Hearing and vision

Hearing

Around half of people over 75 have meaningful hearing loss. Most don't get help — partly cost, partly stigma, partly the slow slide that makes it hard to notice.

Why it matters more than people think

• Doubles dementia risk at the population level (Lancet Commission on Dementia)
• Increases fall risk — hearing helps with spatial orientation and threat detection
• Drives isolation — conversations get exhausting, then avoided. Many "withdrawn" elderly parents are simply unable to hear.
• Mimics cognitive decline — people who can't hear well are sometimes mistaken for cognitively impaired

Signs your parent has hearing loss

• TV volume keeps climbing
• Asking "what?" repeatedly, or smiling and nodding when conversation drifts
• Trouble in noisy rooms — restaurants, family gatherings
• Misunderstanding instructions, particularly on the phone
• Withdrawing from group conversations
• Family members shouting routinely

Free and subsidised hearing checks

• Free checks at most major hearing clinics (Bay Audiology, Triton, Dilworth, etc.) — they're free as marketing, but the assessment is real and useful
• Public-system audiology — Health NZ audiology services exist for under-16s and complex adult cases; standard adult hearing aids are not generally publicly funded for over-16s
• Hearing Aid Subsidy Scheme — $1,022.22 (every 6 years) towards hearing aids for adults who meet the criteria. Most adults qualify. Apply via the audiologist.
• Hearing Aid Funding Scheme — fully funded hearing aids for community service card holders, beneficiaries, and certain veterans / accident-related cases
• ACC — funds hearing aids when hearing loss is service- or accident-related

What to expect from hearing aids

• Out-of-pocket cost: $1,500–$5,000 per pair after subsidy. Cheaper aids work; very expensive ones add convenience features more than core hearing
• Adjustment period of 4–8 weeks is normal — the brain has to relearn to filter
• Don't expect perfection in noisy rooms; expect to hear conversation in quiet rooms again
• Bluetooth hearing aids stream from phone and TV — game-changing for people who avoid phone calls
• Buy from somewhere with a generous trial period (most clinics offer 30–60 days)

If hearing aids aren't possible

• Personal amplifiers ("pocket talkers") — $100–$200 devices that work surprisingly well one-on-one
• Captioned phones — display speech as text in real time
• Hearing loops in churches, halls, cinemas
• Visual smoke alarms — strobe-style for people who can't hear standard alarms

Vision

Vision changes happen so gradually that people often don't notice how much they've lost until they fail a driver's licence test or fall.

The four big issues over 65

• Cataracts — clouding of the lens. Cause: aging. Surgery is highly effective and largely publicly funded for those who meet the threshold; private surgery is around $3,500–$5,500 per eye if waiting times are too long.
• Glaucoma — silent damage to the optic nerve. No early symptoms. Causes preventable blindness. Annual or bi-annual check by an optometrist is the only way to catch it early. Eye drops or surgery prevent further loss.
• Macular degeneration (AMD) — central vision loss. Some forms are slowed dramatically by injections (anti-VEGF), partly funded.
• Diabetic retinopathy — anyone diabetic should have annual retinal screening. Free for most diabetics under Te Whatu Ora.

Free and low-cost eye care

• Optometrist eye exams — typically $60–$100. Many optometrists offer free glaucoma screening during World Glaucoma Week (March)
• Cataract surgery — publicly funded if vision is below the regional threshold; otherwise private
• Diabetic retinal screening — free for diabetics, organised through GP
• Spectacle subsidy for children exists; for adults it generally does not — Disability Allowance can cover ongoing costs in some cases
• Blind Low Vision NZ — formerly Blind Foundation. Free services for people with significant vision loss: equipment, training, audio library, social connection. blindlowvision.org.nz
• Driving and vision — see driving for the medical-licence implications

Things that help around the home

• Bright, even lighting — older eyes need 2–3× the light younger eyes do
• Contrast — dark plates on light tablecloths, dark light-switch covers on light walls
• Large-font phones, large-button TV remotes
• Audiobooks (Blind Low Vision NZ library is free if eligible)
• Voice-activated assistants (Alexa, Google) for timers, weather, calls
• Magnifiers — handheld and on-screen for tablets / phones