Otorhinolaryngology services, GPs and audiologists do not all operate under the same roof. Often the older person who lacks an attentive friend or relative to remind, organise or transport them can find themselves effectively barred from services even when provided free by the public health system. Waiting times in the public system for ORL or audiology assessment can be many months, with arbitrary variations in access criteria according to where a person lives. The lack of requirement for hearing aid dispensers or those who conduct hearing tests to be properly trained or registered in New Zealand means private operators exist who may provide poor service at a high price. This will increase the chance of a poor outcome, and exacerbate the impression many elderly have of hearing aid services.
Cost is a major issue for many elderly people.
The gap between expectation and reality can be significant. Many older people expect hearing aids to correct hearing in the same way that spectacles correct refractive errors. At first, the person may feel overwhelmed by sound input and must learn to tune out unwanted sounds. Although it should be stressed that hearing aids do improve the quality of life in the majority of hearing impaired older people, with improvements in social, emotional and quality of life measures,6 nonetheless many elderly who are prescribed a hearing aid eventually stop using it. Popelka s study reported that 29 per cent of hearing aid owners no longer used their aid.