Hearing aids

Expert reviewer Mr Anil Banerjee, Ear, Nose and Throat Consultant
Next review due June 2020

If you have trouble hearing, you may need a hearing aid. Hearing aids are electronic devices that you wear in or behind your ear. They make sounds louder and clearer so you can hear them more comfortably.

Why wear a hearing aid?

Many people who need hearing aids don’t wear them. This may be because they think hearing aids don’t work well or are uncomfortable, difficult to use and too noticeable. But hearing aids have improved in sound quality and accuracy over the years. Modern hearing aids can also be very discreet and easy to use.

A hearing aid won’t restore your normal hearing. But it can make certain sounds louder, helping you to communicate better with family, friends and work colleagues. If you have hearing loss, wearing a hearing aid can improve your quality of life.

It takes time to learn to use a hearing aid, and to get used to wearing one. If you’ve tried a hearing aid in the past without any success, it’s worth trying one again. There are many different types of hearing aid available.

When a hearing aid may help

A hearing aid can help around one in every two people with hearing loss. You can have trouble hearing properly for many different reasons. Hearing loss can be caused by a problem with your inner, middle or outer ear or the way sound signals travel to your brain.

Image showing the outer, middle and inner ear

A hearing aid may improve hearing loss that’s getting worse as you get older. This may be caused by damage to the hair cells in your inner ears.

A hearing aid may help if sound can’t pass easily from your outer ear to your inner ear. This may be caused by a blocked outer ear or a problem with your middle ear, such as a build up of fluid.

A hearing aid may also help if your auditory nerve is damaged, which means sound signals don’t travel to your brain. This may be caused by an infection or injury.

If you have tinnitus (buzzing or ringing in your ears), a hearing aid may help your symptoms. This is because if you hear background sounds more clearly, you’re less likely to notice the sounds coming from your ears.

Having a hearing test

If you have problems with your hearing and would like further advice, you could start with a hearing check online. Some high street chemists and opticians offer free NHS hearing check-ups too.

However, if your hearing has become suddenly worse or you’re having problems with just one ear in particular, speak to your GP. They may refer you to an audiologist (a healthcare professional who specialises in hearing problems). Or they may suggest you see an ENT specialist (a doctor who specialises in ear, nose and throat conditions). This is more likely to happen if you have sudden hearing loss, tinnitus or ear pain.

Your audiologist will ask you questions about your hearing and check your ears. They’ll then test your hearing to see if they can find a cause and if a hearing aid will help.

You may be asked 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.

You may need to wear a headband with a pad that sends vibrations to your inner ear, which sends sounds signals to your brain. Again, you’ll be asked to press a button each time you hear something.

You may also be asked to listen to a voice recording and then repeat back what you’ve heard.

The results of your hearing tests are plotted on a special chart or graph called an audiogram. This helps your audiologist find the best hearing aid or treatment for you.

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How do hearing aids work?

Hearing aids are small devices that you wear in or behind your ear. They’re made up of a microphone, amplifier and speaker. The microphone picks up sound and converts this into electrical signals that are sent to the amplifier. The amplifier makes the sounds louder and sends them to your ear through the speaker.

With behind-the-ear hearing aids, the microphone, amplifier and speaker are attached to an ear mould that fits around your ear. With an in-ear hearing aid, these are part of the ear mould itself.

Hearing aids make all noises louder, including background noise. But most of them can be tuned into certain sounds you’re struggling to hear before the sound is made louder by the amplifier.

Hearing aids won’t make your hearing perfect, but they’ll help you hear everyday sounds more clearly.

Types of hearing aids

Hearing aids are available in analogue and digital versions. Analogue and digital hearing aids work in different ways. Most hearing aids are now digital whether they’re available on the NHS or privately.

Analogue hearing aids

Analogue hearing aids are the cheapest type of hearing aid. They increase all noises, including background noise. Your audiologist will set the quality of sound you hear when the hearing aid is fitted. This then can’t be changed at all. But you can change the volume of the hearing aid yourself, turning it up when the noise is quiet and down when it’s loud.

Digital hearing aids

Digital hearing aids work like a mini computer. They can be programmed to suit your individual hearing loss and make the sounds you hear as clear as possible. You can even programme them to suit different environments, such as a quiet living room or a crowded restaurant. This reduces background noise and makes listening to conversations much more comfortable.

Wearing a hearing aid

Hearing aids come in various shapes and sizes. The best style for you will depend on how you wear your hearing aid and whether your hearing loss is mild or severe.

  • Behind-the-ear hearing aids have a plastic case that sits behind your ear and an ear mould that fits into your outer ear. They’re the easiest hearing aids to use. Open fit, behind-the-ear hearing aids have a soft earpiece instead of an ear mould. This can make sounds more natural. But you’ll only be able to use an open fit hearing aid if you have mild-to-moderate hearing loss.
  • In-the-ear hearing aids fit completely inside your outer ear. They’re usually less noticeable than behind-the-ear hearing aids, but may need repairing more often. Different types are available to suit different levels of hearing loss.
  • Completely-in-canal hearing aids are smaller and less noticeable than other styles of hearing aid. They’re almost totally hidden inside your ear canal. This can make them fiddly to use. You may not be able to use one if you have severe hearing loss or get lots of ear infections.
  • You may benefit from a bone conduction hearing aid if you have conductive hearing loss. This is when sound can’t pass easily from your outer ear to your inner ear. You may also need to wear one of these if you can’t wear one of the more common types of hearing aid. This could be because you’ve had surgery or your ear has an unusual shape. Bone conduction hearing aids work by passing vibrations through your skull directly to your inner ear. They can be fiddly to use.

If you have poor eyesight or find it hard to use small controls, a hearing aid that you wear on your body may be helpful. 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 plastic ear mould by a wire.

If your hearing loss is severe and isn’t helped by a hearing aid, you may be recommended to have a cochlear implant. This is an electronic device made up of several parts that are surgically inserted into different areas of your ear. This includes your inner ear and under the skin behind your ear.

Caring for a hearing aid

Your audiologist will advise you about caring for your hearing aid so it works well and lasts as long as possible. Your hearing aid should come with instructions about how to use it and clean it. You may find the following tips helpful too.

  • If you have a behind-the-ear hearing aid, remove and wash the ear mould in warm soapy water every night. Don’t wash the hearing aid itself.
  • Clean your in-the-ear hearing aid regularly with a soft, dry cloth, making sure to remove any earwax which may have built up on it. Never use a damp cloth or any fluid to clean it.
  • When you're not wearing your hearing aid, store it in a cool dry place, away from heat, strong light and moisture.
  • Change the batteries as soon as they stop working.
  • Check your hearing aid tubing for cracks or hardening. It may need to be replaced every three to six months.

Living with a hearing aid

Wearing a hearing aid shouldn’t make you feel embarrassed. Think of it as no different to wearing glasses or contact lenses if your sight isn’t as good as it should be. Lots of people, of all ages, wear hearing aids for many different reasons.

It may take you a while to get used to wearing a hearing aid. Sounds may seem different or odd at first. You’ll need to gradually build up wearing your hearing aid, so you get used to the different sounds. This may take several months. Your audiologist will tell you how long to wear your hearing aid each day until you’re wearing it all the time. You may find it helpful to try out your hearing aid in different places and situations.

Practise putting in and taking out your hearing aid comfortably. It may help if you use a mirror. Learn how to use the volume controls and other settings too. The controls will vary from model to model. Many digital hearing aids have different programmes and settings. These change how your hearing responds when you’re in a noisy environment or when you’re listening to music.

You may find it hard to use normal telephones with your hearing aid. Your hearing aid may make a squealing sound when you put your ear near the phone handle. Most hearing aids have a loop setting to use with listening equipment, such as induction loops and hearing-compatible telephones. Loop systems and devices take sound directly to your hearing aid and cut out background noise.

Learn how to replace your hearing aid batteries. Carry spare batteries with you at all times.

Wearing hearing aids doesn’t mean you’ll be able to hear perfectly. It can help if your family and friends know to speak clearly and at a normal pace (not too fast or too slow). They should talk a bit more loudly than usual, but there’s no need for them to shout. Reduce any background noise and ask them to face you when they talk to you. Hand gestures and movements (e.g. nodding/shaking their head) may help, especially if you’re in a noisy environment.

If you have any problems with using your hearing aid, ask your audiologist for advice.

Frequently asked questions

  • It’s important to keep your hearing aid dry. This is because water can damage the electronic parts and the battery. You'll need to remove your hearing aid when you go swimming and store it safely in a waterproof container. You’ll also need to remove it or be careful to keep it dry when you have a bath or shower.

    Swimming pools have bad acoustics, which means your hearing aid will make background noise louder than usual. So even if you wear your hearing aid when you’re out of the water, you may not be able to hear everything clearly.

    It’s important to tell the lifeguard or swimming teacher if you have any level of hearing loss. You may not hear them blow their whistle or shout in an emergency.

  • This will depend on whether you have hearing loss in one or both of your ears and how severe your hearing loss is.

    More information

    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

  • 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.

    More information

    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.

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Related information

    • Ears. Oxford Handbook of Geriatric Medicine (online). Oxford Medicine Online., published July 2012
    • Presbyacusis. PatientPlus., last checked February 2015
    • Ear, nose and throat. Oxford Handbook of General Practice (online). 4th ed. Oxford Medicine Online., published April 2014
    • Nursing patients with sensory system problems (eyes, ears, nose, and throat). Oxford Handbook of Adult Nursing (online). Oxford Medicine Online., published August 2010
    • Hearing tests. PatientPlus., last checked September 2016
    • Types of hearing aids. Action on Hearing Loss., accessed April 2017
    • Hearing loss. The MSD Manuals., last full review/revision October 2016
    • Looking after your hearing aids. Action on Hearing Loss., accessed April 2017
    • How to get used to your hearing aid. Action on Hearing Loss., accessed April 2017
    • Deaf friendly swimming. National Deaf Children’s Society (NDCS)., accessed April 2017
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  • Reviewed by Alice Rossiter, Specialist Editor, Bupa Health Content Team, June 2017
    Expert reviewer Mr Anil Banerjee, Ear, Nose and Throat Consultant
    Next review due June 2020

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