Hearty Healthy Ukrainian Borscht

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In the West, borscht is often thought of as Russian, but it is Ukrainian in origin and popular throughout much of Eastern Europe, with many local variations. Today’s borscht is a vegetarian (and vegan, depending on your choice of cooking fat) borscht from Kyiv, and it’s especially good for the gut, heart, and blood sugars.

You will need

  • 1 quart vegetable stock; ideally you made this yourself from vegetable offcuts you kept in the freezer, but failing that, your supermarket should have low-sodium stock cubes
  • 4 large beets, peeled and cut into matchsticks
  • 1 can white beans (cannellini beans are ideal), drained and rinsed
  • 1 cup sauerkraut
  • 1 large onion, finely chopped
  • 1 green bell pepper, roughly chopped
  • 1 large russet potato, peeled and cut into large chunks
  • 3 small carrots, tops removed and cut into large chunks
  • 1 tbsp tomato paste
  • ½ bulb garlic, finely chopped
  • 2 tsp black pepper, coarse ground
  • 1 bunch fresh dill, chopped. If you cannot get fresh, substitute with parsley (1 bunch fresh, chopped, or 1 tbsp dried). Do not use dried dill; it won’t work.
  • A little fat for cooking; this one’s a tricky and personal decision. Butter is traditional, but would make this recipe impossible to cook without going over the recommended limit for saturated fat. Avocado oil is healthy, relatively neutral in taste, and has a high smoke point, though that latter shouldn’t be necessary here if you are attentive with the stirring. Extra virgin olive oil is also a healthy choice, but not as neutral in flavor and does have a lower smoke point. Coconut oil has arguably too strong a taste and a low smoke point. Seed oils are very heart-unhealthy. All in all, avocado oil is a respectable choice from all angles except tradition.
  • On standby: a little vinegar (your preference what kind)

Salt is conspicuous by its absence, but there should be enough already from the other ingredients, especially the sauerkraut.

Method

(we suggest you read everything at least once before doing anything)

1) Heat some oil in a large sauté pan (cast iron is perfect if you have it), add the onion and pepper, and stir until the onion is becoming soft.

2) Add the carrots and beets and stir until they are becoming soft. If you need to add a little more oil, that’s fine.

3) Add the tomato paste, and stir in well.

4) Add a little (about ½ cup) of the vegetable stock and stir in well until you get a consistent texture with the tomato paste.

5) Add the sauerkraut and the rest of the broth, and cook for about 20 minutes.

6) Add the potatoes and cook for another 10 minutes.

7) Add the beans and cook for another 5 minutes.

8) Add the garlic, black pepper, and herbs. Check that everything is cooked (poke a chunk of potato with a fork) and that the seasoning is to your liking. The taste should be moderately sour from the sauerkraut; if it is sweet, you can stir in a little vinegar now to correct that.

9) Serve! Ukrainian borscht is most often served hot (unlike Lithuanian borscht, which is almost always served cold), but if the weather’s warm, it can certainly be enjoyed cold too:

Enjoy!

Want to learn more?

For those interested in some of the science of what we have going on today:

Take care!

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  • Gravitas – by Caroline Goyder

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    A no-nonsense guide to (more than!) public speaking that isn’t just “tell jokes in your speech and imagine the audience naked”.

    Because this isn’t just about speech-writing or speech delivery, so much as giving you important life skills. The kind that weren’t taught in school, but that nevertheless make a huge impact on success… whether you’re giving a presentation or hosting a party or negotiating a deal or just attending a social event. Or making a phonecall, even.

    Whereas a lot of books of this kind treat “the audience” as a nebulous and purely responsive passive crowd of extras, Goyder does better. People are individuals, even if they’re all facing the same way for a moment. She works with that! She also teaches how to deal with not just hecklers, but also simply those people who sap your confidence and find fault with you and anything you do or say.b

    Bottom line is: if you for whatever reason communicate with people, and would like them to think better of you, this is the book for you.

    Order your copy of Gravitas from Amazon today!

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  • Sizing Aside: Are You Wearing The Right Bra For Your Breast Shape?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s well-known that most women wear incorrectly-fitting bras. Even with careful measurements, buying “off-the-rack” can be a challenge, because the sizing system only takes two measurements, when there are actually many more things to consider. Today’s video demystifies a lot of what else is going on!

    For example…

    Some of the different breast shapes/arrangements to consider:

    • Wide-set breasts: likely to find there’s a bit of a gap between your breasts and the inside (nearest to your sternum) parts of the cups—while spilling out a little at the outside edges. The solution? Bras that offer side-support, to keep things pointing more forwards. Central-closing bras can also help gather things together, and a balconette bra can redistribute things more evenly. Any of these options will be a lot more comfortable.
    • Small breasts: bralettes are your friend, keeping things comfortable while not wearing more bra than necessary to do the job (of course going braless is also an option, but we’re talking bra-fitting here, not bra-flinging-off never to be seen again)
    • Deflated breasts: often the case for someone who used to have larger breasts, but they lost size for hormonal reasons rather than for weight loss reasons. This often occurs a little while after childbirth, and also happens a lot in menopause. The bra recommendation for this? A push-up plunge bra with ¾ coverage not only provides cleavage if that’s wanted, but also, will keep things much more snug and thus more evenly-distributed. If ever you’ve found yourself needing to adjust yourself every now and gain while out, this will fix that and keep you comfortable for much longer.

    There’s more, along with a visual guide, so do check it out:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Further reading

    While we haven’t written about this specifically (maybe we’ll do a “Life Hacks” edition one of these days), we have written about…

    Keeping Abreast Of Your Cancer Risk

    Take care!

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  • Why Many Nonprofit (Wink, Wink) Hospitals Are Rolling in Money

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    One owns a for-profit insurer, a venture capital company, and for-profit hospitals in Italy and Kazakhstan; it has just acquired its fourth for-profit hospital in Ireland. Another owns one of the largest for-profit hospitals in London, is partnering to build a massive training facility for a professional basketball team, and has launched and financed 80 for-profit start-ups. Another partners with a wellness spa where rooms cost $4,000 a night and co-invests with “leading private equity firms.”

    Do these sound like charities?

    These diversified businesses are, in fact, some of the country’s largest nonprofit hospital systems. And they have somehow managed to keep myriad for-profit enterprises under their nonprofit umbrella — a status that means they pay little or no taxes, float bonds at preferred rates, and gain numerous other financial advantages.

    Through legal maneuvering, regulatory neglect, and a large dollop of lobbying, they have remained tax-exempt charities, classified as 501(c)(3)s.

    “Hospitals are some of the biggest businesses in the U.S. — nonprofit in name only,” said Martin Gaynor, an economics and public policy professor at Carnegie Mellon University. “They realized they could own for-profit businesses and keep their not-for-profit status. So the parking lot is for-profit; the laundry service is for-profit; they open up for-profit entities in other countries that are expressly for making money. Great work if you can get it.”

    Many universities’ most robust income streams come from their technically nonprofit hospitals. At Stanford University, 62% of operating revenue in fiscal 2023 was from health services; at the University of Chicago, patient services brought in 49% of operating revenue in fiscal 2022.

    To be sure, many hospitals’ major source of income is still likely to be pricey patient care. Because they are nonprofit and therefore, by definition, can’t show that thing called “profit,” excess earnings are called “operating surpluses.” Meanwhile, some nonprofit hospitals, particularly in rural areas and inner cities, struggle to stay afloat because they depend heavily on lower payments from Medicaid and Medicare and have no alternative income streams.

    But investments are making “a bigger and bigger difference” in the bottom line of many big systems, said Ge Bai, a professor of health care accounting at the Johns Hopkins University Bloomberg School of Public Health. Investment income helped Cleveland Clinic overcome the deficit incurred during the pandemic.

    When many U.S. hospitals were founded over the past two centuries, mostly by religious groups, they were accorded nonprofit status for doling out free care during an era in which fewer people had insurance and bills were modest. The institutions operated on razor-thin margins. But as more Americans gained insurance and medical treatments became more effective — and more expensive — there was money to be made.

    Not-for-profit hospitals merged with one another, pursuing economies of scale, like joint purchasing of linens and surgical supplies. Then, in this century, they also began acquiring parts of the health care systems that had long been for-profit, such as doctors’ groups, as well as imaging and surgery centers. That raised some legal eyebrows — how could a nonprofit simply acquire a for-profit? — but regulators and the IRS let it ride.

    And in recent years, partnerships with, and ownership of, profit-making ventures have strayed further and further afield from the purported charitable health care mission in their community.

    “When I first encountered it, I was dumbfounded — I said, ‘This not charitable,’” said Michael West, an attorney and senior vice president of the New York Council of Nonprofits. “I’ve long questioned why these institutions get away with it. I just don’t see how it’s compliant with the IRS tax code.” West also pointed out that they don’t act like charities: “I mean, everyone knows someone with an outstanding $15,000 bill they can’t pay.”

    Hospitals get their tax breaks for providing “charity care and community benefit.” But how much charity care is enough and, more important, what sort of activities count as “community benefit” and how to value them? IRS guidance released this year remains fuzzy on the issue.

    Academics who study the subject have consistently found the value of many hospitals’ good work pales in comparison with the value of their tax breaks. Studies have shown that generally nonprofit and for-profit hospitals spend about the same portion of their expenses on the charity care component.

    Here are some things listed as “community benefit” on hospital systems’ 990 tax forms: creating jobs; building energy-efficient facilities; hiring minority- or women-owned contractors; upgrading parks with lighting and comfortable seating; creating healing gardens and spas for patients.

    All good works, to be sure, but health care?

    What’s more, to justify engaging in for-profit business while maintaining their not-for-profit status, hospitals must connect the business revenue to that mission. Otherwise, they pay an unrelated business income tax.

    “Their CEOs — many from the corporate world — spout drivel and turn somersaults to make the case,” said Lawton Burns, a management professor at the University of Pennsylvania’s Wharton School. “They do a lot of profitable stuff — they’re very clever and entrepreneurial.”

    The truth is that a number of not-for-profit hospitals have become wealthy diversified business organizations. The most visible manifestation of that is outsize executive compensation at many of the country’s big health systems. Seven of the 10 most highly paid nonprofit CEOs in the United States run hospitals and are paid millions, sometimes tens of millions, of dollars annually. The CEOs of the Gates and Ford foundations make far less, just a bit over $1 million.

    When challenged about the generous pay packages — as they often are — hospitals respond that running a hospital is a complicated business, that pharmaceutical and insurance execs make much more. Also, board compensation committees determine the payout, considering salaries at comparable institutions as well as the hospital’s financial performance.

    One obvious reason for the regulatory tolerance is that hospital systems are major employers — the largest in many states (including Massachusetts, Pennsylvania, Minnesota, Arizona, and Delaware). They are big-time lobbying forces and major donors in Washington and in state capitals.

    But some patients have had enough: In a suit brought by a local school board, a judge last year declared that four Pennsylvania hospitals in the Tower Health system had to pay property taxes because its executive pay was “eye popping” and it demonstrated “profit motives through actions such as charging management fees from its hospitals.”

    A 2020 Government Accountability Office report chided the IRS for its lack of vigilance in reviewing nonprofit hospitals’ community benefit and recommended ways to “improve IRS oversight.” A follow-up GAO report to Congress in 2023 said, “IRS officials told us that the agency had not revoked a hospital’s tax-exempt status for failing to provide sufficient community benefits in the previous 10 years” and recommended that Congress lay out more specific standards. The IRS declined to comment for this column.

    Attorneys general, who regulate charity at the state level, could also get involved. But, in practice, “there is zero accountability,” West said. “Most nonprofits live in fear of the AG. Not hospitals.”

    Today’s big hospital systems do miraculous, lifesaving stuff. But they are not channeling Mother Teresa. Maybe it’s time to end the community benefit charade for those that exploit it, and have these big businesses pay at least some tax. Communities could then use those dollars in ways that directly benefit residents’ health.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • Managing Sibling Relationships In Adult Life

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Managing Sibling Relationships In Adult Life

    After our previous main feature on estrangement, a subscriber wrote to say:

    ❝Parent and adult child relationships are so important to maintain as you age, but what about sibling relationships? Adult choices to accept and move on with healthier boundaries is also key for maintaining familial ties.❞

    And, this is indeed critical for many of us, if we have siblings!

    Writer’s note: I don’t have siblings, but I do happen to have one of Canada’s top psychologists on speed-dial, and she has more knowledge about sibling relationships than I do, not to mention a lifetime of experience both personally and professionally. So, I sought her advice, and she gave me a lot to work with.

    Today I bring her ideas, distilled into my writing, for 10almonds’ signature super-digestible bitesize style.

    A foundation of support

    Starting at the beginning of a sibling story… Sibling relationships are generally beneficial from the get-go.

    This is for reasons of mutual support, and an “always there” social presence.

    Of course, how positive this experience is may depend on there being a lack of parental favoritism. And certainly, sibling rivalries and conflict can occur at any age, but the stakes are usually lower, early in life.

    Growing warmer or colder

    Generally speaking, as people age, sibling relationships likely get warmer and less conflictual.

    Why? Simply put, we mature and (hopefully!) get more emotionally stable as we go.

    However, two things can throw a wrench into the works:

    1. Long-term rivalries or jealousies (e.g., “who has done better in life”)
    2. Perceptions of unequal contribution to the family

    These can take various forms, but for example if one sibling earns (or otherwise has) much more or much less than another, that can cause resentment on either or both sides:

    • Resentment from the side of the sibling with less money: “I’d look after them if our situations were reversed; they can solve my problems easily; why do they resent that and/or ignore my plight?”
    • Resentment from the side of the sibling with more money: “I shouldn’t be having to look after my sibling at this age”

    It’s ugly and unpleasant. Same goes if the general job of caring for an elderly parent (or parents) falls mostly or entirely on one sibling. This can happen because of being geographically closer or having more time (well… having had more time. Now they don’t, it’s being used for care!).

    It can also happen because of being female—daughters are more commonly expected to provide familial support than sons.

    And of course, that only gets exacerbated as end-of-life decisions become relevant with regard to parents, and tough decisions may need to be made. And, that’s before looking at conflicts around inheritance.

    So, all that seems quite bleak, but it doesn’t have to be like that.

    Practical advice

    As siblings age, working on communication about feelings is key to keeping siblings close and not devolving into conflict.

    Those problems we talked about are far from unique to any set of siblings—they’re just more visible when it’s our own family, that’s all.

    So: nothing to be ashamed of, or feel bad about. Just, something to manage—together.

    Figure out what everyone involved wants/needs, put them all on the table, and figure out how to:

    • Make sure outright needs are met first
    • Try to address wants next, where possible

    Remember, that if you feel more is being asked of you than you can give (in terms of time, energy, money, whatever), then this discussion is a time to bring that up, and ask for support, e.g.:

    “In order to be able to do that, I would need… [description of support]; can you help with that?”

    (it might even sometimes be necessary to simply say “No, I can’t do that. Let’s look to see how else we can deal with this” and look for other solutions, brainstorming together)

    Some back-and-forth open discussion and even negotiation might be necessary, but it’s so much better than seething quietly from a distance.

    The goal here is an outcome where everyone’s needs are met—thus leveraging the biggest strength of having siblings in the first place:

    Mutual support, while still being one’s own person. Or, as this writer’s psychology professor friend put it:

    ❝Circling back to your original intention, this whole discussion adds up to: siblings can be very good or very bad for your life, depending on tons of things that we talked about, especially communication skills, emotional wellness of each person, and the complexity of challenges they face interdependently.❞

    Our previous main feature about good communication can help a lot:

    Save Time With Better Communication

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  • Half of Australians in aged care have depression. Psychological therapy could help

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    While many people maintain positive emotional wellbeing as they age, around half of older Australians living in residential aged care have significant levels of depression. Symptoms such as low mood, lack of interest or pleasure in life and difficulty sleeping are common.

    Rates of depression in aged care appear to be increasing, and without adequate treatment, symptoms can be enduring and significantly impair older adults’ quality of life.

    But only a minority of aged care residents with depression receive services specific to the condition. Less than 3% of Australian aged care residents access Medicare-subsidised mental health services, such as consultations with a psychologist or psychiatrist, each year.

    An infographic showing the percentage of Australian aged care residents with depression (53%).

    Cochrane Australia

    Instead, residents are typically prescribed a medication by their GP to manage their mental health, which they often take for several months or years. A recent study found six in ten Australian aged care residents take antidepressants.

    While antidepressant medications may help many people, we lack robust evidence on whether they work for aged care residents with depression. Researchers have described “serious limitations of the current standard of care” in reference to the widespread use of antidepressants to treat frail older people with depression.

    Given this, we wanted to find out whether psychological therapies can help manage depression in this group. These treatments address factors contributing to people’s distress and provide them with skills to manage their symptoms and improve their day-to-day lives. But to date researchers, care providers and policy makers haven’t had clear information about their effectiveness for treating depression among older people in residential aged care.

    The good news is the evidence we published today suggests psychological therapies may be an effective approach for people living in aged care.

    We reviewed the evidence

    Our research team searched for randomised controlled trials published over the past 40 years that were designed to test the effectiveness of psychological therapies for depression among aged care residents 65 and over. We identified 19 trials from seven countries, including Australia, involving a total of 873 aged care residents with significant symptoms of depression.

    The studies tested several different kinds of psychological therapies, which we classified as cognitive behavioural therapy (CBT), behaviour therapy or reminiscence therapy.

    CBT involves teaching practical skills to help people re-frame negative thoughts and beliefs, while behaviour therapy aims to modify behaviour patterns by encouraging people with depression to engage in pleasurable and rewarding activities. Reminiscence therapy supports older people to reflect on positive or shared memories, and helps them find meaning in their life history.

    The therapies were delivered by a range of professionals, including psychologists, social workers, occupational therapists and trainee therapists.

    An infographic depicting what the researchers measured in the review.

    Cochrane Australia

    In these studies, psychological therapies were compared to a control group where the older people did not receive psychological therapy. In most studies, this was “usual care” – the care typically provided to aged care residents, which may include access to antidepressants, scheduled activities and help with day-to-day tasks.

    In some studies psychological therapy was compared to a situation where the older people received extra social contact, such as visits from a volunteer or joining in a discussion group.

    What we found

    Our results showed psychological therapies may be effective in reducing symptoms of depression for older people in residential aged care, compared with usual care, with effects lasting up to six months. While we didn’t see the same effect beyond six months, only two of the studies in our review followed people for this length of time, so the data was limited.

    Our findings suggest these therapies may also improve quality of life and psychological wellbeing.

    Psychological therapies mostly included between two and ten sessions, so the interventions were relatively brief. This is positive in terms of the potential feasibility of delivering psychological therapies at scale. The three different therapy types all appeared to be effective, compared to usual care.

    However, we found psychological therapy may not be more effective than extra social contact in reducing symptoms of depression. Older people commonly feel bored, lonely and socially isolated in aged care. The activities on offer are often inadequate to meet their needs for stimulation and interest. So identifying ways to increase meaningful engagement day-to-day could improve the mental health and wellbeing of older people in aged care.

    Some limitations

    Many of the studies we found were of relatively poor quality, because of small sample sizes and potential risk of bias, for example. So we need more high-quality research to increase our confidence in the findings.

    Many of the studies we reviewed were also old, and important gaps remain. For example, we are yet to understand the effectiveness of psychological therapies for people from diverse cultural or linguistic backgrounds.

    Separately, we need better research to evaluate the effectiveness of antidepressants among aged care residents.

    What needs to happen now?

    Depression should not be considered a “normal” experience at this (or any other) stage of life, and those experiencing symptoms should have equal access to a range of effective treatments. The royal commission into aged care highlighted that Australians living in aged care don’t receive enough mental health support and called for this issue to be addressed.

    While there have been some efforts to provide psychological services in residential aged care, the unmet need remains very high, and much more must be done.

    The focus now needs to shift to how to implement psychological therapies in aged care, by increasing the competencies of the aged care workforce, training the next generation of psychologists to work in this setting, and funding these programs in a cost-effective way. The Conversation

    Tanya Davison, Adjunct professor, Health & Ageing Research Group, Swinburne University of Technology and Sunil Bhar, Professor of Clinical Psychology, Swinburne University of Technology

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Say That Again: Using Hearing Aids Can Be Frustrating for Older Adults, but Necessary

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It was an every-other-day routine, full of frustration.

    Every time my husband called his father, who was 94 when he died in 2022, he’d wait for his dad to find his hearing aids and put them in before they started talking.

    Even then, my father-in-law could barely hear what my husband was saying. “What?” he’d ask over and over.

    Then, there were the problems my father-in-law had replacing the devices’ batteries. And the times he’d end up in the hospital, unable to understand what people were saying because his hearing aids didn’t seem to be functioning. And the times he’d drop one of the devices and be unable to find it.

    How many older adults have problems of this kind?

    There’s no good data about this topic, according to Nicholas Reed, an assistant professor of epidemiology at Johns Hopkins Bloomberg School of Public Health who studies hearing loss. He did a literature search when I posed the question and came up empty.

    Reed co-authored the most definitive study to date of hearing issues in older Americans, published in JAMA Open Network last year. Previous studies excluded people 80 and older. But data became available when a 2021 survey by the National Health and Aging Trends Study included hearing assessments conducted at people’s homes.

    The results, based on a nationally representative sample of 2,803 people 71 and older, are eye-opening. Hearing problems become pervasive with advancing age, exceeding 90% in people 85 and older, compared with 53% of 71- to 74-year-olds. Also, hearing worsens over time, with more people experiencing moderate or severe deficits once they reach or exceed age 80, compared with people in their 70s.

    However, only 29% of those with hearing loss used hearing aids. Multiple studies have documented barriers that inhibit use. Such devices, which Medicare doesn’t cover, are pricey, from nearly $1,000 for a good over-the-counter set (OTC hearing aids became available in 2022) to more than $6,000 for some prescription models. In some communities, hearing evaluation services are difficult to find. Also, people often associate hearing aids with being old and feel self-conscious about wearing them. And they tend to underestimate hearing problems that develop gradually.

    Barbara Weinstein, a professor of audiology at the City University of New York Graduate Center and author of the textbook “Geriatric Audiology,” added another concern to this list when I reached out to her: usability.

    “Hearing aids aren’t really designed for the population that most needs to use them,” she told me. “The move to make devices smaller and more sophisticated technologically isn’t right for many people who are older.”

    That’s problematic because hearing loss raises the risk of cognitive decline, dementia, falls, depression, and social isolation.

    What advice do specialists in hearing health have for older adults who have a hard time using their hearing aids? Here are some thoughts they shared.

    Consider larger, customized devices. Many older people, especially those with arthritis, poor fine motor skills, compromised vision, and some degree of cognitive impairment, have a hard time manipulating small hearing aids and using them properly.

    Lindsay Creed, associate director of audiology practices at the American Speech-Language-Hearing Association, said about half of her older clients have “some sort of dexterity issue, whether numbness or reduced movement or tremor or a lack of coordination.” Shekinah Mast, owner of Mast Audiology Services in Seaford, Delaware, estimates nearly half of her clients have vision issues.

    For clients with dexterity challenges, Creed often recommends “behind-the-ear hearing aids,” with a loop over the ear, and customized molds that fit snugly in the ear. Customized earpieces are larger than standardized models.

    “The more dexterity challenges you have, the better you’ll do with a larger device and with lots of practice picking it up, orienting it, and putting it in your ear,” said Marquitta Merkison, associate director of audiology practices at ASHA.

    For older people with vision issues, Mast sometimes orders hearing aids in different colors for different ears. Also, she’ll help clients set up stands at home for storing devices, chargers, and accessories so they can readily find them each time they need them.

    Opt for ease of use. Instead of buying devices that require replacing tiny batteries, select a device that can be charged overnight and operate for at least a day before being recharged, recommended Thomas Powers, a consultant to the Hearing Industries Association. These are now widely available.

    People who are comfortable using a smartphone should consider using a phone app to change volume and other device settings. Dave Fabry, chief hearing health officer at Starkey, a major hearing aid manufacturer, said he has patients in their 80s and 90s “who’ve found that being able to hold a phone and use larger visible controls is easier than manipulating the hearing aid.”

    If that’s too difficult, try a remote control. GN ReSound, another major manufacturer, has designed one with two large buttons that activate the volume control and programming for its hearing aids, said Megan Quilter, the company’s lead audiologist for research and development.

    Check out accessories. Say you’re having trouble hearing other people in restaurants. You can ask the person across the table to clip a microphone to his shirt or put the mike in the center of the table. (The hearing aids will need to be programmed to allow the sound to be streamed to your ears.)

    Another low-tech option: a hearing aid clip that connects to a piece of clothing to prevent a device from falling to the floor if it becomes dislodged from the ear.

    Wear your hearing aids all day. “The No. 1 thing I hear from older adults is they think they don’t need to put on their hearing aids when they’re at home in a quiet environment,” said Erika Shakespeare, who owns Audiology and Hearing Aid Associates in La Grande, Oregon.

    That’s based on a misunderstanding. Our brains need regular, not occasional, stimulation from our environments to optimize hearing, Shakespeare explained. This includes noises in seemingly quiet environments, such as the whoosh of a fan, the creak of a floor, or the wind’s wail outside a window.

    “If the only time you wear hearing aids is when you think you need them, your brain doesn’t know how to process all those sounds,” she told me. Her rule of thumb: “Wear hearing aids all your waking hours.”

    Consult a hearing professional. Everyone’s needs are different, so it’s a good idea to seek out an audiologist or hearing specialist who, for a fee, can provide guidance.

    “Most older people are not going to know what they need” and what options exist without professional assistance, said Virginia Ramachandran, the head of audiology at Oticon, a major hearing aid manufacturer, and a past president of the American Academy of Audiology.

    Her advice to older adults: Be “really open” about your challenges.

    If you can’t afford hearing aids, ask a hearing professional for an appointment to go over features you should look for in over-the-counter devices. Make it clear you want the appointment to be about your needs, not a sales pitch, Reed said. Audiology practices don’t routinely offer this kind of service, but there’s good reason to ask since Medicare started covering once-a-year audiologist consultations last year.

    We’re eager to hear from readers about questions you’d like answered, problems you’ve been having with your care, and advice you need in dealing with the health care system. Visit http://kffhealthnews.org/columnists to submit your requests or tips.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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