Hearing aids: how to find the right kind for you

If you’re having trouble hearing the talk going on around you, but you feel on the fence about getting hearing aids, you’re not alone. Tens of millions of Americans suffer from hearing loss. But less than 30 percent of people over age 70 who could benefit from hearing aids use them.¹ And those who do wait a long time to get them — an average of nearly nine years after having hearing loss.²

“Don’t put off getting hearing aids,” says Kimberly Rorabaugh Abeyta. She’s an American Board of Audiology–certified audiologist. She’s also director of audiology at Virginia’s Hearing Resource Center and Ear, Nose and Throat and Facial Plastic Surgery Center. Untreated hearing loss isn’t just an inconvenience. It’s also linked with serious health and well-being concerns, including:³

• Lower quality of life
• Social isolation
• Cognitive decline
• More time spent in the hospital
• Higher health care costs

Many people may be reluctant to get hearing aids because they think they’re clunky, ugly or uncomfortable. But nowadays you have plenty of options that are discreet and easy to wear.

“Most people know someone who has had a bad experience with hearing aids. But just because your uncle or grandparents didn’t do well with hearing aids doesn’t mean you will not do well,” says Abeyta.

Cost also holds back a lot of people. “But for most people, they are worth the expense. They can provide a huge improvement in quality of life,” says Abeyta. “And there are a lot of different options available to make hearing aids more affordable now, like leasing hearing aids.”

Many audiologists offer financing plans. (An audiologist specializes in diagnosing and treating hearing loss and balance problems.) It’s also possible to get hearing aids through organizations such as Lions Clubs International and the U.S. Department of Veterans Affairs. And some health plans give members an annual allowance for hearing aids.

Thinking about investing in hearing aids but have questions or concerns? Here are answers to common questions to help you make the right decision.

How do hearing aids work?

All hearing aids contain a microphone, an amplifier, a speaker (called a receiver) and a battery, says Rebecca Blaha, AuD. She’s the lead audiologist at the Pennsylvania Ear Institute of Salus University in Elkins Park, Pennsylvania. How those parts are put together depends on the type of hearing aid you get. Some have all the technology in one piece. With others, there might be one part that sits in your ear connected to another part that rests behind your ear.

Hearing aids can help you hear better by amplifying the sounds around you. But they don’t bring hearing back to normal, Blaha says. Instead, you need to relearn how to listen.

“When you first start hearing aids, your brain is going to focus on all of the little annoying sounds that you’re not used to hearing. But the more you wear them, your brain will habituate to [or get used to] those sounds and learn what’s important to listen to and what it can ignore,” Abeyta says.

How do I know if I need a hearing aid?

The tricky thing about hearing loss is that you might not even realize that you’re missing things. “People with hearing loss are often the last to know,” says Blaha. “When you lose sensitivity to sounds, you may not be aware of what you didn’t hear until someone alerts you that you missed part of the conversation.” 

If friends or family have concerns about your hearing, it’s probably time to have your hearing tested to see if you could benefit from hearing aids. Another sign: You feel that you can’t take part in conversations the way you used to. Blaha stresses that hearing loss doesn’t have to be severe to benefit from a hearing aid.

“Some patients feel that their hearing isn’t bad enough to use a hearing aid,” says Blaha. “But these patients could be missing out on a really helpful tool.”

What types of hearing aids are available?

There are two main types of hearing aids: in the ear (ITE) and behind the ear (BTE). In-the-ear hearing aids, as the name suggests, nestle inside your ear. They’re typically the smallest and most discreet. But they aren’t always powerful enough for all types of hearing loss.

There are a few styles of ITE hearing aids:

• Full shell: These take up much of the opening of the ear. They are the most visible ITEs but also the most powerful.
• In the canal (ITC), or half shell: They take up less of the ear than full-shell ITEs. Both have large batteries, so they have longer battery life. Many come with added features, such as Bluetooth compatibility, so you can connect your hearing aid to your phone.
• Completely in the canal (CIC): These hearing aids are very small and sit inside your ear canal.
• Invisible in the canal (IIC): These models are the smallest hearing aids available. They fit entirely inside the ear canal. Not all people’s ear canals are big enough for IIC. They have small batteries that need to be changed every three to seven days.

Like ITEs, behind-the-ear hearing aids also have one part that goes into your ear canal. But most of the hardware is in another piece that sits behind your ear. The two parts are connected by a wire that goes over the top of your ear. BTEs tend to be more powerful and offer more features.

Styles of BTE hearing aids include:

• Standard: All of the electronics in these hearing aids sit in a shell that goes behind the ear. A small tube runs over the top of the ear and connects to an ear mold that sits in the ear. They are the most powerful and durable. They can be used for a wide range of hearing loss.
• Receiver in the ear (RITE) or receiver in canal (RIC): These hearing aids put the amplifier and batteries behind the ear and the speaker in the ear. They’re the most popular choice. The reason: They combine the power and features of behind-the-ear models but are sleeker and smaller.

BTE hearing aids can be upgraded and reprogrammed if you need more power later on. They have longer-lasting batteries, which are often rechargeable, and other features such as Bluetooth. Because there’s a wire that goes over the top of the ear, they can sometimes get in the way when removing glasses, masks or oxygen tubes or change the way glasses rest on your face.

How do I decide which hearing aid is the right one for me?

The first step is to have your hearing checked by an audiologist. They will determine your level of hearing loss — mild, moderate, severe or profound. This will play a role in which type of hearing aid you need.

“Many people’s first thought is about the visibility of the device,” says Blaha. But there are several other factors to think about, she says. On the list:

• Battery styles (rechargeable vs. traditional)
• Accessories such as remote microphones for noisy environments
• Bluetooth compatibility
• Ear shape
• Lifestyle (do you do activities that might cause the hearing aid to fall out?)
• Dexterity (can you grasp small items?)
• Other health conditions

Also, know that you might need to try more than one hearing aid before you find the right fit. “Not every brain works with every hearing aid. Even the most experienced clinicians will not get it right every time on the first try,” says Abeyta. “Make sure you really love the hearing aids before settling so you’re not stuck with a set of hearing aids that get thrown in a drawer.” Many have a 30-day trial period — take advantage of it.

¹National Institute on Deafness and Other Communication Disorders. Quick statistics about hearing. March 25, 2021. Accessed June 13, 2022.

²Simpson AN, Matthews LJ, Cassarly C et al. Time from hearing-aid candidacy to hearing-aid adoption: a longitudinal cohort study. Ear and Hearing. May-June, 2019; 40(3): 468-476.

³Reed NS, Altan A and Deal JA. Trends in health care costs and utilization associated with untreated hearing loss over 10 years. JAMA Otolaryngology Head & Neck Surgery. January 2019; 145(1): 27-34.

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