doctor-holding-hearing-aid

The Problem with Hearing Aids—and the Solutions

If you find yourself straining to hear in crowded places or saying “What did you say” more often than you used to, you probably need a hearing aid. If despite the strain, you tell yourself that your hearing’s fine, you’re not alone. A whopping 80 percent of adults between the ages of 55 and 74 who would benefit from a hearing aid do not use them, according to the International Journal of Audiology. (Take this quiz to find out if you might need hearing aids.)

Why wouldn’t you correct your hearing, the same way you correct your vision if you can’t see well enough? People have a variety of reasons. Some have tried hearing aids before and complain about discomfort or difficulty handling them, or disappointment that that they’ve failed to restore their former sense of sound. Many haven’t even tried them, because they don’t want to wear something associated with “old.” For a lot of people, expense is an issue. But most people don’t realize the profound damage that uncorrected hearing loss can do to your physical, emotional and cognitive health. Studies have associated being hard of hearing with poor general health, mood disorders—even shorter lifespan.

Hearing Loss and the Brain

In a study that tracked 639 adults for nearly 12 years, Johns Hopkins expert Frank Lin, M.D., Ph.D, and his colleagues found that mild hearing loss is associated with a doubled risk of dementia. Moderate loss tripled risk, and people with a severe hearing impairment were five times more likely to develop dementia.

The fact is that hearing is not only a function of the ears, but of the brain itself. Not being able to hear well reduces stimulation of the auditory centers of the brain, and that can lead to an actual reduction in gray matter. People with uncorrected hearing loss are also more likely to withdraw from social life, which leads to increased loneliness and depression, which also increases the risk for Alzheimer’s. It’s a vicious cycle.

Straining to hear, Dr. Lin finds, may also lead to what he calls “cognitive load” or mental fatigue, and that kind of subconscious multitasking could contribute to the fact that hearing loss dramatically increases your risk of falls. Another reason is the mechanism of balance: As you walk, your ears may pick up subtle cues that help with balance. Hearing loss may mute these important signals.

Still resistant to the idea of hearing aids? Let’s take a look at the reasons for not wearing them. In every case, there are ways to get around the problem.

Pick Your Hearing Aid Problem

With new hearing technologies and consumer avenues for buying the hardware and audiologist services, many of the issues that people have with hearing aids can be remedied. We’ve explored the main reasons why so many older people deal with uncorrected hearing loss and offer some ways you might get around them. Pick your problem—and share your hearing aid problem in the poll at the end. (If we haven’t covered your issue with hearing aids, let us know in the comments section.)

1. Hearing Aids Are Too Expensive

THE PROBLEM You probably assume that hearing aids cost thousands of dollars—and generally, you’re right. Only a handful of companies manufacture hearing aids, which may be keeping prices high, and on the provider side, you’re paying an unknown amount to the audiologist for services, because traditionally, hardware and service have been “bundled”—they come as a package from the same provider.

THE ANSWER  Times are changing. More audiologists are “unbundling” service from hardware, making it possible for you to compare prices and pay for only the services you’re getting.  This is a new trend that many audiologists are resisting—just ask the audiologist whether she or he unbundles.

When it comes to hardware, there are bargains out there—especially with the new online-only options available for hearing aid purchase and, for people with mild hearing loss, the even newer hearables (not technically hearing aids) that are becoming available for as little as $300. Check out our story  about how to find a good deal.

2. Hearing Aids Are Unattractive  

THE PROBLEM Many people who really need hearing aids resist because they’re embarrassed to be seen wearing them. “If I wear these aids I’ll really start to look old!” said one respondent to an online query about the issue.  It’s bad enough that my hair is totally gray.”

THE ANSWER Those ugly pieces of hardware that cover the entire ear canal are rarely prescribed today. In the past few years, new technologies have enabled hearing aid manufacturers to shrink their products so much, they’re virtually invisible. The most common versions—behind-the-ear models—are completely obscured by the top of the ear.  In-the-ear hearing aids are totally invisible.

Hearing aids today aren’t just tiny, many are super techy, too. They can stream music, phone conversations and more from your smartphone and let you customize your hearing experience via a paired app. These are not your father’s hearing aids. But if even a barely visible, bluetooth enabled hearing aid isn’t an option, see if a hearable works for you. These high tech earbuds come without a prescription and both amplify and manipulate sound, as well as streaming audio, and while they’re in their infancy now, at least one model might make a difference for people with mild hearing loss. Yes, earbuds are visible—but everyone wears earbuds.

3. Hearing Aids Don’t Help   

THE PROBLEM  Studies show that a primary reason for what’s been called “hearing aid in the drawer syndrome” is wearer complaints that the device doesn’t provide enough benefit—they still can’t distinguish speech in noisy environments; they experience poor sound quality or hear too much background noise.

THE ANSWER There are several solutions to sound quality issues. If you can afford the latest technology, newer hearing aids like the Oticon Opn and Widex Beyond do an amazing job of distinguishing speech from background noise. Their multiple processors mimic the brain’s ability to hear sound. They’re also adjustable via a smartphone app for volume, directionality and audio environment, among other variables.

Less expensive hearing aids can provide solid benefit, too, if you can adjust your expectations: You can’t simply put in a hearing aid and expect to hear like you once did. “Older people, especially, who’ve been losing hearing over the years haven’t heard many sounds for a long time,” says Kari Lane, assistant professor of nursing at the University of Missouri. “They put hearing aids in and can hear sounds they haven’t heard for years and experience sensory overload.  They get overstimulated and can’t tolerate it.”

In response, Lane came up with the Hearing Aid Reintroduction Program, or HEAR. To remedy hearing aid in the drawer syndrome HEAR uses a workbook (soon to be an app) with a 30-day schedule that increases wear time daily to help you adjust to your hearing aids. The program has had a 80 percent success rate with Lane’s group.

Lane’s tips:

  • Take it slow. Start by wearing your hearing aid for an hour a day and increase one hour every day. Introduce new sounds daily.
  • Keep persisting. Your brain has to relearn how to hear and make sense of sounds, and the only way to do that is to be exposed to those sounds.
  • Accept limits. Hearing aids are just that—an aid—and deciphering speech in a noisy environment will always be difficult. Focus on one person and don’t expect to hear more than one person at a time.
  • Keep going back to your audiologist until you’re satisfied.

It can take four months to get used to hearing aids, according to the makers of Starkey hearing aids, whose site has some helpful suggestions.

4. Hearing Aids Are Uncomfortable

THE PROBLEM When it comes to comfort, unrealistic expectations are an issue. You don’t put in contact lenses and get used to them immediately. Similarly, you have to wear hearing aids for a while to acclimate to the feeling of having something in your ears. Eventually you may get so used to them, you’ll forget to take them off.

THE ANSWER The site HearingHealthMatters.org provides several tips for getting comfortable with your hearing aid, including making sure it’s well inserted and not trying to remedy pain in the ear by pulling the hearing aid out a little; it’s not going to help and in fact, it’s likely to increase the irritation. The site also recommends lubricating your ear canal by gently rubbing a little baby oil in and around it with your finger.  You can even put a little of the oil on the hearing aid itself before you insert it, as long as you keep the lubricant away from the opening of the sound tube.

5. Hearing Aids Batteries Are Hard to Handle

THE PROBLEM  If your manual dexterity or eyesight isn’t what it used to be, handling a hearing aid can be a stumbling block—and the smaller the hearing aid, the greater the barrier, especially in the battery department. Batteries are tiny, and getting them into a miniscule hearing aid can be impossible for someone with arthritis or poor eyesight.

THE ANSWER To address this issue, more manufacturers are coming out with rechargeable hearing aids that you can simply drop into a charger every night. Here’s a report on which type of battery hearing aid wearers prefer and which rechargeable hearing aids are available right now.  If a rechargeable battery is not feasible for you due to expense or length of battery life (some of the older versions may have a short battery life), here are some other fixes:

  • Get a “low profile” hearing aid that’s molded to fit in the curved outside “shell” of your ear. You won’t get the benefits of invisibility, but since low profile designs are large enough to accommodate features like directional microphones and manual controls (a volume wheel and push-button for changing programs), they’re easier to handle.
  • Practice manipulating the batteries and hearing aid insertion in your audiologist’s office and then at home. After enough practice, almost anyone can do it.
  • If feasible, ask a friend or relative with better dexterity to change the batteries for you—they only have to be changed once a week or so.

6. Hearing Aids Are Easy to Lose

THE PROBLEM  Hearing aids are tiny and can fly off when you’re exercising or even getting undressed. People tend to take them off, put them down wherever they’re sitting and lose track of them.

THE ANSWER Some high tech hearing aids today, like those made by ReSound and Starkey, come with an iPhone locator app.  Either way, consider  buying  insurance for loss. And always put them in the same place each time you take them off, even if you have to get up off the couch. Treat them like diamond earrings and you’ll be less likely to lose them.

Here’s a good article on taking care of your hearing aids.

7. Hearing Aids Make Me Feel/Look Old

THE PROBLEM  We live in an ageist culture and want to ignore the fact that we’re getting old. You may blame others for not talking loud enough or talking too fast—or you blame theaters for keeping the volume too low.

THE ANSWER  Get over it! Maybe the link between hearing loss and Alzheimer’s will convince you that it’s worth getting the most out of the life you’re living by being part of the conversation and hearing every bar of music, every beautiful sound that your world makes.

Do you need hearing aids? Take this quiz and find out.


This article was written/produced with the support of a journalism fellowship from New America Media, the Gerontological Society of America and the Silver Century Foundation.

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8 comments
  • Tim T.
    REPLY

    If you can’t understand speech with the hearing aids you have then you have the wrong hearing aid or the wrong doctor. I have profound hearing loss in both ears and have 8 pairs of hearing aids four different brands in the last 25 yrs. I always had problems understanding voices in noisy situations and even two people talking at one time but I understood people dramatically better with each aid. My last aid lasted me 10 yrs before I got my new ones this year. But let me say my new ones which are ( I don’t want this to sound like an advertisement for widex) the widex beyond 440 are unbelievable, I can here speech in noisy situations such as party’s and restaurants. I also can understand more than one person that are talking at the same time, I have never been able to do either with my old aids. Another plus is the Bluetooth which I would recommend to anyone that needs aids and can afford the BT. Its amazing being able to listen to music in stereo and to hear a person on the iPhone in both ears without everyone else hearing my conversations because the column was set to high. I could go on an on but people get the right aid and the right doctor and you will hear more than 95% of everything.

  • Abby Hardey
    REPLY

    Times are changing and so are hearing aids. There are a lot of modern hearing aids today that looks invisible and it’s barely noticeable in the naked eye. It can be tailored specifically to the person who needs to wear it. I got mine from a Professional audiologist and got the invisible one. It is by far the best thing I wore.

  • Gary Hetzel
    REPLY

    Over the past decade I’ve had ReSound, Oticon, Phonak, and Starkey hearing aids. (Yep, that’s well over $20K of UNINSURED medical device cost). I’ve worked with three different audiologists. I still can’t really understand speech on a consistent basis. If you think poor hearing leads to anger and depression; try spending a fortune on devices and getting no acceptable results. I don’t care if I look old; I know I need help with hearing; I don’t care how they look. I just want to be able be able to engage in a conversation.

    I’m happy for those who find that hearing aids work for them. For me, they’ve left me unable to understand my wife, my grandchildren and forced early retirement because I can’t communicate with my customers. And, of course, the audiologists act like I’m doing something wrong. I’m sure that the hearing aids work perfectly when they’re at their conventions in Vegas or Key West.

    By the way, the claims about reducing background noise and differentiating speech from noise, etc are BS. If you suppress the frequencies that reduce noise, you also reduce the full range of sound that is speech. So the noise goes down and the speech becomes muddled.

    For those who get their hearing aids and wax poetic about hearing birds for the first time in years, tell me about understanding your spouse or your client.

    • Bill O’Brien
      REPLY

      I agree with you Gary. My expensive Miracle Ear didn’t help much with improving distinguishing speech, but, they helped me hear with other sounds which are not important to me.

  • Lola
    REPLY

    There are many reasons I do not like my hearing aids. I no longer worry about appearing “old” because at 84 I AM old, but to write “… The most common versions—behind-the-ear models—are completely obscured by the top of the ear.” is incorrect…they ARE visible, and wearing glasses compounds the problem. I understand that my hearing will not be “perfect” but I miss my music…it will never sound the same and I’ve limited any social functions because conversations with more than one person are not possible, I can only understand the person next to me. It’s exhausting trying to make sense of what people are talking about. I’d much rather stay home and read a good book.

    I’ve been wearing hearing aids for over seven years and have spent far too much money on them…seems an upgrade is necessary every few years. This last pair I bought at Costco and they have been very good about helping with adjustments. I have a ‘remote’ that’s supposed to help with different environments but it’s not too effective, and TV is impossible without closed captioning. I wear them dutifully and am happy that I can at least hear the birds singing. I don’t intend to buy another pair.

    Another problem that no-one seems to address is earwax formation. I never had a problem until I began wearing hearing aids. Clearing your ears isn’t something one can do on their own so where does one go to have them cleared?…another doctor’s appointment. I seem to have a particular problem with one ear…but that’s another story. Hearing loss is just another part of growing old and I accept it…but I sure don’t like it.

  • Bev
    REPLY

    I have Siemens hearing aids, they are computer programmed. I have not the top of the line but fairly high up on the expense ladder. There were some daily exercises that I did for 30 days to help my brain reconnect to sounds that I’d been missing. I do notice that I can hear more things but some noises are so loud I can hardly stand them while some voices are still difficult to hear and people want to talk quietly or whisper and I can’t hear them with or without the aids. I put my hearing aids in a charger overnight so batteries aren’t often a problem. The warranty expired before I realized the aids weren’t working correctly. My hearing specialist is knowledgeable but I feel that he expects me to know how the aids should work or not work. They are a piece of new technology and he understands it but I don’t. And since they weren’t working as they should, useable but something with the volume and on/off capability is the issue. Anyway he suggested that I purchase a new pair…these work so not another several thousand dollar investment. I don’t go back for adjustment too often because I simply don’t care for the audiologist attitude/personality. So I wear what I have and when I don’t and I’m at a meeting or meet up I miss much of the conversation I leave wishing I had remembered to wear them. Hearing is better, but not perfect and I’m making an effort to wear them more when I go out in public.

  • Mary Hulsey
    REPLY

    I love my hearing aids, since I do need them. Not only can I hear much better, but I have also learned that lack of them can add to dememtia. Having a social life again more then pays for my Starkeys. Being 84, I am just sorry that I Waited so long. The service you receive men’s a lot, so shop around. Thank you for the above article. More people should read it.

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