Despite fifty million people who could benefit from hearing aids, only a small fraction actually use one. Why is that? In the United Kingdom, hearing aids are free from the National Health Service. However these are successful for most people. Manufacturers bring out smaller, snazzier hearing aids. The market is still not biting. What types of hearing aids are going to improve someone’s hearing?
Today in 2019, over ten million people in the United Kingdom could benefit from hearing aids. However, less than 40% of these have tried them. Neither the hearing charities nor the National Health Service provide product information.
]Private companies are constantly redesigning hearing aids to try and make them more attractive. Over three decades, less than a third of the people who could benefit use hearing aids. The uptake figures in America are even worse. Now they have passed the Over The Counter Hearing Aid Act. But will it make any difference?
Providing the right product
Bigger companies such as Boots and Specsavers have entered the hearing aid market this millenium. Do they recognise that sound is more important than size and price? Hearing loss can increase isolation and loneliness. Therefore hearing aids need to meet the needs of people with hearing loss.
This Guardian article from 2012 shows how little the hearing aid industry tries to connect with its potential customer base. Meanwhile an increasing amount of people could benefit from hearing aids but are still not catered for.
The media has not recognised how daunting it is to acquire a hearing aid before you even know what happens next. Imagine going to buy a home entertainment system and the sales person shows you a wind-up gramophone.
Then they say that this product would allow you to hear your records but would take some getting used to. Hearing aid provision has not changed in its approach in three decades. Charities such as Action on Hearing Loss still blame end-users for not using more aids. The hearing aid industry does not want to listen.
Struggle with Conversations
Short-sighted people cannot drive a car without prescription glasses. Therefore, why are hard of hearing people not catered for properly. In 2001, the NHS provided a private public partnership through hospitals. This allowed you to pay half the cost of hearing aids from the private market. The best aid at the time was programmable, analogue and in the ear.
Even so, the audiologist did not know which hearing aid would work best. He presented the latest digital model, which was also the most expensive.The customer was also expected to pay up front. The full amount would be refunded if they didn’t take the aid.
However, a Hidden Hearing audiologist called Mr Sims had recommended a “programmable” hearing aid. This aid was half the price of the digital one and came with a “directional microphone”. Unlike NHS aids it was in the ear (ITE) and had an air vent for the ear to breathe.
Hearing What People Are Saying
This hearing aid was a life-changer. It allowed hearing the rustle of leaves in the trees and hum of cars on the road in the background. It corrected the hearing loss particularly in the middle frequencies. This is why human speech is often drowned out by other noises. For instance, in a restaurant, many hearing aids feedback and screech in your ear. Wax builds up and the chinking of cutlery can drown out conversation. A programmable hearing with a directional microphone meant hearing conversations with background noise.
Additionally, the hearing aid was comfortable to wear all day. Many hearing aids including open fit and free ones from UK hospitals have these issues:
- Blocked up or “boxed in” feeling. Without an air-vent the wearer’s ear is cut off from the world by the plastic tube.
- Cannot be inserted easily. Many aids require precision and being able to see the ear to fit correctly.
- Feedback. If anything, such as a hand, goes near the aid it starts screeching.
- Indiscriminate amplification. Without being programmed to correct the actual loss, everything is louder. This makes hearing speech just as hard as without.
- Complicated settings. Some high-end aids are sold with a range of programs to deal with wind, the outdoors, theatres, etc. Our own ears are set to pick up sound in front of us and to select what we want to hear. Hearing aids do not need to do that if hearing speech is improved.
Charities, the health service and providers use excuses for not prescribing the best aid for the customer.
- It takes getting used to. A programmable, in the ear hearing aid with an airvent will provide immediate hearing improvement and the benefits are instant.
- Your brain will be startled at hearing signals it has missed before. No it won’t as it already knew what it was missing: speech definition. This could also mean the aid is trying to do too much. It just needs to correct middle frequencies to make hearing speech easier. Not being drowned out by amplified noises we don’t want to hear.
These just mean the customer’s needs have not been heard or met. A hearing aid provides instant improved hearing, which sounds natural and the ear piece can be worn all day without discomfort.
On today’s market, hearing aids are mostly digital and programmable. These are set to correct the hearing loss derived from your test for how much sound you hear on each pitch.
However, some hearing aid dispensers will replicate these environments when you go to try your new aid. Therefore a range of settings can be programmed into the aid.
Basic hearing aids
Behind the Ear (BTE) – This is the type of hearing aid provided free in the United Kingdom by the National Health Service. The manufacturer has provided these aids to the NHS for decades. This provider has a monopoly on NHS customers. Only private alternatives are exist. Today, NHS aids are digital and programmed but not comfortable to wear for long on the back of the ear.
In The Ear (ITE) – (image above right) this basic aid can provide enough natural amplification for moderate hearing loss. When they were all analog, it came with a Telecoil switch and directional microphone. Now these are all digital. However, this hearing aid needs to be programmed to the individual’s hearing loss audiogram.
In the Canal (ITC) – (image left) For most wearers, this is an ideal size. Firstly, although they still cost over £500 it provides ample sound programmed to correct the tested hearing loss and they are manageable. This size aid can improve mild to moderate hearing loss and has a volume, program setting for directional and omni-directional and an air vent.
Although it is only fleetingly mentioned on some sites that a hearing aid without an air vent will “box you in” or make your ear feel blocked if it cannot breathe. The ear also builds more wax to defend itself from a perceived intruder. Therefore you need to ensure your hearing aid dispenser includes an air vent that provides an open canal from inside the ear to the outside of the aid.
It seems that hearing aid providers just make assumptions to sell you the aids instead of wanting to listen to discover what more potential customers want. Essentially we want to be able to hear people talking to us and around us as well on TV or stage.
Size is less important as the features that improve hearing are better not crammed deep inside the ear. For an entry level customer with a limited budget, they will try and sell the cheapest hearing aids still being made, perhaps even from the one supplier to the NHS, who still supply them for free.
Hearing Aid Features
Therefore, here is a guide to the various features that make a hearing aid do its job for someone with mild to significant (but not severe) hearing loss:
- In the Ear or In the Canal. The piece fits inside the ear so the sound to be heard has passed by the ear lobes before being amplified.
- Air ventilation. An air vent channel from outside to in, so the ear canal can breathe. Beware of badly designed aids with ear vents that do not extend all the way through.
- Directional microphone. This is a digital program setting on the hearing aid to focus on collecting sound in front of you. Particularly good for chatting at parties.
- Telecoil. A setting that amplifies the telephone. Also found in supermarket tills and shop counters.
- Volume dial. There is nothing worse than technology deciding how much you can hear.
- Programmable. This is now standard on most hearing aids. The hearing test will provide a chart by which to set the hearing correction.
Tried and tested
For those near London, a tried and tested provider of hearing aids, one of the few audiological scientists, is Alan Aaronson, based in North London and his own hearing aid centre in Golders Green. He is now part of a large company with five offices. There is one in Harley Street, London’s centre of medicine. They also now provide musicians with vital selected sound hearing and protection from noise trauma. Going in with good hearing aid product information is still essential get the right device for the right price.
Opportunity for hearing aid wearers
This Hearing Times feature from 2007 contains an interview with a hearing aid audiologist who wore a hearing aid herself. Audiologists with hearing loss would be great for customers and providers. University College London provide an MSc. High street providers including Boots and Specsavers might train people to provide hearing aids to gain the required experience.