What Causes Low Usage of Hearing Aids Among Singaporeans?

Explore the reasons behind the low usage of hearing aids among Singaporeans. Gain insights into the barriers to hearing aid adoption.

The process of purchasing and having a hearing aid fitted in Singapore is more complicated than it is, compared to being in the United States, where you can purchase them from pharmacies.

In the United States, the Food and Drug Administration recently legalised the sale of over-the-counter hearing aids to make them more accessible and affordable for those who need them. Moreover, customers who are 18 years old and up can purchase a hearing aid directly from the pharmacy shelves. You can do this without a prescription, a medical exam, a professional fitting, or the requirement of a licensed supplier.

For hearing aids marketed in Singapore, the patient must be registered with the Health Sciences Authority (HSA) because hearing aids are regulated medical devices. Before they are sold or provided to Singaporeans, the devices must first meet the requirements for safety, quality, and efficacy, according to the authority. Moreover, HSA licenses are required for hearing aid makers, importers, and wholesalers. In response to questions from TODAY, HSA stated that hearing aids should only be prescribed and used under the guidance of a hearing care specialist, such as an audiologist.

To assess their hearing state and have their hearing aids fitted by hearing care professionals, customers need to consult healthcare professionals. A person suspected of hearing loss often receives a complete evaluation before purchasing a hearing aid. This includes the use of hearing and listening tests as well as a professional assessment. Hearing aid users are also encouraged to participate in counselling and follow-up sessions.

OTC bought outside of Singapore: Is it worth it?

Some users have chosen to purchase hearing aids from e-retailers because they offer these devices at a lower price. Online research revealed that for as little as S$35, you could buy a “medical grade” hearing aid from e-retailers and have it delivered to your door in one or two days. Plus, there is no need for a hearing test.

Some buyers purchase these over-the-counter (OTC) hearing aids directly from the United States or online shopping. However, according to Dr Ho Eu Chin, an ENT surgeon and senior consultant at The ENT Clinic in Gleneagles Hospital and Mount Elizabeth Novena Hospital, some patients who purchased the hearing aids online complained about how noisy it is once they’re outside. They also have issues and concerns on servicing and warranty from the purchased devices, making it sometimes disappointing and frustrating. The overall review of the online purchases is mostly: POOR.

These hearing aids, at best, help them hear better in one-on-one, face-to-face conversations in very quiet environments. However, a conducive communication environment can be challenging in the real world.

According to the HSA, consumers should avoid purchasing hearing aids from unknown websites or sellers on e-commerce sites, discussion forums, or social media channels. Dr Chin mentioned that wearing ill-fitting hearing aids can cause discomfort and irritation, poor sound quality, and, in severe cases, further ear damage.

Medical Verdict: OTC hearing aids may bring more harm than good. There is no guarantee of improving one’s hearing.

How is professional fitting beneficial?

According to Jennifer Lee, a senior clinical audiologist, while hearing aids make sounds clearer and louder for the user, it is “not as simple as picking up sounds, amplifying them, and then channelling them to the person.” She added there are differences between professionally fitted hearing aids and self-fitting versions sold online.

She noticed that most people looking for over-the-counter hearing aids are generally older adults looking to save money. Adult children may also be given hearing aids to test how well they adapt to wearing hearing aids before investing in the real thing. This analogy is more like comparing apples to oranges.

Why don’t patients visit clinics instead?

A recent study discovered many barriers during Dr Ho’s and other research team members’ studies.

Here are some of the things they observed:

  • Patients felt discomfort from improper fitting and unpleasant experiences such as intensified background noise experienced by users while wearing a hearing aid.
  • According to Dr Ho, some elders may also need help using the devices independently.
  • Some respond negatively to the cost of hearing aids, particularly the younger patients who are not eligible for the Agency for Integrated Care’s Seniors’ Mobility and Enabling Fund. The financial scheme assists needy Singaporeans aged 60 and up.
  • Other hindrances included psychological barriers and a lack of understanding about the importance of treating hearing loss.

Todayonline recalled a story from one user who had hearing loss for over two decades. They mentioned that Daphne Neo, a 32-year-old patient, suffered hearing loss when she was 7. The abovementioned reasons were mostly why she didn’t take this issue to an audiologist. Furthermore, Daphne was hit by a car at 13 because she couldn’t hear the vehicle while crossing the street. She got her hearing tested and resolved with a hearing aid at 32. Before that, she felt misunderstood, frustrated, and disassociated from some people because she was made fun of.

After using the appropriate hearing aid, she can commit to her work better as a financial consultant. Daphne is just one of the few who experienced the same concern of developing severe hearing loss due to the lack of education, proper fitting and guidance. It also took her time to realise that she could have avoided severe hearing loss if she had addressed the concern at an earlier age.

Now, wearing a hearing aid opened up a new world of sounds for Daphne, despite constraints. She wears a Bluetooth-enabled hearing aid that picks up and wirelessly transmits sound waves from her right ear, which was she severely deafened. The cost was approximately S$5,000.

She currently has 2 children, and when they’re playing in the next room, she can respond more quickly during conversations. It gave her more confidence to communicate; even hearing her colleague’s whispers changed her life. It granted her a newfound way to express herself, resulting in better communication and lifestyle.

Addressing the Elephant in the Room

“There are probably more hearing aids sitting in drawers than in patients’ ears,” Dr Ho said, counting each hearing aid that remains in a drawer represents an untreated ear with hearing loss.

That’s the biggest blunder. Let’s address the biggest problem: untreated hearing loss.

Rather than debating whether Singapore should follow the US lead on over-the-counter hearing aids, consider what can be done to help people with hearing loss become successful long-term hearing aid users. How can hearing services in Singapore be developed to effectively and successfully treat individuals with hearing loss so that all adverse effects of untreated hearing loss are mitigated?

Non-use or improper use of hearing aids is a serious problem, even in developed countries such as Singapore are prevalent according to Dr Ho.

Ms Lee proposed using the Central Provident Fund’s MediSave to purchase hearing aids and subsidising costs — even at the private sector level — to improve access to hearing aids, given that cost is a reason why the general public turns a blind eye to buying the right hearing aid. She also expressed a necessity to raise awareness about hearing health and normalise hearing aid use in Singapore.

Some people find wearing hearing aids embarrassing, but what about the humiliation they feel when asking somebody to repeat themselves multiple times?

Since the biggest concern still dominates Singapore, the question now is — how long should you wait for your hearing to deteriorate ultimately? When you start having hearing loss signs, make sure you address it. Don’t hesitate to book an appointment with a trusted audiologist. Act now before it’s too late.

About The Listening Lab

Listening Lab is a home-grown company whose mission is to help our clients restore their hearing to enjoy the life that they desire. Experiencing hearing loss can be detrimental to one’s quality of life. Hence we commit to providing high-quality hearing solutions.

Our hearing solutions include hearing tests and treatment and prescribing hearing aids. Clients may come to get their hearing checked, and we will assess whether hearing aids are required.

If hearing aids are required, clients can choose from a variety of the best hearing aid brands we provide. Each of the products offers unique features that complement daily use and perform well in helping our clients enjoy the life that they desire.

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I started experiencing loss of hearing sometimes in 2010 (41 years old) owing to some medical issue. I was having difficulties hearing conservation especially in meeting. Thus, giving me the fear in attending meeting.

Initially I started with Phonak hearing aid. It helps amplified the sound and I could hear better then. Somehow, my hearing loss deteriorated further that in late 2012 (43 years old), there was profound loss of hearing on my right ear. Even digital hearing aid could not help. On my left ear there is still about 50% to 60% hearing with hearing aid. I was lost at this point of time. I was considering learning sign language. I went to see my ENT specialist and my audiologist Mr. Bala advised me to go for an CI as an alternative to my hearing loss.

I also thank God for Engineer and Scientist, giving them the knowledge to create such a complex and sophisticate device to help those with hearing loss like me. It will be all perfect if the cost is affordable too.
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I took my mum to Listening Lab at Simei to get her hearing aid fixed, during our first visit, she patiently explained the whole procedure to my mum and also explain to my mum why she really in need to fix the hearing aid. She is very knowledgeable, and friendly, and we are encouraged to ask questions. she is also very patient with old people which is the most importance. Also her after service is superb so I highly recommend.
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My mum, Madam Kek (73 year old) had the Cochlear implant (CI) done on her left side in 10th September 2019. Thereafter, thanks to the subsequent auditory verbal therapy, evaluation from SGH ENT team, as well as, the support from AB's and Listening Lab staffs; Madam Kek was able to hear, comprehend sound and music from her Cochlear implant, Naida CI Q90, and hearing aid (HA), Naida Link UP, for her right side before end year. We are happy that both the CI and HA have improved mum qualify of life. Now Madam Kek is looking forward to work again to pass her time as she can hear and better communicate with others.
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Titus was implanted when he was 18 months old. He is a happy, talkative 6.5 years old now. AB has been with him for 5 wonderful hearing years and we are looking forward to a bright future that lies ahead for him. AB’s Naída CI sound processors are reliable and the technology is constantly evolving and upgrading. When Titus was introduced to Naida Link CROS, his life was enriched. The wireless network established between his Naida CI sound processor and a Naida Link CROS transmitter allows him to hear from both ears. This changes Titus’s life and the way we interact with him. We are also very pleased with the prompt response and service provided to us. The staff in AB genuinely cares! We want to thank AB for making Titus’s hearing journey an enjoyable and a relatively stress free one!
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mr tan
I have been living with progressive hearing loss for more than three decades. Socially, I find myself fearful of communicating with people and at home, watching 'soundless' television programs is a norm.

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Mr Tan

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