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How to Choose a Hearing Aid

GENERAL INFORMATION:

What is a hearing aid? A hearing aid is a small electronic device placed behind or in your ear to help you hear sounds better. It contains a small microphone, amplifier, and speaker. The microphone receives sound and changes it into an electrical signal. The amplifier increases the loudness of the signal. The speaker receives the signal, changes it back to sound waves, and transmits the sound waves to your inner ear. A hearing aid is used by people who have mild or moderate hearing loss. While a hearing aid can help you hear better, you may not be able to hear perfectly even with an aid. Even using hearing aids, you still may have trouble hearing well when there is noise around you, such as in a restaurant or at a concert.

How does an ear work? The outer ear flap catches sound waves and sends them to your eardrum. The eardrum separates your outer ear from your middle ear. Sound strikes the eardrum and is sent through three bones in the middle ear to the inner ear. The inner ear is a fluid-filled space containing the cochlea. The cochlea has many cells that can feel the fluids move. When the cells feel the fluid move, nerve impulses (messages) are sent to the nervous system. The impulses travel through the hearing part of the nervous system before they reach your brain. Hearing loss may be caused by problems in any part of the ear or nervous system.

What causes hearing loss? Having too much ear wax in your ear is one of the most common causes of hearing loss in older adults. The following are other causes of hearing loss:

• Aging.
  
  
• A growth or tumor (lump) in the ear canal.
  
  
• Being around a lot of noise, over a long period of time.
  
  
• Damage to any part of the middle or inner ear caused by a head injury.
  
  
• Holes, breaks, or tears in the eardrum, middle, or inner ear.
  
  
• Infections.
  
  
• Liquids that get inside the middle ear.
  
  
• Using certain medicines, such as antibiotics, antimalarial, or anti-inflammatories.

What are the signs and symptoms of hearing loss? Hearing loss can happen quickly, or it may develop over time. Signs and symptoms of hearing loss can include:

• Asking often that others speak louder, especially if it is noisy around you.
  
  
• Not hearing sounds clearly.
  
  
• Not understanding questions or comments correctly.
  
  
• Tilting your head, leaning towards the person speaking, or cupping a hand behind your ear to try to hear better.
  
  
• Turning the radio or television to a very high volume so that you can hear it.

• Ear pain or drainage.
  
  
• Feeling that you or everything around you is moving or spinning.
  
  
• Headache.
  
  
• Ringing, roaring, or buzzing in your ear.

How is hearing loss measured? You may need to see a specialist who works with people that have hearing loss. You may also see an an audiologist. This is a caregiver who has special training with testing and fitting hearing aids. They will talk to you about how hearing loss affects your life. The following may be done to test hearing loss:

• Pure tone test: Tones or sounds will be played for you to see what you can and cannot hear. You may need to sit in a very quiet room for this test, or a device called an audioscope may be used.
  
  
• Questions: You may need to complete a short test on paper to help caregivers learn more about your hearing loss.
  
  
• Speech reception threshold test: This will test how well you hear soft sounds, and at what point you cannot hear them at all. Caregivers use this test to show them how to adjust your hearing aid.
  
  
• Tuning fork test: For this test, a vibrating tuning fork is held to the bone behind your ear. You will be asked if you can hear certain sounds. This test can tell caregivers what type of hearing loss you have, and if it is in one or both ears.
  
  
• Whispered voice test: You will be asked to repeat words that are spoken to you.

What is feedback? Feedback is sound that leaks around or through the ear mold of a hearing aid. If you have feedback when you use a hearing aid, you will find it harder to hear. Feedback can sound like whistling. A well-fitting ear mold can help prevent feedback. Earwax and dirt in your ears can make feedback worse. Feedback can worsen if there is an object close to your ear, such as clothing, or if the volume of the aid is turned too high. An ear infection can also worsen feedback.

What are the types of hearing aids? Your caregiver will talk to you about the type of hearing aid that would be best for you. The type of aid may depend on the type of hearing loss you have, and other factors. When choosing a hearing aid, pick an aid that helps you hear as well as possible. Avoid choosing a hearing aid just because it cannot be seen in your ear. The following are types of hearing aids:

• Behind the ear: A small plastic case rests behind your ear. This is connected to a tube that goes to a mold in your ear. A mold is a small plastic piece that fits into your ear. Feedback is not often a problem with this aid. It has larger controls and dials, so may be better than other aids if you cannot use your fingers well when working with small objects. This aid may fall off when you are active, and it is hard to use with headphones.
  
  
• In the ear: This small plastic case fits into your outer ear. It fits securely, and may not be as easy to see as some other hearing aids. You will need to be able to do small tasks with your fingers to use this hearing aid, and feedback may be a problem.
  
  
• In the ear canal: A very small plastic case fits half way into the ear canal. This aid is well- hidden in your ear. You will need to be able to do small tasks with your fingers to use this hearing aid, and feedback may be a problem. Using a telephone may be hard. This type of aid can be damaged by ear wax or drainage.
  
  
• Completely in the ear canal: This is a tiny plastic case that fits entirely into the ear canal and is very hard to see. It is easy to use with headphones and the telephone, and has less wind noise. You will need to be able to do small tasks with your fingers to use this hearing aid. This type of aid can be damaged by ear wax or drainage.

What else should I do to try to hear better?

• If you have hearing loss in both ears, it is better to have an aid for each ear. Using two aids will help you hear better than using only one aid.
  
  
• Assistive listening devices (ALD) may be used with hearing aids to help you hear better. Ask your caregiver for more information about the use of ALD's.
  
  
• Decrease background noise at places such as restaurants by sitting with your back to the wall. Sit close to where most people are talking, and in a place where you can clearly see their faces.
  
  
• Have the person speaking to you face you directly, and not cover his mouth with his hand. Ask people not to shout or mumble when they speak to you. People should speak using their usual tone and volume.
  
  
• If you need to wear eyeglasses, make sure that you wear them. They will help you see faces and lips more clearly.
  
  
• Give yourself and those around you time to get used to you being able to hear. It can take three months or even longer to get used to the hearing aid, and to get used to hearing better.
  
  
• Talk to caregivers about using a hearing aid. Not being able to hear or understand speech decreases your telephone use, and makes you less likely to join in social events. If you work at a job, you may have fewer job options, and have trouble getting around safely and easily. You may feel alone and depressed (very sad). Getting hearing aids can help decrease these problems. You may not want to wear the aids because you feel so alone and sad. If your hearing aids break, need new batteries, or do not work, you may not feel like getting help so that they will work again. You and your family or friends may be worried about the cost of the aids, and that they will break or be lost. Tell your caregiver about these problems, and ask him for help.

How do I care for my hearing aid? Ask caregivers to talk to you about the following:

• A warranty for the aid, and insurance in case it is lost or broken.
  
  
• Changing the volume of the hearing aid (if needed).
  
  
• Charging and changing the batteries in the hearing aid. Batteries may need to be changed every 1 to 2 weeks.
  
  
• Cleaning and care of the hearing aid.
  
  
• Putting in and taking out the hearing aid.
  
  
• Turning the aid on and off.
  
  
• Using the remote control and memory (if the aid has these features).
  
  
• Using the telephone with the aid in place.

Where can I get more information? Contact the following:

• American Hearing Research Foundation
  8 South Michigan Avenue, Suite 814
  Chicago, IL 60603-4539
  Phone: 1-312-726-9670
  Web Address: http://www.american-hearing.org
  

• Better Hearing Institute
  515 King Street, Suite 420
  Alexandria, VA 22314
  Phone: 1-703-684-3391
  Web Address: www.betterhearing.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

Copyright © 2007 Thomson Micromedex. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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