Are AirPods the Missing Option We’ve Needed for Patients With Dementia?

In my first year as an audiologist, I took over care for a patient with dementia whose family had gone through at least four sets of hearing aids in just over a year. The patient lived in a memory care facility that wasn’t managing the devices well, and they kept getting lost. The family was in an impossible position. They wanted their parent to be comfortable and to enjoy the time they had together. But after spending thousands of dollars on lost hearing aids, they had to ask hard questions: What’s the right path forward? How much should we spend on hearing care? Is there another way?

At the time, there wasn’t a good answer. Prescription hearing aids weren’t working, and going without them would have cut the family off from their parent. We settled on a middle path: a headphone-style amplifier that gave the patient louder, non-customized sound to use when it mattered most. It was the definition of a “least bad” solution, and it stuck with me. It shaped the values I’ve built Sono Audiology and Orelo Hearing on: access, affordability, and creativity. Years later, I think I’ve finally found a better option for families like that one.

If you’ve seen me in the last couple of months, you probably know I’ve fallen down the rabbit hole of the Hearing Aid feature on AirPods Pro 2 and 3. If you’ve somehow avoided my evangelizing: since September 2024, AirPods Pro have been FDA-authorized as over-the-counter (OTC) hearing aids for adults with perceived mild-to-moderate hearing loss. They can be programmed using Apple’s built-in hearing test or results from a professional hearing test. For people facing real barriers of access and cost, a $250 option is a game changer. I got deep enough into it that I built an Orelo course on setting up and using the feature. Along the way, AirPods became my go-to for patients when prescription hearing aids aren’t viable and no hearing aids isn’t acceptable. Here’s how I use them, and why the hearing health professional is still a crucial partner, even with a direct-to-consumer product.

Why AirPods Are Viable

Cost‍ ‍AirPods Pro 3 retail for $250 on Apple’s website. My most popular prescription hearing aids run about $2,300, including fitting and aural rehab. For a patient at risk of losing devices, that means you could replace AirPods nine times for the cost of one set of prescription aids. I can already hear fellow professionals saying, “Our value is in the service we provide!” I agree, and I’ll get to that. But cost is a real factor in medical decisions for many families, and we can’t ignore it.

Performance‍ ‍After a couple of months of testing, the performance is there. Do AirPods match a premium prescription hearing aid in challenging environments? No. But these patients aren’t spending most of their time in those environments. The goal is better communication in quiet, one-on-one and small-group settings, and there, properly fitted AirPods hold their own against prescription devices. And because the hearing aid processing runs on the AirPods themselves, not the phone, the patient doesn’t need an iPhone or iPad nearby once setup is done.

Familiarity We have to plan for the world these patients actually live in. We’d all love memory care staff who can confidently insert, remove, charge, and troubleshoot hearing aids, but many caregivers are overworked and undertrained. What nearly every caregiver has used is AirPods. They already know how to put them in, take them out, and charge them. Choosing a familiar consumer device instantly expands the patient’s support network.

The Hearing Health Professional’s Role

“Our value is in the service we provide.” It’s never truer than here. These are some of the most complex patients I see, and AirPods without clinical expertise won’t serve them as well as they could. Families and caregivers need our counseling. The AirPods replace the devices; we provide everything else, and we should be paid fairly for it. Here’s what that looks like at Sono Audiology, math included.

Consultation When choosing AirPods involves real decision-making with the family, a consultation fee is reasonable for that expertise. At Sono Audiology, I charge $100 for this service.

Hearing evaluation Apple’s built-in test is convenient, but it’s no substitute for a professional evaluation. AirPods perform best when programmed from a real audiogram. At many clinics this is covered by insurance. At Sono, I charge $180 for an ear health and hearing evaluation.

AirPods Setup Setup is user-friendly, but a professional still adds value, most importantly through real-ear measurement (REM). REM uses specialized equipment to measure how much sound the AirPods actually deliver in the patient’s ears and compares it to their prescription (like eyeglasses, ears have a prescribed amount of amplification for each pitch.) Once that’s done, the settings can be applied to replacement AirPods through the patient’s iPhone or iPad, keeping replacement costs low. At Sono Audiology, I charge $200 for setup, real-ear measures, and counseling on use and care. Adding Orelo’s AirPods Course for $25 provides ongoing, self-guided support for patients and caregivers to be active partners in their hearing health care.

Add It All Up Adding it all up, we’re looking at a total setup cost of $505 (plus $250 for the AirPods) to get a patient up and running with a set of AirPods Pro professionally tailored as OTC hearing aids. For the patient, this represents a flexible hearing solution. As an audiologist, this allows me to help my patients and their families outside of the traditional hearing aid model, while still meeting my clinic’s required revenue.

The Takeaway

My duty as an audiologist is to provide my patients and their families with options and guidance to make the best choices for their situation. Are AirPods the right solution for every patient and every family? No, of course not. Again, that is where the expertise of a hearing health professional can be invaluable in making sure that connections and memories can continue to be made, even as families navigate the changing landscape of living with dementia. This is one more tool in the hearing health toolbelt, and one that I intend to use when I can and when it’s appropriate.

Dr. Bryan Greenaway is the owner and audiologist at Sono Audiology, serving Gresham and Portland, Oregon. He also runs Orelo Hearing, which creates online courses that help hearing aid users become active partners in their hearing health. This article was edited for concision and clarity with AI.