How to buy a hearing aid
I am occasionally asked by family who live in other provinces if I can “sell” them a hearing aid to save them money. I understand that hearing aids are an expensive proposition, but I have refused every time and referred them to excellent colleagues. My explanation is always the same. I tell them, “Who you see will make a bigger difference than what you get.” My family will need follow up and aftercare that I can’t deliver when they don’t live in Alberta. As a result, even though my own mother wears hearing aids, I am not her Audiologist.
We should never lose sight of the fact that hearing aids fall squarely under health care but it can be a confusing experience, with a lot to lose. It may be worthwhile to consider a few tips in finding the right professional.
- Beware of misleading advertising. I saw a TV ad the other day from a major entity in the world of hearing aids that implied their hearing aids could “erase” background noise and only let you hear speech. There is not a hearing aid on the planet, for any amount of money, that can do that the way they suggest. If they could, we would all wear them like we wear sunglasses, even when our vision is normal. Likewise with digital advertising, if you have any internet presence or social media, you are being targeted with ads based on your age, search history, etc. Be wary of what they are telling you. There is no single hearing aid that has “taken over the (Red Deer or Olds) market.” That is a digital manipulation. Be skeptical.
- Am I being helped or am I being sold? The experience should feel like health care, not a retail transaction. The conversation should be about treatment outcomes (speech understanding) before gadgetry and smart phones. There should be a plan to achieve this that includes best practices and real ear measurements (see part 1 in a previous article).
- What is being recommended? There are about 6 major global hearing aid manufacturers. It is in your best interest to use a technology developed by a major manufacturer to ensure cutting edge research as well as reliability. These have to pass testing with Health Canada to qualify as a medical device. They are therefore exempt from GST and can be claimed as a medical expense on your taxes.
- Can anyone adjust my hearing aid? You have the right to choose the professional you work with. But what happens if you lose faith in your professional or if you move cities? Sometimes, the devices are “locked” and can only be adjusted or changed by the company that originally dispensed the devices. This restricts your choice of health care provider. Make sure you get “open platform” devices that can be programmed by any Audiologist or hearing care provider anywhere you may be.
- What is the plan for after care? You absolutely will need aftercare, support and counseling about your hearing and hearing aids.
- Do I have time to make my decision? You should have no less than one month to try the hearing aids with an option to return them if they don’t meet your expectations. You should not sign anything that obligates you before that trial period is completed. Any suggestion that “you’ll get used to it” is not a legitimate reason to sign something before you are happy with the results.
Health care regulation ensures minimum competence. But maybe we should be looking for excellent, not just competent. You should be comfortable with the relationship and know that professional is committed to your improved communication. Don’t be afraid to interview your health care providers and make the right decision for you.
“Everyone mumbles.” or “if everyone spoke more clearly, I wouldn’t have a problem.” Have you thought or said either of those sentences before? If you have worked around industrial noise or find yourself over the age of 55, there is a good chance you have. But why? Surely it couldn’t be a reduction in hearing. Or could it? One of the most common misconceptions about hearing is that if it changes, you’ll know it. The truth is, in most cases, you probably won’t unless you get it checked. A reduction in hearing can be sneaky. It usually progresses slowly and usually involves higher pitches first. Both of these factors mean other people will probably notice you’re having difficulty before you do. Many people think that a reduction in hearing is like turning the volume down on the TV. It isn’t. When we lose our hearing from noise or age, for example, the part of our ear responsible for hearing higher pitches is what is damaged first. This leaves us with more of a problem related to clarity, than loudness. In other words, you may find yourself saying, “I heard you, I just didn’t understand you.” In speech, vowel sounds (oo, ee, ah) are low pitched and are what gives us the power or volume. Consonant sounds (p, t, k, s, sh) are high pitched. They are the ones affected first in most hearing losses. Unfortunately, they are also the sounds we need to understand one word from the next. That phenomenon is also why you may be able to hear the traffic on the highway outside, but yet can’t hear the TV or your spouse every time. So what are you supposed to do if you or someone in your life suspects you have a reduction in hearing? Well the good news is a hearing test is quick and painless. Depending who you see it may even be free of charge. What you will want to make sure of is that the test is comprehensive and thorough. There should be at least 5 or 6 procedures performed in that visit to even begin to come up with some answers. The “beep test” alone is not good enough. If the test results show some degree of hearing reduction, it is important to be educated completely about what your options are. If the results show that your hearing can be improved medically or surgically (about 15-20% of hearing losses), then you will be referred to your family doctor or an ENT (ear, nose, throat surgeon). If your hearing loss is permanent (age, noise, etc.) then you may be a candidate for hearing aids. A competent clinician should prescribe and dispense hearing aids with honesty and integrity. You should not feel as though you are being sold something, but rather that you are being cared for as you would be with your dentist, optometrist, etc. If you choose to adopt hearing aids into your life, you should know that you will undergo a trial period for the first 30-60 days. During that time, if you feel that your needs aren’t being met, you should have the option to return them, hopefully without charge. The hearing aid process should be a positive one in which you are able to work with your clinician to improve your conversations, relationships and overall quality of life.
“Biology is better than technology….” That’s a phrase I seem to repeat on a daily basis in my Audiology practice. In fact, I say it so much, I recently had a patient tell me I should trademark it! When it comes up in our clinical counselling, what I am usually stressing is that we need to protect our hearing, because once it’s gone, it’s gone. There is no medical or surgical method that can reverse the effects of noise damage. When that is the case, hearing aids are the only option for improved communication. But that is where my phrase comes from, because normal hearing is better than aided hearing, and aided hearing is not normal. My point is that we all need to learn how to preserve what hearing we have, so we don’t have to use hearing aids sooner than expected. Noise-induced hearing loss is really the only type of hearing loss that can reliably be prevented. In Central Alberta, it is a very real and widespread concern. With the number of blue collar jobs that sustain our local economy, it puts a large number of people at high risk for permanent hearing loss. Occupational health and safety only legislated protection from noise in the late 1980’s, but even now, there are workers that continue to be at risk for hearing loss, due to improper or inadequate protection from noise. I used to fly a lot for a previous job and I would always observe the ground crew faithfully wearing their hearing protection, but it seemed more often than not, that the earplugs were not inserted properly and therefore not offering any protection from the noise they were exposed to. Sometimes, improved counselling and instruction is all that is required to improve safety compliance and effectiveness. Other times though, a different strategy for hearing protection is needed and a basic foam earplug just isn’t the answer. To determine what the best solution is for you, we have to consider what it is that you do and what the requirements are. Is it industrial noise? Are you a musician? Are you a hunter or sport shooter? Each of these activities require very different solutions for noise protection. We also have to consider what we call “dose.” Noise is damaging from a combination of factors, including the loudness and time exposed. Industry calculates that we can safely withstand 85 dBA of noise for 8 hours unprotected. For every doubling of sound pressure (roughly 3 dB), we have to cut the time in half. So if the noise is 88 dBA, then 4 hours is safe, 91 dBA, 2 hours is safe, and so on. However, we also have to consider a unique form of noise induced hearing loss called acoustic trauma. These are sounds that are so loud, the effects are instantaneous. Firearm use would be a common example of this. For example, a shotgun blast can be 140 dB, which can do instant damage. In fact, that intensity of sound is above our pain threshold. The only reason we don’t necessarily perceive it as painful is because it is of short duration. But never the less, the damage is done. Every problem has a solution and step one in solving the problem of hearing protection is consulting your Audiologist. If you are a musician, there are earplugs that can maintain the fidelity of your music without distortion. If you are a hunter/shooter, there are earplugs that allow you to hear properly and activate instantly at the moment you shoot. More commonly, if you work in noise, there are earplugs that can be custom fit to you, easy to wear and even filtered specifically to allow communication while still protecting from noise. Simply put, everyone’s situation is different and requires a solution specific to that person and that situation.
