If you think a hearing aid may help with your hearing, speak to your GP for more advice. He or she may refer you to an audiologist (a healthcare professional who specialises in identifying and treating hearing disorders). In some situations, your GP may suggest you see an ENT specialist (a doctor who specialises in ear, nose and throat conditions). You will need to have a hearing test to find out what sort of hearing loss you have and whether or not a hearing aid will be helpful.
Your audiologist will ask you questions about your hearing and examine your ears. He or she will ask you to listen to sounds through headphones at different pitches and volumes. Every time you hear a sound, you’ll be asked to press a button.
The audiologist may then ask you to wear a headband with a vibrating pad that sends sounds to the cochlea in your inner ear on both sides of your head. The cochlea turns sounds into nerve impulses and sends them to your brain, which reads the vibrations as sounds. Again, you’ll be asked to press a button each time you hear something.
For children under the age of four, it can be difficult to get reliable results with these techniques, so a paediatric audiometric assessment is used. This often requires more than one audiologist and can take longer.
The results of your hearing tests are plotted on a special chart or graph called an audiogram. This is used to help your audiologist find the most suitable hearing aid or treatment for you. Your audiologist will discuss your test results with you. He or she will advise you if a hearing aid is likely to help, or if a different treatment will be more beneficial.
A hearing aid is made up of a microphone, amplifier and speaker. The microphone picks up sound and converts them into electrical signals that are sent to the amplifier. The amplifier makes the sounds louder and sends them to your ear through the speaker.
Your hearing aid can be tuned into certain sounds you’re struggling to hear without making noises that are already loud even louder.
Hearing aids won’t make your hearing perfect. They will help you hear everyday sounds like the telephone, doorbell and kettle boiling.
Hearing aids are available in analogue and digital and come in various shapes and sizes.
Analogue hearing aids
Analogue hearing aids are traditional hearing aids that use a transistor (a device that increases the power of a signal) to increase the volume of the sounds picked up by the microphone. An analogue hearing aid increases all noises, including background noise. Your audiologist will set the hearing aid so that the sounds you’re having difficulty hearing are made louder and sent into your ear through the speaker.
Analogue hearing aids are usually cheaper than digital ones, but have almost been completely replaced by digital aids. These use improved technology and are easier to customise to your individual needs.
Digital hearing aids
Digital hearing aids work like a mini-computer. Sounds picked up by the microphone are first broken up into very small, separate units. The mini-computer is programmed to make some of the units louder and some of the units quieter depending on your specific hearing difficulty. This means that digital hearing aids can be more flexible than analogue ones, as they may be adjusted to filter out background noises. Some digital hearing aids can be adjusted to suit different situations or environments, such as a quiet library or a noisy bar.
Many hearing aid manufacturers now only produce digital hearing aids.
There are a number of different styles of hearing aid. The style you have will determine where you wear your hearing aid. Some examples are listed below.
- Behind-the-ear hearing aids have a plastic case that sits behind your ear and an earmould that fits into your outer ear. Open fit, behind-the-ear hearing aids have a narrow tube that inserts into your ear canal instead of an earmould. This leaves your ear canal open so is a good choice if you tend to get a build-up of earwax. It can make sounds more natural. Open fit, behind-the-ear hearing aids are suitable if you have mild to moderate hearing loss.
- In-the-ear hearing aids fit entirely within your outer ear and may be used if you have mild to severe hearing loss. These hearing aids are usually less noticeable than behind-the-ear hearing aids. Some in-the-ear hearing aids have a part called a telecoil that makes telephone conversations easier to hear. In-the-ear hearing aids aren’t generally used by children because the casings need to be replaced as their ear grows.
- Canal hearing aids fit into your ear canal and come in two styles. In-the-canal hearing aids are made to fit the size and shape of your ear canal. Completely-in-canal hearing aids are smaller and less visible than other styles of hearing aid. They are almost totally hidden inside your ear canal. Canal hearing aids may not be suitable if you have severe hearing loss or have frequent ear infections. This is because they are very small and can’t hold a very powerful amplifier.
- You may benefit from a bone conduction hearing aid if you have conductive hearing loss and you’re unable to wear one of the more common styles of hearing aid. This could be because you’ve had ear canal or middle ear problems, such as frequent ear infections or surgery. Bone conduction hearing aids work by passing sound through your skull directly to your inner ear, missing out your outer and middle ear.
- If you have vision problems or find it difficult to work small controls, you may find a hearing aid that you wear on your body useful. This type of hearing aid has a small box that you can put in your pocket or attach to your clothes. The box is connected to a microphone by a lead, which can be very powerful.
If you have severe or profound deafness that isn’t helped by a hearing aid, then a cochlear implant may be suggested. This is a form of implantable hearing aid which is surgically inserted into your inner ear. It’s suitable for adults and children.
Your audiologist will give you instructions about how to care for your hearing aid so that it works well and lasts as long as possible. You may find the following tips helpful.
- If you have a behind-the-ear hearing aid, wash the part that goes inside your ear about once a week in warm soapy water.
- Clean your in-the-ear hearing aid regularly with a soft, dry cloth to remove any earwax. It’s important that your in-the-ear hearing aid doesn’t come into contact with any liquid.
- When you're not wearing your hearing aid, store it carefully in a box in a cool, dry place, away from heat and moisture.
- Turn off your hearing aid when you're not using it.
- Change the batteries as soon as they stop working. Batteries may need changing every one to two weeks.
If you look after your hearing aid it should last, on average, at least three to five years.
You may find it takes a while to get used to wearing a hearing aid. Sounds might sound different or odd at first, but you will adjust to them. It’s important to wear it as much as possible and practise using the controls and different settings.
You may find it helpful to gradually try out your hearing aid in different situations. Your brain may have adjusted to not hearing some sounds, so will need time to re-learn and adapt. Try listening to everyday noises, having a conversation with one person and then listening to group conversations. Practise wearing your hearing aid outside and in noisy places. Getting used to living with a hearing aid is a gradual process.
Even though you may not be that keen on getting a hearing aid, it is worth it if you need it. Wearing a hearing aid can reduce the psychological, emotional and social effects of hearing loss. The sooner you get a hearing aid, the more benefit you’re likely to get out of it.
Your audiologist will be able to give you advice about using your hearing aid in different environments. He or she can also help if you have any problems with your hearing aid.
Can I go swimming with my hearing aid?
No, you'll need to remove your hearing aid when you go swimming.
It's important to keep your hearing aid dry because water can damage the electronic parts and the battery. You’ll need to take it out when you go swimming and either remove it or be careful to keep it dry when you have a bath or shower.
Some manufacturers have developed hearing aids that are water-resistant, but generally you're advised to remove these before going swimming.
Will I need hearing aids in both ears?
This will depend on whether you have hearing loss in one or both of your ears and how severe your hearing loss is.
If your hearing loss is in both ears, it may help you to have a hearing aid in each ear. Two hearing aids can help you follow conversations despite background noise and tell which direction sound is coming from. Your audiologist will recommend a hearing aid for both ears only if it’s appropriate for your level of hearing loss.
You may only need one hearing aid if:
- you have hearing loss in one ear only
- one of your ears has hearing loss that is much worse than the other
- you have frequent infections in one ear
What will it be like when I start wearing my hearing aid?
It can take a few months to feel comfortable wearing your hearing aid so you’ll need to be patient. Regularly wearing your hearing aid and building up the amount of time you wear it will help speed up this process.
Familiarising yourself with how the settings work on your hearing aid will help you get used to using it. Practise the following when you’re with your audiologist so that you know how to do them correctly when you’re on your own.
- Putting in and taking out your hearing aid.
- Cleaning your hearing aid.
- Identifying left and right hearing aids.
- Replacing your hearing aid batteries.
- Testing your hearing aid in places that you have problems hearing.
- Learning to adjust the volume setting of your hearing aid.
While you’re getting used to your new hearing aid, you may have the following problems.
- You may feel uncomfortable wearing your hearing aid at first. Your audiologist will be able to advise you how long to wear it to begin with.
- Your voice may sound too loud. This is a common problem for people that have just started wearing a hearing aid. Most people get used to this after wearing their hearing aid for a while.
- You may get feedback, such as whistling or squealing, from your hearing aid. This may be because your hearing aid has a problem that needs to be fixed, or has earwax in it.
- You may hear more background noise. Your hearing aid won’t completely separate the sounds you want to hear from the ones that you don’t want to hear. Occasionally, however, your hearing aid may need adjusting.
About eight to 12 weeks after you’ve had your hearing aid fitted, you should be offered a follow-up appointment. This is to check your hearing aid is fitted correctly and that you’re not having any problems. Speak to your audiologist for advice at your follow-up appointment, or sooner if you need help with correcting any problems you’re having.
- Action on Hearing Loss
0808 808 0123
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- What is an audiogram? Hearing Link. www.hearinglink.org, published 2012
- Cochlear implants for children and adults with severe to profound deafness. National Institute for Health and Care Excellence (NICE), 2009. www.nice.org.uk
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- Simon C, Everitt H, van Dorp F. Oxford handbook of general practice. 3rd ed. Oxford: Oxford University Press; 2010
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- Action on Hearing Loss
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