What you need to know about hearing aids

Gradually losing your hearing is more than an annoyance. It can significantly diminish your quality of life and relationships. Suddenly your world gets smaller and smaller. Fortunately, hearing aids can help—if you get the right kind and use them correctly.

“Only a small percentage of the 30-plus million people who need hearing aids in the U.S. actually wear them, and only half of those are happy with them,” says New York- and New Jersey-based otolaryngologist Sujana S. Chandrasekhar, M.D. But that doesn’t have to be you. “If you are assessed properly and fit with the right devices for you, you will be really happy with your improved quality of life.”

When you’re experiencing hearing loss of any kind, the first step is to see your primary care provider or an otolaryngologist (aka an ear-nose-throat-neck doctor), who may refer you for a hearing test administered by an audiologist. If that visit results in the recommendation of hearing aids, don’t panic. Help is on the way. You just need to sort through the many options in front of you. Your doctor will review those choices and answer your questions. Here’s a quick primer on what to expect (including key terms to be familiar with):

For mild to moderate hearing loss, there are over-the-counter personal sound-amplification products (PSAPs), in the range of $100 to $300. “They have no bells and whistles and are not adjustable or programmable. They are considered reasonable ‘starter’ devices for early hearing loss, similar to the way reading glasses at the drugstore are ‘starter’ eyewear,” Dr. Chandrasekhar says.

For more advanced hearing loss, you’ll need a more advanced device, maybe in just one ear, or possibly both, and there are several options:

BTE (behind the ear): This device can be programmed off the shelf, is visible, and is toned to match your skin color. BTEs also come in micro/mini formulations that are less visible. “If you have the most common type of hearing loss associated with aging, ‘presbycusis,’ a sloping hearing loss that affects the high frequencies—primarily consonant sounds—you will do well with mini or micro BTE aids,” Dr. Chandrasekhar says.

For more of a flat hearing loss across all frequencies, Dr. Chandrasekhar says, patients should pursue an aid placed inside the ear.

ITE (in the ear): These sit inside the “bowl” of the ear, just outside the opening of the canal.

ITC (in the canal): This is placed all the way inside the canal and thus is not visible to others.

The ITE and the ITC varieties require a mold to be made that’s specific to your ear—but it isn’t painful or uncomfortable. That takes about two weeks. Generally, smaller devices are less powerful, less specialized, and require more manual dexterity to manipulate. Patients with more severe hearing loss may need a larger-size aid, Dr. Chandrasekhar says. Your provider can weigh in on this.

If you may be in the market for hearing aids, or need updated ones, take a friend or relative with you to consult with your provider. This person can help take notes and ask questions.

Six Key Issues to Consider

1. YOUR HEARING NEEDS. Make sure your audiologist understands how you use your hearing. If you are in various listening situations over the course of your day or week (quiet conversations, restaurants, music/TV listening), consider a device with programming options that you can toggle between. 

2. YOUR COMFORT WITH HIGH-TECH. Make sure that your audiologist understands your technological literacy. If you’re less tech-savvy, you may prefer a “put them in and go” type of device that you don’t have to mess with; if you are a technophile, there are devices that you can adjust via your smartphone. 

3. THE RIGHT POWER. Get the right amount of power for your degree and type of hearing loss. Most devices come with a 30- to 60-day consumer protection plan, so road test the device, and then exchange it if it isn’t meeting your needs.

4. THE COST. Hearing aids can range from about $1,000 to $5,000 per unit. Ask about cost, insurance coverage, how many visits or years of service are included, battery life, and whether the audiologist provides batteries for free. Also ask them which brands they carry and why.

5. HOW TO ADJUST IT. Most hearing aids are now programmable, says Dr. Chandrasekhar. If the devices are sized and fit properly for you, your audiologist or hearing aid dispenser should be able to adjust the programs to your satisfaction—but sometimes you’ll need a second round of programming to achieve the best outcome. 

6. THE FOLLOW-UP. Patients usually receive one or two programming/adjustment visits within the first few weeks. Once you get the hang of using your device, you may want to get it checked once or twice per year. If your hearing changes, you will need another programming session. Once you are diagnosed with hearing loss, your hearing should be checked at least once per year, with any subtle changes addressed via programming tweaks.