Illustration by Jean-François Martin
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Now Hear This
By Cathie Gandel, March & April 2006
Millions of hard-of-hearing Americans don’t use hearing aids. Will the latest
high-tech devices change their minds?
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Are you sick of hearing (just barely) from friends and family that you can't hear? If so, the time has come to stop stalling and buy a hearing aid. Twelve million Americans 55 and up have age-related hearing loss, yet people wait seven years, on average, to seek treatment. The reason? Often, it's vanity. There's an everyone-will-stare-at-me stigma that makes us more worried about how we look than how we listen. But hearing aids have never been less noticeable—or more effective. "I actually feel younger, smarter, and happier since I got mine," says Sandra Betzina, 63, an author and a sewing teacher in San Francisco.
The price of a hearing aid depends on the type you buy (and no, Medicare and most insurance companies won't cover the costs). The newest high-tech digital models typically run from $2,000 to $3,500 per ear. Old-fashioned analog models are usually cheaper—$800 to $1,600 is normal—but the difference in sound quality is like the difference between a microphone and a bullhorn. Analog models simply make sounds louder. Digital models make them clearer, sharpening speech and other noise that can get muddled in an older ear. Digital models also offer more flexibility, faster processing, and better hearing in noisy places—key reasons that they make up 80 percent of hearing aid sales. Best of all, prices for digital hearing aids are dropping.
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"I compare them to airplane tickets," says David Fabry, a vice president at Phonak Hearing Systems in Warrenville, Illinois. "Digital hearing aids used to be all first class, so to speak. Now, manufacturers are making business- and economy-class models, too."
In short, we have seen the future—and it sounds marvelous, thanks to these new breakthroughs.
The Perfect Fit
Hearing aids that fit in your ear canal are popular because they're hard to see (there are two types: one that sits on the top part of the ear canal and another that fits deep in the ear canal). But wearers often report feeling "stuffed up" because the ear canal is blocked. The blockage also means wearers may not be able to benefit from their residual hearing.
The solution: a new class of hearing aids introduced in 2005 called open-ear fittings, which sit behind your ear like a traditional hearing aid. Behind-the-ear models have always been more comfortable and easier to switch on and off than in-the-ear aids, and they're particularly good for severe hearing loss because they provide the strongest amplification. But these new open-ear versions are much smaller and have a barely visible thin tube that extends into the ear canal (which is how the sound is transmitted). Open-fitting models include GN ReSound's Air; Starkey's Aspect On-the-Ear; and Acuris, from Siemens. They tend to cost $1,800 to $3,000.
"Open fittings are the way the technology is going," says Thomas Powers, chief research officer at Siemens Hearing Instruments Inc. in Piscataway, New Jersey. "These devices are physically and acoustically open and comfortable. They are a boon to people with mild to moderate sensorineural hearing loss."
You Can Hear Me Now
One of the most exciting new advances is fully adaptive directional microphones, available in both behind-the-ear and in-the-ear models. These mikes pick up speech no matter where it comes from (in the past, directional microphones amplified sounds in front of you). Though some models are operated manually, others are automatic: if someone is speaking on your left, the hearing aid "knows" and adapts so you can hear more clearly. And feedback—the annoying whistle you hear when amplified sounds are picked up again by the hearing aid—has been lessened in most models, as well.
Tuning in Tandem
Until now, people with hearing loss in both ears would have to adjust their hearing aids by hand, one at a time. But with e2e wireless technology, developed by Siemens, hearing aids communicate with each other and operate as one system, even if the user has more hearing in one ear than the other. The technology automatically adjusts the settings in both ears as the listening environment changes. The price for hearing aids with e2e is typically $2,000 to $2,500.
Location, Location
Some new hearing aids provide different settings for different environments. You can choose one setting for a quiet room, another for a concert, and yet another for a noisy restaurant. The options are preprogrammed, so all you do is adjust the aid to the proper setting, typically with a remote control (Phonak Savia offers a remote control that is also a watch). Better still, some models—such as Oticon's Tego and the Senso Diva, by Widex—build in the adjustment capability. "The hearing aid 'listens' to the environment and manipulates the microphones so the wearer always has the best understanding of speech," says Francis Kuk, director of audiology at Widex, USA. Programmable models range from $2,000 to $3,500.
Sound Advice
If you are rushing to finish this story so you can start shopping, keep in mind that everyone's needs are unique. "Don't go to your audiologist and say, 'I want this type of device because my friend has one and loves it,'" says Carole Rogin, executive director of the Hearing Industries Association. "Not all features are necessary for all people. That's why working with a licensed audiologist is so important." To find one, contact the American Speech-Language-Hearing Association (800-638-8255) or the American Academy of Audiology (800-222-2336).
Also, calibrate your expectations. It's unlikely your hearing will return to 100 percent, no matter which device you choose. But you may be surprised how much a hearing aid helps. Carl Borders, 69, an orthopedic surgeon in San Francisco, recently started wearing a digital, behind-the-ear model. "I didn't realize how many words I was misunderstanding," he says. "My aids aren't perfect, but I'm getting much more of the conversation."
Many stores have relatively short trial periods—usually 30 days—during which you can return the aids for a refund. So don't delay if you need adjustments or feel the aids are not helping. But if you just feel awkward, try to relax. "Give yourself at least six months to get used to having something in your ear," says Sandra Betzina. "Hearing aids changed my life."
Cathie Gandel last wrote for AARP The Magazine about fighting noise pollution.
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