WHAT YOU NEED TO KNOW BEFORE YOU BUY THEM
I have always found something interesting about hearing aids. Tell someone they need glasses and they usually say, “Okay. Where do I get them?”
Tell someone they might need hearing aids and suddenly you get: “My hearing isn’t that bad.” “Everyone mumbles.” “The restaurant was just noisy.”
Or my favorite:
“I hear you just fine when you’re looking at me.”
There is still a stigma attached to hearing aids that simply doesn’t exist with eyeglasses. But if you are struggling to follow conversations, turning up the television, or constantly asking people to repeat themselves, hearing aids may make a tremendous difference in your daily life.
And hearing aids have changed.
They are smaller, smarter, and easier to use than the devices many of us remember our grandparents wearing. You can even buy certain hearing aids without a prescription.
But that creates another problem.
How do you know what to buy?
Let’s sort through it.
First, What Does a Hearing Aid Actually Do?
A hearing aid is basically a tiny computer that you wear in or around your ear.
A microphone picks up sound. A processor analyzes and adjusts that sound. A speaker delivers the amplified sound into your ear.
But modern hearing aids do much more than simply make everything louder.
That is important because age-related hearing loss is not usually a matter of turning up the volume on the world.
Certain frequencies are often affected more than others. Many people can hear someone talking but have difficulty understanding the words, particularly when there is background noise.
A properly fitted hearing aid can be programmed to emphasize the sounds you have difficulty hearing while doing less to sounds you already hear reasonably well.
Some hearing aids can also reduce background noise, use directional microphones to focus on the person in front of you, connect to your smartphone, and stream telephone calls or television audio directly into your ears.
We have come a long way from the hearing aids of 30 years ago.
How Do You Know If You Need One?
Here’s a simple question. Is your hearing interfering with your life?
Maybe you have trouble understanding conversations in restaurants. Maybe your spouse complains about the television volume. Maybe you are constantly saying, “What?” Or maybe you have begun sitting quietly during group conversations because it is simply too exhausting trying to figure out what everyone is saying.
That last one concerns me.
When hearing becomes difficult, some people begin withdrawing socially without realizing it.
Instead of going to dinner, they stay home. Instead of participating in a conversation, they sit quietly. Instead of calling a friend, they avoid the telephone.
That is why hearing loss is not simply about your ears. It can affect your relationships and your quality of life.
Start With a Hearing Test
Before spending hundreds or thousands of dollars on hearing aids, I generally recommend knowing what you are treating.
A hearing evaluation can tell you how much hearing you have lost and which frequencies are affected.
t can also identify situations where you may need medical evaluation rather than simply purchasing a hearing aid.
For example, hearing loss that is much worse in one ear deserves additional evaluation.
So does hearing loss associated with persistent one-sided ringing, dizziness, ear pain, drainage, or other unusual symptoms.
And if you suddenly lose hearing in one ear, don’t order a hearing aid online. Seek medical attention promptly.
Sudden sensorineural hearing loss can be a medical emergency, and treatment may be time-sensitive.
Prescription vs. Over-the-Counter Hearing Aids
This is where hearing aids have changed considerably.
Adults can now purchase certain over-the-counter hearing aids without seeing a doctor or audiologist first.
These devices are intended for adults age 18 and older who perceive that they have mild-to-moderate hearing loss.
For the right person, this can be a reasonable option.
OTC hearing aids may cost considerably less than professionally fitted devices, and some allow you to adjust the settings yourself through a smartphone app.
But cheaper doesn’t automatically mean better—or worse. The important question is whether the device matches your hearing needs.
If your hearing loss is more severe, complicated, or difficult to manage, working with an audiologist may be worth the additional expense.
Think of it like buying reading glasses at the drugstore versus getting prescription glasses.
Drugstore readers work wonderfully for some people. Other people need something more customized.
Don’t Confuse Hearing Aids With Sound Amplifiers
This is an important distinction. You may see inexpensive devices advertised online that simply amplify sound. They are sometimes called personal sound amplification products, or PSAPs.
These are not the same thing as hearing aids.
A simple amplifier makes sounds louder. That may include the sound you want to hear along with the air conditioner, dishes clattering, the dog barking, and the person talking three tables away.
A hearing aid is specifically designed to compensate for hearing loss.
When shopping, make sure you know what you are buying.
A $49 device advertised as a “hearing solution” may not actually be a hearing aid.
Why Hearing Aids Sometimes End Up in a Drawer
Here is something people don’t always expect.
You put hearing aids in for the first time and suddenly everything sounds strange. Your own voice sounds different. Paper crinkling seems ridiculously loud. You hear footsteps. The refrigerator suddenly sounds like it has developed an engine.
And you think:
I don’t like these things.
That doesn’t necessarily mean the hearing aids aren’t working.
If you have gradually lost hearing over many years, your brain has become accustomed to a quieter world. Now you are giving it sounds it hasn’t processed normally for a long time.
There can be an adjustment period.
That is one reason professional fitting and follow-up can be valuable. The hearing aids may need to be adjusted, and you may need time to adapt to them.
Don’t necessarily give up after two days.
What Features Do You Really Need?
Hearing aids now come with an impressive—and sometimes overwhelming—list of features.
Bluetooth. Rechargeable batteries. Noise reduction. Directional microphones. Smartphone apps. Automatic environmental adjustments. Telecoil technology.
Some of these features can be extremely useful.
But don’t buy a hearing aid because it has the longest feature list.
Think about your life.
If you frequently eat in restaurants or attend meetings, performance in background noise may be particularly important.
If you use your smartphone constantly, Bluetooth connectivity might matter.
If changing tiny batteries would be difficult because of arthritis or vision problems, rechargeable hearing aids may make life much easier.
Buy for the life you actually live.
Not for the technology brochure.
Will Hearing Aids Prevent Dementia?
You may have seen headlines suggesting that hearing aids can prevent dementia.
We need to be careful here.
Untreated hearing loss has been associated with cognitive decline and dementia, but an association does not necessarily prove that one causes the other.
A major randomized study called the ACHIEVE trial looked at whether treating hearing loss could slow cognitive decline.
Across the entire study population, hearing intervention did not significantly reduce cognitive decline over three years. However, among participants who were already at higher risk for cognitive decline, the hearing intervention appeared to provide a meaningful benefit.
So I would not tell you to buy hearing aids because they will prevent dementia.
We simply cannot make that promise.
But I would tell you to treat significant hearing loss because hearing better can help you communicate, remain socially connected, and participate more fully in life.
Those are pretty good reasons by themselves.
What Should You Look for Before Buying?
Whether you buy prescription or OTC hearing aids, pay attention to the practical details.
Understand the return policy. Ask how long you have to try the devices. Find out what the warranty covers. Determine whether adjustments and follow-up visits are included in the price. Consider whether you can comfortably insert, remove, clean, and charge the devices.
And don’t underestimate comfort. The most sophisticated hearing aid in the world won’t help you if it spends most of its life in your nightstand.
Here Is What I Recommend
If you are struggling with your hearing, don’t ignore it for another five years because hearing aids make you feel old.
You know what can make you feel older?
Constantly saying: “What?”
Start with a hearing evaluation, particularly if you are uncertain how much hearing you have lost.
If you have uncomplicated mild-to-moderate hearing loss, an over-the-counter hearing aid may be worth considering.
If your hearing loss is more significant, complicated, or difficult to manage, I would strongly consider working with an audiologist.
Then give yourself time to adjust.
The goal isn’t perfect hearing. The goal is to hear your spouse across the dinner table. To follow the conversation when your family gets together. To hear your grandchildren tell you a story without pretending you understood every word. To remain involved.
Hearing aids aren’t about admitting you’re getting older.
They’re about making sure you don’t miss the good parts.