There is an often-cited statistic in the field of audiology that people wait an average of seven years from the time they notice they have difficulty hearing to when they pursue hearing aids. This leads us to the big question when are hearing aids needed? and why wait so long?
Patients have a variety of reasons for putting off the inevitable. Let’s break some of these down in this article.
1. “Hearing Aids Are For Old People”
One frequent concern is that hearing aids will make a person “seem old.” While age-related hearing loss, also known as presbycusis, is a real phenomenon, there are two simple arguments to counter this fear. The first is that hearing aids are incredibly small and discrete these days. They can be nearly impossible to see, particularly if you have any amount of hair on your head! And even for our bald patients, styles like receiver-in-the-ear or completely-in-canal are hard to detect unless you’re looking for them.
This brings me to my favorite point for anyone concerned about how hearing aids might make them look, which comes from a very wise preceptor I had in graduate school. “Your hearing loss is more conspicuous than your hearing aids.” Think about that for a moment. If you have reached a point where you are frequently asking others to repeat themselves, missing things in conversation, or just dully nodding along because you can’t follow what is being said, that behavior is far more noticeable to your friends, family, and colleagues than a tiny set of computers on your ears.
One sign it’s time to pursue hearing aids is when you find yourself withdrawing from social gatherings or avoiding other activities where listening might be a struggle. There is a very strong link between hearing loss and dementia, which is believed to be related, in part, to the social isolation that can occur as a result of hearing loss. Hearing aids can give you the confidence to re-engage in social situations, which is a positive for your mental and physical health. Hearing aids can restore confidence in your ability to stay active and in communicate with others on a daily basis.
Most hearing losses begin in the higher frequencies (pitches), which is where consonant sounds occur. Consonant sounds provide clarity of speech, and they also tend to be pronounced more softly than vowel sounds. If you find yourself hearing that someone is talking but having trouble distinguishing whether they said “sin,” “thin,” or “fin,” it’s a sign that you have some hearing loss. This becomes even more difficult in the presence of background noise or when you can’t see the person who is speaking. Context clues can only get us so far! This type of hearing loss can begin very early on, it is not exclusive to elderly individuals. Additionally, the longer you wait to pursue hearing aids once you are deemed a candidate, the more challenging it will be to adjust to them.
2. “Hearing Aids Are Too Expensive”
The financial burden of hearing aids can be a very real obstacle for many individuals. They are expensive, and many commercial insurers still do not provide any kind of assistance for purchasing hearing aids. That said, hearing aids don’t have to be out of reach.
First, do your research. There are a variety of different settings where you can purchase hearing aids, from private practices to hospitals to university clinics. The cost may vary significantly between these settings based on the way the office has structured their pricing. Hearing aid dispensers or big-box stores can be another less expensive option. However, be aware that these settings typically use a specific type of hearing aid with proprietary software, so you will be tied to that location and provider if you move forward. This might be okay! But if you anticipate that you might want or need some flexibility, these are not the best choice.
Remember that while hearing aids are an investment, they have the potential to substantially improve your quality of life. You should consider how hearing better and using less listening effort in your everyday life might benefit you personally and professionally. You may consider budgeting to make the purchase feasible. Many clinics also offer payment plans and/or sliding scale pricing based on your income level not to mention that many hearing aid manufacturers have some sort of finance options such as Ergo, Jabra and Starkey. Additionally, it is a state requirement to offer a trial period for hearing aids. So, if you do give them an earnest try and find that they are not having the impact you had hoped, you will be able to return them within the trial period, less the cost of the fitting fee.
If you have looked around and checked your insurance benefit and cannot financially afford the investment, check with local organizations to see if they have donated hearing aids. Many churches, Elks Clubs, and Lions Clubs keep a collection of hearing aids that can be taken to an audiologist and re-programmed for your hearing loss. In this situation, you would have to pay for the hearing test and the fitting fee, but you would save on the devices themselves. There are other organizations, such as the Starkey Hearing Foundation, which provide hearing aids for people who cannot afford them if they meet a specific set of criteria.
Don’t make the mistake of thinking that one expensive hearing aid would be better than two less expensive ones. The ears are designed to work as a pair, and most hearing losses are symmetrical (if yours is not, this warrants a referral to an ear, nose, and throat physician). There is also research that shows this unilateral fitting of a hearing aid for bilateral hearing loss can actually cause the hearing in the unaided ear to become worse, which you definitely don’t want.
3. I’ve Tried Hearing Aids Before, And They Didn’t Help
Ask yourself if you truly gave the hearing aids a chance. One common faux pas I witnessed in the clinic was the patient who pops their hearing aids in only when they are about to enter the most difficult listening situation (i.e. dinner with a group of friends at a noisy restaurant) and then is disappointed and discouraged when they don’t catch every word of the conversation.
First, hearing aids are not perfect. Remember that even people with normal hearing struggle in these situations. Second, there is a period of time when the brain needs to adjust to hearing aids. The best way to make this happen is to wear your hearing aids during all waking hours, even if you are alone and in quiet. This gives your brain the opportunity to re-learn what “quiet” sounds like, in addition to your car, the television, your church choir, and that noisy restaurant.
This re-calibration will happen more quickly the more often you wear your hearing aids, and you’ll find more success in difficult situations. You should know that hearing aids have a technology called “data logging,” which means that your audiologist is able to tell how often you have worn your hearing aids and in what situations. So before making substantial programming changes, the first recommendation is often to simply increase the wear time.
Finally, depending on how long it has been since you tried hearing aids, the technology has come a long way. On a basic level, the technology for microphone directionality, feedback cancellation, and automatic adjusting for changes in the environment are constantly improving. Many hearing aids now have full Bluetooth compatibility, which means you can stream phone calls, music, and podcasts directly through your hearing aids. Rechargeable hearing aids are also commonplace now, so if you struggled with those tiny batteries in the past you can forget about the nuisance of those.
This is all-important to remember, too, if you’re thinking, “My grandfather/aunt/friend had hearing aids, and they didn’t work.” Every patient is a bit different, and just because one person didn’t find success with their hearing aids doesn’t mean that you won’t.
4. “If I Get Hearing Aids, My Hearing Will Get Worse”
This simply isn’t true! Hearing aids are not going to provide amplification at a level that would damage your existing hearing, and they are not going to make your ears “lazy” or “reliant” on the hearing aids. On the contrary, the sooner you introduce amplification to the auditory system when it is appropriate, the more success you are likely to have with your hearing aids because your brain has remained accustomed to receiving auditory input. Your audiologist will likely recommend repeating your hearing test every year or every other year to monitor for changes, but there is no reason to think that the hearing aids will cause a decline.
Need To Test Your Hearing? Here Are A Few Recommended Tests
It never hurts to get a hearing test as a baseline, so if you feel that you are having more difficulty hearing than you used to, see an audiologist for a diagnostic audiogram. They will be able to explain your results to you and determine whether you might be a candidate for hearing aids. Sometimes patients are on the border where they do have some measurable hearing loss but can probably get by for a bit longer without amplification. This is okay! It is always helpful to your audiologist to have an initial test to track the progression, if any, of your hearing loss over time.
Erin Edwards received her Doctor of Audiology degree from Towson University in 2015 and her Ph.D. in Education and Leadership from Pacific University in 2022. She has worked with patients of all ages in a variety of settings and has a specific interest in cochlear implants, the relationship of hearing loss and dementia, and interdisciplinary healthcare.