It happened again the other day. What I didn’t hear almost caused an accident.

I was walking briskly along a trail path when I stopped suddenly to look at something. A man right behind me – on a bike – almost plowed into me. 

“Oh, I’m sorry”, we both said. I’m Canadian – we apologize for everything, even when it’s not our fault. 

To my apology, he responded, “That’s OK, I was going slow.”

Well I would hope so, but why was he that close in the first place? As he rode on by, I wondered if he had rung his ringy-dingy bike bell. Did he call out, “Excuse me, coming through?” If he had, I didn’t hear either the bell or his voice. But when I didn’t respond, did he get off his bike and walk it, or move to the road’s bike lane where he should have been riding in the first place?  No. He risked certain injury to at least one of us – me – by riding very closely behind. If he had hit me, the damage would have minimal-to-none, except for a more drawn-out Canadian apology-dance, with me saying I have hearing loss, then him saying oh I’m sorry, and then me saying don’t be. But I was rattled by the near collision, partly because it’s not an uncommon occurrence in the hearing loss life. 

A couple of days later, my family and I were walking along a driveway outside a hotel. The Hearing Husband was far ahead of me, and a car, without enough space to pass, was moving slowly behind him. I wondered why Doug didn’t move aside and just as I was about to call out, he turned his head and startled visibly on seeing the car. He hadn’t heard the Hybrid-Electric vehicle that, moving at slow speed, emitted almost no sound. I hadn’t noticed its quietness because I often don’t hear a car’s motor. Although the driver had Doug in his sights, what if Doug had suddenly moved directly into the car’s path?

The quiet cars pose a real and recognized danger for any pedestrian, let alone those with hearing loss. A 2011 report from the National Highway Traffic Safety Administration concluded that Hybrid-Electric vehicles had a higher likelihood of being involved in a crash with pedestrians or bicyclists than did vehicles with an Internal Combustion Engine (which presumably is what makes the noise that we hear). A 2009 article by Healthy Hearing called Hearing Loss Safety, If You Can’t Hear It, How Can You Avoid It?”, focusing primarily on our (in)ability to hear smoke and fire alarms, says: “But here’s the thing, not all dangers come with alarms. Not all dangers are loud. In fact, some may be soft – the murmuring cry of an infant, a distant tornado siren or a neighbor’s call for help.”  To that list, I would also add the high frequency ringy-dingy bike bell, quiet cars and almost any sound that occurs outside of our line of sight.

How can people with hearing loss protect themselves against these soft-sound dangers? 

Wearing our assistive hearing technology at all times is obviously a priority, giving us a fighting chance to hear what we need to hear. But I’m darned if I’ll wear, every time I go outside, a high visibility vest that tells people to use cautious behavior around me. When walking, bike-riding or driving, we simply need to be super-aware of our surroundings, even if it means keeping our head and eyes in constant motion, especially in busy, high traffic areas. 

But other people, the hearing people, have safety responsibilities as well. Hearing loss in strangers is seldom obvious and when people get caught up in their thoughts, regardless of hearing ability, they’re not as aware of potential danger situations. If someone is not responding to you, there are options. If a bike bell doesn’t work, call out loudly. If that doesn’t work, go around them, or use some sort of visual alert, such as arm-waving. If you get too close, we might startle, which can be dangerous. While I do try to stay alert to my surroundings, I’ve had many minor collisions, mostly with people, and many near-misses that would have been more painful. 

What other are some other safety ideas for people with hearing loss when they’re “out and about”?


Photo credit: High visibility vest by Tingley’s

The topic of Over-the-Counter (OTC) hearing aids is of intense personal and professional interest to me.  However, I’m Canadian and our hearing loss advocacy on OTC is years behind that of our American colleagues. But I don’t feel qualified to write about the issue from the consumer point of view because, quite frankly, like many Canadians, the American health system completely baffles me.  So, I’ve asked my friend, renowned writer and advocate, Katherine Bouton, to give a consumer perspective on OTC devices.  She does so in the following article modified for the Better Hearing Consumer.  – Gael Hannan


By Katherine Bouton


Last week (August 3), the U.S. Senate passed the Over-the-Counter Hearing Aid Act of 2017, which had earlier passed the House of Representatives. Once it is signed by the President, it will become law.

Why does the United States need an over-the-counter hearing aid act? What’s wrong with conventional hearing aids sold through audiologists and hearing aid dispensers? The answer is that nothing is wrong with them, but not everyone needs these expensive devices and services. The average cost of a hearing aid is $2400, which is not generally covered by insurance. Medicare, which covers most Americans over 65 (the age with the largest degree of hearing loss), does not cover hearing aids at all.

What exactly is an over the counter hearing aid?

We already have a device available over the counter that corrects hearing loss. So what is that if not an OTC hearing aid?  It’s a PSAP, a Personal Sound Amplification Product, which can cost anywhere from $50 to $500.  A PSAP can be marketed as a sound amplifier but only for people with normal hearing.

An OTC hearing aid will probably do what a good PSAP already does, but with FDA approval. It will be a digital device, possibly with directional microphones, Bluetooth capability and a telecoil, and presumably will cost $1000 or less. An OTC hearing aid will be sold direct to the consumer. The choice to work with an audiologist or hearing aid dispenser is the consumer’s.

An OTC hearing aid will be subject to FDA safety and efficacy standards, which PSAP’s currently are not. OTC hearing aids are not for people with severe hearing loss, single sided hearing loss, or hearing loss caused by a number of medical conditions.

Why do I, who can never benefit from an OTC aid, support it? A free market in hearing aids is good for everyone with hearing loss.

Four out of five older Americans with hearing loss ignore it, so clearly something needs to change. Many cannot afford hearing aids or worry about stigma. More widespread hearing devices of all kinds would help with both those issues. Many believe that OTC hearing aids will be a gateway device for the 85 percent of people with hearing loss who do not now treat their loss.

Some people worry that health insurance will not cover an over-the-counter product. But in my opinion, Medicare and other coverage will never happen unless hearing aid prices down come down. It’s possible that Medicare may not cover OTC hearing aids, but it might recognize more serious hearing loss as the legitimate medical condition that it is. So those of us who have to pay $3000-$4000 for hearing aids may at last get some relief from Medicare. Those with mild to moderate loss can benefit from much less expensive hearing aids.

Right now, an OTC hearing aid remains a concept, not a product. Once the bill is signed into law, it will go to the FDA, which will begin drafting rules and regulations for it, including labeling indicating who these hearing aids are intended for, and who should seek medical advice. This could take up to three years.

Meanwhile, the Hearing Loss Association of America, which strongly backed the bill, urged consumers not to wait If they think they have a hearing loss. HLAA recommends seeing an audiologist or hearing instrument specialist if you are having trouble on the phone, asking others to repeat, turning up the volume on your television, or showing other warning signs. “Untreated hearing loss can cause falls, isolation, depression, anxiety, and it has been shown that there is a link to cognition,” their statement said. “Hearing loss should be prevented, screened for, and treated without delay.”

Many in the field of hearing loss see this bill as an unmitigated positive development. Competition will bring prices down. Ubiquitous use will end stigma. What’s not to like?


Katherine Bouton is the author of “Shouting Won’t Help: Why I – and 50 Million Other Americans – Can’t Hear You.” She is on the Board of Trustees of the Hearing Loss Association of America. Portions of this post appeared in slightly different form on “Hearing Aids, Hearing Loss, Hearing Help,” at