Hearing Loss

Care & Treatment

Some causes of hearing loss can be treated medically or surgically. However, most hearing loss in older adults is treated with strategies to improve communication, devices to amplify the sound (such as hearing aids), or both. 

Hearing Assistance Technologies

These devices include:

  • Microphones and transmitters that you put close to the sound source (like your TV). They transmit the sound to a receiver and headphones or earpieces, usually wirelessly.
  • Personal pocket devices that amplify sounds closest to you, such as conversation, while reducing background noise. The devices are about the size of a business card, with about 100 hours of battery life. You clip it onto your belt, slip it into a pocket, or wear it around your neck, where it transmits the sound to headphones or earbuds.
  • Telephone ringers. These increase the volume of telephone rings or make the phone vibrate or flash a light. Text telephones are also available. Most are free to people who are deaf or have severe hearing loss. 

Other hearing assistance devices include closed-caption televisions, and vibrating and flashing devices such as alarm clocks and timers, smoke alarms, doorbell alerts, and motion sensors. You can find many of these items through state agencies for people with hearing loss, or online.

Hearing Aids

Hearing aids are the most common amplification devices. They can improve your ability to understand speech, particularly soft speech and loud conversational speech. It’s best to get hearing aids in both ears because that helps you identify the direction of the sound. Most importantly, it improves understanding in noisy situations. If you have only lost hearing in one ear, you may only be eligible for one hearing aid, but there are now a variety of options for persons with single-sided deafness. Don’t wait until the loss is severe. Getting a hearing aid early on can help you get used to using it and can reduce the psychological impact related to hearing loss.

Although you can buy hearing aids from many sources, including online, you should work with an audiologist or other healthcare professional trained in audiology.  This way, you can make sure you get the right hearing aid for your needs and be sure it is fitted and adjusted correctly.

Not everyone benefits from hearing aids and they do require gradual adjustment. Some people can’t tolerate the feeling of having something in their ear.  However, open-fit hearing aids, used for those with mild to moderate hearing loss, reduce this sensation. Others may have so much damage that they still can’t understand speech.  However, the chances of success can be improved by counseling that teaches communication strategies and aural rehabilitation in addition to hearing aids. So make sure you can return your hearing aid at no cost after a trial period. At the same time, don’t give up too soon! Your audiologist can often adjust the fit and settings to improve the comfort and sound quality.

A hearing aid is just part of the equation for improved hearing—the other half is a hearing rehabilitation program. This includes counseling regarding the benefits and limitations of hearing aids and suggestions for communicating with others. It is typically included in the cost of the hearing aid.

Of course, hearing aids can’t help if you don’t use them. Many older adults purchase hearing aids but then don’t use them or only use them occasionally. Possible reasons include:

  • Problems manipulating the tiny devices with their hands (especially for people with arthritis)
  • Amplification of background noise
  • Thinking the aid is not needed
  • Memory loss
  • Cost concerns:
    • Medicare does not cover hearing aids or other listening devices, although some Medicare Advantage plans may offer them as an added benefit.
    • Most private insurers also don’t cover hearing aids or other listening devices.
    • Some state Medicaid programs may cover hearing aids, but the reimbursement usually does not cover the whole cost.
    • Federal programs such as the Department of Veterans Affairs may pay for hearing aids, depending on your eligibility.

Background noise is another problem. Traditional hearing aids increase all sound, so noises like rattling papers, running water, or other conversations can be very distracting. Newer technologies use multiple microphones and digital signal processing to decrease background noise, which can significantly improve your ability to understand speech in noise and increase your satisfaction with the hearing aid. The majority of hearing aids today are digital and most include features to promote understanding in difficult listening situations.

Choosing the Right Hearing Aid

There are numerous styles of hearing aids. The best style for you depends on:

  • the amount of your hearing loss
  • the available features you want
  • your motivation and ability to properly insert and use the hearing aid

The most popular hearing aids are the behind-the-ear type, followed by in-the-ear models. Hearing aids have custom programs that can be adjusted to your particular hearing loss and lifestyle needs. You can also often get two or more programs within a single hearing aid. For instance, you could use one program when you’re in an environment with background noise and another when you’re in a quieter environment. The audiologist uses a computer to adjust ranges and balance for each program. Some of the newer hearing aids automatically adjust the volume to increase amplification of soft sounds without background sounds becoming too loud.

Behind-the-ear hearing aids hang behind the ear.  They are connected directly to an ear mold that is customized to fit your ear, or to a dome which varies in terms of how much it blocks the outer ear canal. These aids are more visible than in-the-ear models, but they are durable, easily adjusted, and easily repaired. Some behind-the-ear aids can also be connected to other assistive-listening devices such as telephone or television amplifiers. 

In-the-ear hearing aids are smaller devices that are custom fit to your ear. Some of them can be very difficult to adjust and maintain because tiny particles of skin or wax can damage them. However, most behind-the-ear hearing aids and in-the-ear hearing aids now come with wax guards, to minimize the chances of blockage.

Cochlear Implants

A cochlear implant is an electronic device surgically implanted in your ear. It bypasses the damaged cochlear hair cells and transmits sensory impulses directly to the cochlear nerves.  Cochlear implants are used only in people with severe to profound hearing loss whose hearing doesn’t improve with hearing aids. Cochlear implants don’t restore normal hearing, but they can help you hear environmental sounds, understand speech better, and use a telephone.  They can even restore the enjoyment of music for many people. 

Having cochlear implant surgery requires extensive testing before surgery and training after surgery. The cochlear implant is activated 4 weeks after surgery. Patients typically achieve optimal hearing and understanding of speech within 6–12 months. General health, rather than age, is an important predictor of health outcomes after cochlear implantation. Most Medicare programs and insurance companies cover the procedure.

 

Last Updated November 2016