5 Things to Know Before Choosing a Hearing Aid

A Keck Medicine of USC audiologist shares tips on how to pick the best hearing aid for you, including what types of devices are available, costs and lifestyle goals.

Losing some of your hearing as you get older is very common. In fact, one in three Americans between the ages of 65 and 74 experiences age-related hearing loss, called presbycusis. In addition to age, changes in the inner ear, noise damage, medications and conditions like diabetes and high blood pressure can also contribute to hearing loss.

Yet, despite how common hearing loss is, only about one in five people who need a hearing aid actually wear one. Payton A. Brown, AuD, an audiologist with the USC Caruso Department of Otolaryngology – Head and Neck Surgery, part of Keck Medicine of USC, shares what people should consider when looking for a hearing aid.

1. There are some key differences to consider when choosing a hearing aid.

Although hearing aids don’t restore your hearing back to normal, they make the pitches that were inaudible to you audible again. They can also reduce competing background noise so you can better hear and understand when other people are talking, when engaging in group activities or when watching television. Another benefit of hearing aids is that they improve your sound awareness for safety.

According to Dr. Brown, there are several differences to consider among hearing aids: prescription versus over-the-counter (OTC) and daily-wear versus extended-wear.

• Prescription hearing aids. This type of hearing aid is purchased through a licensed dispensing professional and requires a doctor’s or audiologist’s prescription. The hearing aids are programmed to your hearing loss and are managed under a professional’s care. Prescription hearing aids can accommodate complex situations such as single-sided deafness that may require a special type of hearing aid system called the CROS. This option is great if you have dynamic hearing loss (different across the pitches) or if you want hearing aids to be customized to your ear canal.
• Over-the-counter hearing aids. This type of hearing aid can be purchased online or in person without a doctor’s or audiologist’s prescription. These hearing aids typically are not programmed to your hearing loss and will not be managed under a professional’s care. This option is great if you have a flat hearing loss or if you have limited funds. These hearing aids are typically programmed by the consumer.
• Daily-wear hearing aids. This type of hearing aid can be taken in and out of the ear by the user. In most cases, you would put the hearing aid in at the start of the day and remove it when you go to bed. Daily-wear hearing aids can be used during most activities and are water resistant; however, they should be removed while showering or swimming. (Some manufacturers may offer waterproof models.) There are several styles of hearing aids in this category: behind-the ear, receiver-in-the-canal, in-the-ear, in-the-canal, completely-in-the-canal and invisible-in-the-canal. These are available over the counter and by prescription.
• Extended-wear hearing aids. This type of hearing aid is invisible and can only be inserted into your ear by an audiologist. The device sits near your eardrum and, as a result, can remain in the ear for a longer period — generally between one to two months. About every eight weeks, you will need to visit your audiologist to replace the device. The device should be removed during swimming but can be used with caution while showering. These are prescription-only hearing aids.

2. Understanding your listening challenges is key.

Do you have trouble hearing sounds in certain situations? Knowing what your unique hearing challenges are can help your audiologist determine which device might be the best hearing aid for you.

“Think about what you have difficulty hearing on a day-to-day basis,” Dr. Brown says. “Think about what you have difficulty hearing when you are alone, when you are with family and friends, or when you are in a work setting. Think about the types of activities you are involved in. These are the details you want to share with your audiologist. Developing a relationship with your audiologist will help you succeed in your hearing goals.”

“It’s important to work with an audiologist who evaluates not just your hearing test but your hearing loss as a whole,” she adds. “This includes understanding your listening challenges, listening goals, and lifestyle.”

3. A device that works for someone else may not work for you.

Hearing aids are not one-size-fits-all. A hearing aid that works for a friend may not be the right fit for you. Choosing a hearing aid because it’s expensive or advertised as high-tech does not guarantee that it will be the best choice for your needs either. You and your audiologist should discuss your individual needs and goals to determine which hearing aid will ultimately be the right fit for you.

“Many patients do try to get hearing aids that they know their friend got or one they saw on the internet/TV, but those hearing aids end up not being the right fit for them after a hearing aid evaluation with their audiologist,” Dr. Brown says.

Many factors, such as hearing levels between the ears, the size and shape of your ear canal, your budget and insurance coverage, can play a role in deciding which hearing aid is right for you.

“The best hearing aid is one that is selected by you and an audiologist,” Dr. Brown says.

4. You can take a hearing aid on a test drive.

Deciding on a hearing aid can be an overwhelming process, but you can try hearing aids out for 45 days per California law before making your final decision. “Hearing aids are an investment — and they come with a 45-day trial period,” Dr. Brown explains.

During your trial period, reflect on the change in your listening abilities with your new hearing aid and assess whether the device will be convenient and easy enough for you to use. People with arthritis, for example, may find it difficult to use daily-wear devices and may prefer the lower maintenance of an extended-wear hearing aid.

It is recommended to meet with your audiologist at least two times during the trial period. These meetings will allow your audiologist to fine-tune your instrument to better meet your specific needs, increase your comfort level with the different features of your hearing aid and answer any of your questions.

You should also follow up with your audiologist six months after your hearing aid fitting to measure whether there has been an improvement in your listening abilities and quality of life. This six-month assessment provides an additional opportunity to make improvements in the function of your hearing aid.

5. Having a support person at your hearing appointment can help.

If you have an appointment with your audiologist to discuss the different types of hearing aids available, asking a family member or friend to accompany you may help. Your companion can help you keep track of all the information you receive.

“I encourage people to bring a close friend or loved one so that they have support on their hearing journey,” Dr. Brown says.

She also encourages patients to reach out to their audiologist with any questions or concerns they may have regarding their hearing aids at any time, whether they message through the patient portal or through a hearing aid appointment.

“We are always happy to be a resource for you,” she says.

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