Hearing Loss and Home Health: An Unmet Need and an Opportunity for Action

The purpose of this study was to identify unmet hearing care needs among older adults receiving home healthcare as a potential method to reach a population unserved by clinic-based care. Cross-sectional analyses were used to identify hearing loss and hearing aid use among beneficiaries enrolled in home care, using data from the nationally representative 2017 Medicare Current Beneficiary Survey (MCBS). Survey participants who reported enrollment in home healthcare services in 2017 (n = 3,183,693) were included for the purposes of analyses. Home health and hearing status were assessed through MCBS questionnaires, reported by Medicare beneficiaries or an appointed proxy, along with hearing status evaluated at initial home care intake. Among older Medicare beneficiaries receiving home healthcare, 51.8% self-reported hearing concerns. Of this population, only 16.1% reported hearing aid use. Recipients with hearing difficulty received an average of 30 visits per year, totaling to $5,208.25 in expenditure. By self-report, 44% of older home care recipients with hearing difficulty were misclassified as having "adequate" hearing on initial assessment and 31% of initial assessments identified hearing loss among those who self-reported no difficulty hearing. Effective management of chronic health conditions is core to healthy aging, including sensory health. Hearing loss represents a largely unaddressed need among home care recipients and frequently goes unidentified. Home-based hearing services that integrate into existing assessments and practices may be an avenue in identifying hearing loss and extending care to older adults who have traditionally gone without access to hearing intervention.