Frequently Asked Questions – Audiology
- Asking people to repeat
- Difficulty hearing in background noise or group situations
- Feeling like people are mumbling
- Asking people to repeat often
- Hearing ringing or other noises in one or both of your ears
- Difficulty hearing over the phone or when watching TV
- Having difficulty hearing women and children
- Avoiding social situations
Audiologic test results are used to determine the type, degree and configuration of the patient's hearing loss and this information will help determine hearing aid candidacy. Motivational factors are also important in determining whether a patient is a candidate for a hearing aid. It is important to discuss the impact of the hearing loss on everyday life, as well as the patient's perceived need for amplification. A highly motivated patient is more likely to receive benefit from hearing aid(s).
Whenever hearing levels are the same between ears, we will always recommend that the patient wear two hearing aids. There is a substantial amount of research, which suggests that the brain is meant to hear in a "balanced" fashion with equal input from both ears. Occasionally, there are cases of asymmetric hearing levels (hearing levels which are different between ears) in which we might not recommend two hearing aids.
Using a hearing aid with success takes patience, as hearing aids will not restore your hearing back to normal. Becoming adjusted to a hearing aid is a process involving learning to listen in varied listening environments while becoming accustomed to hearing different sounds. Wearing your hearing aid on a regular and consistent basis will help through the adjustment period. Eventually, you should feel like your hearing aid has become a part of you.
When programmed appropriately, hearing aids will not make your hearing worse with normal use. They are usually programmed to provide more amplification of soft level sounds than loud level sounds. They also have a set maximum output level so that sounds leaving the hearing aids do not exceed a certain loudness level. However, you are still responsible for protecting your ears in extremely noisy situations (e.g., music concerts, heavy machinery, hunting).
If you suspect that you have a hearing loss, consult with an audiologist. An audiologist is trained to identify whether a hearing loss requires medical or non-medical treatment and will refer you to the appropriate medical specialist when necessary. The audiologist will identify, diagnose, treat and manage your hearing loss.
Hearing aids are available in a variety of sizes and shapes, from instruments that fit behind the ear to instruments that totally fit within the ear canal and are minimally visible. Electronic circuitry has advanced significantly in the recent past, allowing patients greater sound comfort and improved speech recognition in noisy situations, to name a few. Digital and programmable hearing aids, which are adjusted via a computer connection, provide the most flexibility, allowing the audiologist to custom fit the response of the device to a specific hearing loss. Digital hearing aids can be modified if hearing changes or as your listening needs change. Your audiologist will help you choose the best instrument according to your needs and your budget.
Professional Services Required for Maximum Benefit
Today’s hearing aids are like mini computers on your ears. In order to receive maximum benefit from hearing aids, a professionally trained audiologist is involved in the fitting process which typically involves an average of five to eight direct contact hours during the first year. In many cases, audiologists will provide unlimited service during the warranty period (from one to three years) or beyond, for no additional charge. This follow-up care may be "bundled" into the upfront cost of the hearing aid. In other words, when a hearing aid is dispensed, it is typically part of a package that routinely includes certain required professional services such as verification of the hearing aid fitting including, but not limited to, real ear (or probe tube) measurements and aided sound field testing. This package may also include ear impressions, selecting/ fitting/adjusting/reprogramming the hearing aid, patient and family counseling regarding hearing aid use, maintenance and realistic expectations and follow-up appointments.
Mail order or budget clubs may sell hearing aids at lower prices because they are often placed on the user with minimal or no instructions and/or adjustments. (Their components may be less expensive, too.) The user may be charged for return visits including minor tubing changes and adjustments. In the long run, the patient may pay as much or even more than they would from a full-service audiology practice.
The minimum training required for a dispensing audiologist has been a master's degree, which is now transitioning to a doctoral degree (Au.D.). Mail order discount centers, by contrast, are often staffed by sales people with minimal technical training. Why does it matter? Audiologists know that the most important consideration in hearing aid selection is not the hearing itself; rather, it is the skill and knowledge of the professional dispensing the hearing aid. The audiologist's responsibility is to ensure that a suitable instrument is selected and to provide an understandable explanation of its merits and limitations.
High Tech/Low Volume
Hearing aids are sold in relatively low volume when compared with other electronic devices. For example, approximately 1.7 million hearing aids are sold in the U.S. per year as compared to several million stereos; yet, the amount of time and resources manufacturer's spend on development and research is considerable. One manufacturer reports spending more than twenty million dollars developing a single model.
Return for Credit Policy
"Return for Credit" policies are standard among hearing aid manufacturers and required by state and federal hearing aid guidelines, allowing new hearing aids to be returned within an established evaluation period. The costs associated with these policies are considerable, especially for custom products, and naturally must be absorbed in the overall pricing structure.
Weighting the Costs
Communication is vital to human existence. According to a ground-breaking study published by the National Council on Aging (1999), "Untreated hearing loss has serious emotional and social consequences for older persons." The benefits hearing aid users reported in their lives ranged from improved relationships at home and sense of independence to improved social and sex life. According to the study, the families of hearing-aid users noticed improvements in every dimension the survey measured. An additional "Beyond Fifty" survey conducted by the AARP and Harris Interactive (2003) found that the ability to stay connected to family and friends contributed to quality of life more than overall health. So if wearing hearing aids allows you to resume activities you enjoy, improve relationships with friends and family, retain your independence, etc. the cost becomes a lot more justifiable.
Besides helping you to hear and understand voices better, properly adjusted hearing aids will allow you to hear sounds that previously may not have been audible. You may notice that your own voice is louder, too. Your entire auditory system will adjust to the new sounds that have not been heard for a long time. The sound of wrinkling newspaper or water running may be annoying at first. However, after about 2-3 weeks, you will notice an adjustment to these environmental sounds. Gradually increasing the amount of time you wear the hearing aids and following the schedule provided by your audiologist will result in an easier transition to amplified sound. During the initial adjustment period, you may be asked to visit the audiologist several times so that he/she may monitor your progress and adjust the controls of your hearing aid(s), if needed. These follow-up visits are crucial to your success with amplification.
The number one cause of hearing aid failure is ear wax debris in the speaker opening of the hearing aid, the small hole in the hearing aid that goes into your ear. If your hearing aid stops working, first check this part of the hearing aid to be sure that it is free of any ear wax or other debris. Use the brush or the pick that came with your hearing aid to carefully remove the blockage. Hearing aids should be inspected and cleaned daily to prevent problems. If you have a chronic problem with wax build-up, your audiologist may offer other solutions.
Weak or Dead Battery
The second most common cause of hearing aid failure is a depleted or weak battery. Test your battery or replace it with a fresh battery.
If you have cleaned the hearing aid and replaced the battery and your hearing aid continues to malfunction, contact your audiologist.
A wide range of products, often refereed to as assistive listening devices (ALDs), are available to help people hear better in specific situations. For example, assistive listening devices are available to improve hearing while watching television or for group-listening situations such as movies, lectures or religious services. Specific devices are also available for individuals who have difficulty hearing the doorbell, car signal, or emergency alarms. Telephone amplifiers are available for individuals who are experiencing difficulty understanding speech while using the telephone.
Speak with your audiologist concerning other ALDs that may be beneficial for your specific situation.