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Ann Davison, 79, adjusts her hearing aid in her home in Halifax on Thursday, May 3, 2018. After years of struggling to pay for her hearing aids, for a time only wearing one because she couldn't afford the second, Davison now has two with the help of the Dalhousie University health clinic.

Darren Calabrese/Globe and Mail

For Erica Lindell, hearing aids are essential. Without them, the mother of two living just outside Winnipeg couldn’t hear her kids call for help, or even keep her IT job, which requires a lot of phone calls. But the devices are also a source of debt: She’s had to take out two separate loans – one for $10,000 and another for $5,000 after the first pair expired – to cover the cost of the devices.

Ms. Lindell’s situation is not unique. Hearing aids can range from $1,200 to $4,000 or more for each ear, depending on the level of hearing loss and the technology in the device – and they often must be replaced every four to five years. Yet Quebec is the only province that provides full coverage for hearing aids as part of its provincial health plan. Most other provinces provide only partial subsidies for those who qualify because of advanced age or low income.

Ontario, for example, gives up to $500 an ear. Alberta offers subsidies to low-income adults. Manitoba provides a one-time payment of up to 80 per cent of the cost of the hearing aid, to a maximum of $500 an ear, through its employment and income assistance program for those with a low enough income, while Nova Scotia provides no subsidies to adults at all.

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For many lower-income people, the lack of coverage means they must simply go without, says Rachel Caissie, an audiologist at Dalhousie University in Halifax.

“I have seniors show up who’ve had hearing loss for 10 years and have never received help for their hearing loss because they cannot afford it,” says Dr. Caissie, who holds a PhD in audiology and runs a hearing clinic for low-income Nova Scotians.

Hearing loss causes more problems than just being unable to hear. Studies have found it can also lead to social isolation and loneliness as those affected withdraw from friends and family. People with untreated hearing loss also experience higher rates of depression.

Various studies have also found links between hearing loss and an increased risk of dementia, including one published in the Journal of Gerontology in 2016 led by researchers at Johns Hopkins University. The study also says more research is required into whether treating hearing loss can reduce the risk.

People 65 or older – those most likely to be relying on a fixed pension income – are also most likely to lose their hearing.

To make hearing aids more accessible, some individuals and politicians have tried to put pressure on governments to provide better subsidies.

In Manitoba, for example, Ms. Lindell started an online petition to the provincial government in 2015 to create hearing-aid subsidies for adults, but she says she received little acknowledgement from the government at the time. It had 315 supporters.

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In Nova Scotia, several versions of the same private member’s bill – calling for financial assistance for hearing aids for low-income seniors – have been presented to the provincial legislature. The bill has been proposed by several MLAs, including members from different political parties.

The most recent version of the bill, the Hearing Aids for Low-income Seniors Act, was introduced by Larry Harrison, the Progressive Conservative MLA for Colchester-Musquodoboit Valley, in October, 2017, and calls for up to $500 an ear for low-income individuals aged 65 and up.

Rather than waiting for governments to change, some groups are also helping provide people with the hearing aids at a reduced cost, or even free of charge, such as the Hear4U Foundation, based in Kelowna, B.C., which refurbishes used hearing aids, and distributes them at a nominal cost to recipients who qualify.

Also in British Columbia, the Western Institute for the Deaf and Hard of Hearing runs the Lend an Ear program for low-income people who can’t afford hearing aids. They clean and refurbish donated hearing aids and provide them to those in need for a one-time fee of $140.

Since it was started in 1998, the program has treated approximately 1,400 people, says James Bacon, the manager of marketing and fundraising with the institute.

In B.C., adults can get a hearing aid through the provincial health plan, but to be eligible, they must meet a series of strict requirements. For instance, the recipient must be the hard-of-hearing parent of a dependent child or the recipient must be both blind and hard of hearing, among other specific criteria.

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Other subsidies are available in the province for those who meet specific criteria, but Mr. Bacon says the program has been “constantly combatting a year-long waiting list.”

On the opposite coast, Dr. Caissie founded the Dalhousie Hearing Aid Assistance Program in 2011. The clinic provides hearing aids – as well as adjustments and follow-up appointments – for a one-time fee of $50.

She says patients at the clinic have an average annual income of $14,000. Potential patients must have an annual income of less than $25,000 and no other financial help for hearing aids.

Ann Davison is one of many who have been helped by the Dalhousie program. Ms. Davison, 79, went four years with one hearing aid when she needed two. It was going to cost her $1,200 an ear, but she only had enough saved up for one. She now gets her hearing aids through the Halifax clinic.

The clinic surveys all of its patients. “We get responses like ‘The hearing aids have changed my life completely’ or ‘I was born again.’ ” Dr. Caissie adds: “That one was from an 86-year-old man.”

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