them at all.
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"It's nothing that came on right away," said James, who turns 62 next month. But the bottom line was inescapable: It was time for hearing aids.
"Hearing aid." Two words that'll shatter any remaining delusions of youthful immortality a baby boomer may hold. But, ready or not, hearing aids increasingly are becoming a fact of life for boomers, that demographic blob of Americans born between from 1946 to 1964 who are now beginning to tiptoe into their golden years.
"We are starting to see more people in that age group come into our office," said David Anderson, a Southern Nevada audiologist.
And, even if they're not necessarily relishing the prospect, boomers do seem to be a bit more willing than their own parents to do something -- ASAP -- about their diminishing hearing.
Studies indicate that boomers "have more active lifestyles," Anderson said. "They're retiring later and they're familiar with technology. So, as a result, they're seeking out help, I think, at an earlier age."
Boomers also are "a lot more health-conscious" than previous generations, said Thomas Powers, an audiologist and vice president of audiology and professional relations for Siemens Hearing Instruments Inc., and that makes them more likely to seek out solutions when hearing wanes.
Paul Pessis, president of the American Academy of Audiology, suspects career considerations also offer boomers an incentive to get hearing aids.
Boomers are "a little more realistic in what the implications of a hearing loss are," he said. "It can affect job performance. It can affect their ability to advance within the job environment."
Also important is that, as Pessis puts it, "the hearing aid industry has come to the plate. They are giving audiologists far better hearing aids to work with and hearing aids that are more frequency-specific than ever before so we can target the specifics of hearing loss where, before, we were more broad-spectrum (aids)."
Oh, and it doesn't hurt that today's smaller, subtle, aesthetically less-obvious hearing aids help to reduce the stigma that once may have been associated with wearing one.
"It's not your grandfather's hearing aid," Powers said. "Now, we have small devices that fit in your ear, and we also have very small devices that fit behind your ear."
Most boomers will find that the ability to hear higher-frequency sounds is affected first. That's important because "high frequency is what gives clarity," Pessis says. "So it's not that you can't hear, it's that clarity is compromised."
Anderson says many of his boomer clients report hearing conversations as though they are mumbled, or say they have difficulty separating the voices in a multiperson conversation. Also common, he added, is that family members point out to their loved one that they're watching TV at increasingly higher volumes, or that they're asking others to repeat what they've said more often.
Although medical conditions, from tumors to infections, can affect hearing, Anderson estimates that fewer than 10 percent of cases of hearing loss are associated with a medical problem. Dr. Matthew Ng, an otologist and assistant professor at the University of Nevada School of Medicine, said patients sometimes can recall a specific incident -- a firecracker pop or a loud noise -- that marked a decline in their ability to hear.
But beyond such instances of "acoustic trauma," Ng said, hearing loss typically occurs cumulatively, after years of exposure to noises at work, at play or simply spending time in a noisy environment.
A hearing aid consists of a microphone to receive sound, an amplifier to process sound, a speaker to direct it into the ear and a power supply to run it all. Today's aids come in four basic types: Completely-in-the-canal (CIC) aids, custom-made devices that fit deep inside the ear canal and are virtually invisible to others; in-the-canal (ITC) aids, also custom-made, that fit almost completely in the ear canal; in-the-ear (ITE) aids that are custom-made and fit within the external ear; and behind-the-ear (BTE) aids that direct sound into the ear via a tube or tip that runs from a housing worn behind the ear.
Which aid is best for a particular person varies with the degree and type of hearing loss, as well as the person's lifestyle and personal preferences. But, in every case, a hearing aid will be customized to a particular person using the results of tests that pinpoint the frequencies of hearing affected.
While analog hearing aids still are practical for some people, "most of the technology we use today will be digital type of amplification," Anderson said. "We can get better reproduction of the sound as it goes through the amplifier with the digital processing, and we can more closely approximate the person's hearing needs."
According to Powers, the sophisticated circuitry in today's aids can help to address such specific aims as filtering out background noise, limiting feedback, pumping up needed frequencies and dealing with such "stationary noises" as the hum of a fan.
"You are truly customizing hearing loss intervention more than ever before," Pessis says. "In my initial days of fitting hearing aids, you had a very generic prescription and had to have the patient try to adapt to the hearing aid. Today, what you try to do is adapt the hearing aid to the patient."
Still, hearing aids do take getting used to. Anderson said an aid can require several adjustments before a patient feels comfortable with it.
"That's probably the biggest counseling thing we do before they leave: Don't expect it to go out of our office and hear like when you were 20," he added.
"The hearing is more than just the ear itself. We have an auditory processing center in the brain that's responsible for a lot of what we do understand and what we hear, and if that has been deprived of sound due to hearing loss, it takes some time to adjust."
How long? "I think it varies on the patient and how long they've been without amplification, how severe their loss is, how adaptable they are," Anderson said. "But usually within a few weeks most patients are becoming accustomed to the new sound and adjusting to the way the sounds are appearing."
One adjustment may involve cell phones, some of which will create feedback when used with a hearing aid. Cell phone manufacturers "are catching up," Powers says, but "there is still some interference that occurs with some cell phones."
"But cell phone manufacturer are working to have multiple models within all their product lines that would be fully compatible with hearing devices," he adds.
Another possible hurdle is the price of a hearing aid. A good digital hearing aid can begin at $995 and cost as much as $3,400, Anderson says, although most will last for at least four or five years.
When the time came to buy his aids, James opted for in-ear models that, he says, are nearly invisible to others.
Each cost about $2,500, he says. "When I heard the price, I said, 'Oh my god.' "
But, he continues, "the change in quality of life is unbelievable. You can hear things. You can carry on conversations.
"When I walked out (wearing the aids) that first time the birds were chirping. I don't know how many years I just got accustomed that there weren't any birds."
