Choosing the right hearing aid can make all the difference to how happy you will be in the long run. It’ll determine whether you will be a life-long hearing aid fan or abandon them after a few days. But having so many choices can be a double-edged sword. This decision is not one you are expected to make by yourself, so we’ve decided to create a short guide to finding the very best hearing aid for you and your hearing needs.
Hearing aid selection is very much like buying a new car. Whilst some may love a fancy sports car, it may not suit the family lifestyle. Others may like a roomy 4WD but can’t manage to park it. Imagine buying a new car and not having a salesperson to talk to or be able to take it for a test drive? Hearing aids are the same.
Your audiologist will be that person for you when you’re picking new hearing aids! You’ll be able to discuss your needs, hearing aid features and even arrange for a hearing aids trial that will determine if your choice of device really meets your needs. So let’s consider the basics of making the right hearing aid choice!
All hearing aids have a piece that goes inside your ear to deliver the sound. You will need to adjust to having something in your ear. It may feel itchy or blocking, but you will get used to it with daily use. Your hearing aid – when inserted correctly – should be comfortable. If you are experiencing any discomfort, try reinserting your hearing aid, or return to your audiologist as soon as possible.
More advanced hearing aids reduce background noise, work to amplify one speaker among others and increase the volume of the talker while reducing unwanted sound. Despite current technology, hearing aids don’t know for certain which talker you want to hear nor which environmental sounds you want to keep. A trial will help you determine if a hearing aid will work as effectively as you wish.
There are two main types of hearing aids. Behind-the-Ear (BTE) and In-the-Ear (ITE). Within those categories, there are varying sizes.
The workings of the aid are fitted into the part that sits behind your ear. There is less chance of feedback (whistling), fewer breakdowns and they are the most powerful. They are big enough to have all hearing aid functions. They are robust in design with easily replaceable
tubing that can be done in house and at a low cost. Any BTE or RIC can be tried before purchase. These are powerful aids that are versatile and easily managed. They can also be fully subsidised on the HSP government program.
These also sit behind the ear, but with a discrete wire that leads into the ear canal. The workings are still behind the ear, but there is an additional motor on the wire that goes in your ear. This allows you to increase or decrease power without changing the aid itself. Due to the two motors, the back part of the aid can be smaller and more discrete. ITEs suit most hearing losses and usually fit Bluetooth and wireless features. If the receiver breaks, it can be costly to replace if out of warranty. It is not fully subsidised and less robust, with moisture leading to more breakdowns in humid environments.
The larger style sits in the ear, with nothing that goes behind. It has good power and function because it is bigger, which also makes it very visible. It can be easier to put in than a BTE but harder to change the small battery. This can be good for those who require oxygen or who spend a lot of time lying down. ITEs are also prone to wax and moisture problems because the workings of the aid are very close to where wax and sweat can enter. ITEs usually feel more blocking, and your own voice seems louder (occlusion) than BTEs. ITE styles cannot be trialled. However, a similar BTE can be later exchanged upon purchase. These types of hearing aids can be fully subsidised.
ITCs are smaller versions of ITEs with reduced power output, making them the best hearing aids for mild to moderate losses. They’re still visible but don’t take up the whole ear, making them a good option if you have good management. They do have some of the same disadvantages: Wax build-up, hard to manage controls, occlusion and if your ear canal is small, some features will not fit inside. These can be fully subsidised.
This hearing aid fits in the canal and doesn’t fill any part of the ear bowl. It is still visible, but you would need to be looking in the ear directly. Bigger models can fit wireless functions but no Bluetooth. Deep placement of CICs and IICs is supposed to retain your ear’s natural directionality, so directional microphones may not be required with this shape. This is a discrete aid, but its features are highly dependent upon the size of the canal. The tiny battery lasts about three days. These are not fully subsidised for adults.
This aid can’t be seen in the ear. As it is so tiny, small ears may not be big enough to take the motor and thus are not suitable for IICs. They are worn deep in the ear and cannot fit a directional microphone, BT or wireless functions. They are good for mild losses and those who want the most discrete aids with no requirement for connectivity. Advanced features are limited to the minuscule size. These are not fully subsidised.
Severe and profound losses require heaps of power and a big motor. That’s why tiny aids will not be suitable. Those with industrial deafness usually have good hearing in the low pitches and poor hearing in the high pitches. In most cases, a hearing aid that sits In-The-Ear entirely will sound too blocking. A Behind-the-Ear style usually sounds more natural. A BTE can sometimes be too hard to insert for people with poor dexterity so that they may prefer an ITE style.
Once you’ve chosen a style of hearing aid, you then need to select the level of technology. All brands will generally have entry-level devices up to the top of the range devices. For example:
The higher the technology level, the greater the features, the better they are at reducing background noise, the more automatic they are. The ‘best’ level of technology for you depends on your needs and lifestyle. Someone living in a nursing home may benefit from value level devices, whereas someone working and attending multiple meetings daily may benefit from platinum level devices.
Let’s look at some of the key features that may narrow down our choice.
Rechargeability is suitable for those who can’t or don’t want to change their batteries. Some environmentally conscious people like a rechargeable option. Different brands have different battery life durations varying from one to six years. Rechargeable options cost more to purchase ($500-$1000 extra). They take three to four hours to charge fully, and some brands now have portable charging cases that can recharge your aids on the go. The shell is sealed to enclose the battery, making it more robust to moisture, thus having fewer breakdowns.
BT enables you to hear your mobile phone, TV, iPad etc., through the hearing aids. To use BT for the TV, you need to purchase a TV box, which usually costs $300-$500. Small aids can’t fit BT. Currently, only one brand on the fully subsidised list can access a version of BT called “Made for iPhone” which works for iPhone only.
Wireless functionality means the hearing aids link to each other and work together. For example, if you change the volume on one side, the volume changes on the other. The two aids can work together in noise, so two microphones on each side can become four for better noise reduction. Different brands use wireless in different ways.
Some use it to reduce wind noise by sending the sound from the non-windy side to the side with more wind, cutting wind noise down for the listener. Some tiny aids can’t fit wireless. Wireless technology is required to access the best zoom features on a hearing aid in the top levels, and they allow the aids to zoom into one speaker whilst reducing speech from other talkers. Fully subsidised aids usually have wireless capability.
Most brands now have accessories that link with your hearing aids. You need either telecoil, Bluetooth or wireless functionality to use accessories.
A TV streamer plugs into the back of your TV and sends the sound to your hearing aids without amplifying the fan noise or other noise around the house. It is a more precise signal than listening to the TV with hearing aids alone, especially in noisy homes. Some brands use Dolby Digital sound for the best listening experience for the TV.
A portable microphone device is used to overcome difficulties hearing at a distance or in noise. Suitable for restaurants, church, golf, shopping centres, listening from the car’s back or at busy parties. It is usually a two-part system, with one piece that hangs around the hearing-aid wearer’s neck and the other is a microphone that can be placed on the table, clipped to the shirt or hung around the neck on a lanyard.
It can be difficult for some to manage, but it is the best way to increase one voice among background noise. It can also be used for answering the mobile and can plug into the TV directly. Prices range from $1400-$2500. This device can be added to a fully subsidised aid, offering a cost-effective way to achieve better hearing in nearly all environments. It requires a commitment to learning to use the devices well and be able to manage small buttons.
Your trusted hearing professional will discuss your hearing goals with you. They will then consider the chances of meeting these goals to your expectations. Hearing aids and hearing loss have limits that even technology can not overcome. You must maintain an open and honest dialogue with your audiologist to know what to expect from your hearing aids and how you can get the best out of your hearing devices.
Unlike a car salesperson, an audiologist will support you for life, so it is in their best interest to work with them to choose the best hearing aid for you. To start your journey to better hearing, give your local Attune Audiology a call today!