Hearing loss can have a big impact on your life, from your work to your relationships and emotional well-being. Hearing aids can make a big difference, especially if you pick the right ones and get help adjusting to them.
How Hearing Aids Help
A hearing aid is a battery-powered electronic device designed to improve your hearing. Small enough to wear in your ear or behind it, it makes some sounds louder. Hearing aids may help you hear better when it's quiet and when it's noisy. Here’s how they work:
- A microphone picks up sound around you.
- An amplifier makes the sound louder.
- A receiver sends these amplified sounds into your ear.
Not everyone with hearing loss can benefit from hearing aids. But only 1 in 5 people who could have improvement wear them. Most of the time, they’re for people who have damage to their inner ear or the nerve that links the ear with the brain. These are some of the things that can cause damage:
- Disease
- Aging
- Loud noises
- Medications
- Trauma to the head or ear
- Clogged ear wax
- Poor nutrition
- Viral infections
Hearing loss caused by problems with the ear canal, eardrum, or middle ear is called conductive hearing loss. Usually, surgery or other medical help can make it better. But those options aren’t right for everyone. If you have an open ear canal and a relatively normal external ear, a hearing aid may help.
Some people are born without an external ear or ear canal, which means they can’t use a typical hearing aid. Instead, they may be able to use a device that sends sound to the inner ear through the bone of their skull.
How to Get Hearing Aids
Prescription hearing aids
You'll need to see a health care provider to get prescription hearing aids. Usually, you start with a hearing test done by an audiologist. This specialist can give you a hearing aid if you need one.
But if you have asymmetric hearing loss – meaning the condition is worse in one ear – or any other concerning finding, then you'll see an ear, nose, and throat doctor (ENT). You can also start with an ENT, but that isn't typical.
If you don’t already know an ENT, ask your regular doctor to send you to one. This specialist can evaluate and treat your hearing loss.
If you have hearing loss in both ears, it’s probably best to wear two hearing aids.
Over-the-counter hearing aids
If you're 18 or older, you can buy hearing aids in a store or online without seeing an audiologist or an ENT. Over-the-counter, or OTC, hearing aids are meant to help people whose hearing loss is mild to moderate. They may be the right choice if your hearing trouble is limited to certain situations.
Although you don't have to see a medical professional to get OTC devices, you may not be able to measure your hearing loss on your own. An audiologist can find out how much help you need and guide you through your choices.
Another option is to have your hearing tested by a professional and get a copy of your results. You can use that information to buy your hearing aids online or in a store.
The FDA regulates OTC hearing aids. There are two types. "Self-fitting" hearing aids are those you can program to your specific needs. You'll use an app or a website to make adjustments. If your device is not self-fitting, it will have a volume control and a few simple settings.
Pros and cons of over-the-counter hearing aids
Being able to buy hearing aids without a prescription is fairly new, so all the advantages and disadvantages aren't clear yet.
Among the pros:
Price. The least expensive OTC hearing aids cost hundreds of dollars. Prescription hearing aids can run four times as much.
Convenience. You can buy your hearing aids and start using them the same day.
Among the cons:
You have to self-diagnose. You may not be the best judge of your hearing loss and how much help you need.
Research. You'll need to do a lot of homework to learn about the different types of OTC hearing aids, their features, warranties, and prices before you make a decision.
Hearing care professionals have expressed concerns. First, a medical problem that needs attention could be causing a hearing loss. Another worry among audiologists is that, given full control of their devices, users will turn up the volume too high
Types and Styles of Hearing Aids
The right device for you depends on:
- The type of hearing loss you have and how serious it is
- Your age
- How well you can manage small devices
- Your lifestyle
- Cost
There are two main types of hearing aids:
Analog hearing aids convert sound waves into electrical signals and then make them louder. They’re usually less expensive and have simple volume controls.
Digital hearing aids convert sound waves into numerical codes similar to computer codes, then amplify them. The code includes information about the direction of a sound and its pitch or volume. That makes it easier to adjust the sound to what you need, whether you’re in a restaurant, a quiet room, or a stadium. Most will adjust automatically. Although this type costs more than an analog hearing aid, the results are much better. They’re also smaller and more powerful.
There are three main styles of hearing aids. They differ in size, placement in or on the ear, and how well they make sound louder:
Canal hearing aids fit inside your ear and are harder to see. An in-the-canal (ITC) hearing aid fits your specific ear canal. A completely-in-canal (CIC) aid is smaller and nearly hidden in your ear. Either type can help with mild to moderately severe hearing loss. But because of their size, they can be harder to adjust and remove. This style of hearing aid isn’t ideal for children or adults who might have problems with very small devices. An invisible-in-canal (IIC) aid is nearly impossible for others to see. You may put it in every day, or it may be a device you wear for several months at a time.
In-the-ear (ITE) hearing aids fit completely inside your outer ear. They have a hard plastic case that holds the electronics. They’re best for people with mild to severe hearing loss, but they don’t work as well for children whose ears are still growing.
Behind-the-ear (BTE) hearing aids sit in a hard plastic case behind your ear. A plastic ear mold fits inside the outer ear and directs sound to the ear. A different type, called a Mini BTE, fits entirely behind your ear, with a narrow tube that goes into your ear canal. This helps keep earwax from building up and makes sure your own voice sounds clear. BTEs can work for mild to severe hearing loss, but they aren't for everyone.
Receiver-in-canal (RIC) and receiver-in-the-ear (RITE) styles both have a behind-the-ear component that connects to a receiver in the ear or ear canal with a tiny wire. These allow low-frequency sounds to enter the ear naturally and high-frequency sounds to be amplified through the hearing aid. RIC and RITE may be a good choice for people with mild to profound hearing loss.
Be sure to ask if the device you choose has any special features you want. Not all hearing aids have the same ones.
Directional microphones help you respond better to sound coming from a specific direction and tune out background noise.
A telephone switch quiets background noise and is better at picking up sounds from the phone. This system can help you hear in theaters, auditoriums, and churches.
A direct audio input allows you to plug in a remote microphone or FM listening system. You can also connect directly to a TV or other device.
There are other types of hearing aids for specific types of hearing loss. For example, one type uses a bone vibrator for people without an ear canal or outer ear. Others may attach to eyeglasses. And others, like noise-canceling hearing aids, actually help filter out background noise. Ask about other devices that may make your hearing aids work better in certain settings.
You may want to check out services offered for smartphones that allow you to answer calls and hear from both ears like a headphone.
Adjusting to Hearing Aids
Your hearing aid can’t make your hearing what it used to be. But as you use it, you’ll become more aware of sounds and where they are coming from.
When you first get your hearing aids, be patient. It may take some time to get used to them. In most states, you're allowed a trial period after you buy a device. Then, if yours don't work out for you, you may get a partial refund and be able try a different type that works better for you. Also ask about warranty coverage.
Take time to learn how your hearing aids work and insist on a good fit. You want to avoid problems such as:
- Discomfort
- Echo-like sounds from your voice
- Feedback or a whistling sound
- Background noise
- Buzzing when you use a cellphone
It may help to start wearing your hearing aids in quiet areas and to keep a diary about how you feel.
Caring for Your Hearing Aids
Your hearing aids will last much longer if you take good care of them. Some tips to keep in mind:
- Keep them away from heat, moisture, hair care products, children, and pets.
- Clean them as directed.
- Turn off your devices when you are not using them.
- Replace dead batteries right away.
Hearing aid batteries may last from several days to a couple of weeks. Battery life depends on the battery type, hearing aid power requirements, and how often you use it.
In general, hearing aids can last for 3 to 6 years. You may need a new one sooner if your hearing loss gets worse. Behind-the-ear hearing aids give you more flexibility because they can be programmed for a wider range of hearing loss.
Digital hearing aids get stronger and better every few years as computer technology improves. This often prompts people to upgrade their devices.