If you're new to the world of hearing aids, you may be full of questions and feel overwhelmed with the myriad choices. As with any new endeavor, learning more about the topic will help put your mind at ease and give you the confidence to make the right choice.

I began practicing audiology in 1992. Over the years, I've seen thousands of patients and have been actively involved in consumer groups for hearing loss. I wrote this guide to equip those experiencing hearing loss with the knowledge they need to find the hearing aid.

In this guide, I'll explain the different types of hearing aids that are available, so you can decide which will work for you or your loved one. I'll also go into detail about the types of hearing loss that can occur — and the early warning signs you should know.

I began practicing audiology in 1992. Over the years, I’ve seen thousands of patients and been actively involved in consumer groups for hearing loss. I wrote this guide to accomplish a few things.

First, I’d like more people to seek help for hearing loss. Millions of Americans (mostly seniors) have hearing loss. A discouraging fact has rung true for almost a century: just 20 percent of people who would benefit from a hearing aid wear one.1 In my experience, a big reason for that is a lack of knowledge. This guide aims to address this.In my experience, a big reason for this is a lack of knowledge. This guide aims to address this.

Second, I wanted to open the curtain on the seemingly endless options for hearing aids. Just like buying a car, there are hundreds of makes and models to choose from. But if you zoom out a bit, all of them have four wheels, a frame, a motor, and a body. Beyond that, most models just differ based on convenience and style. Hearing aids are much the same.

Finally, I wanted to arm you with some not-so-common tools to weed out the good, the bad, and the ugly in terms of who actually dispenses these devices. Returning to the car analogy, you want a mechanic who won’t quit “wrenching” until your ride is purring like a kitten. With a smidge of knowledge and healthy skepticism, you can push your “hearing mechanic” to help you hear the best you can.

Hearing aids are electronic devices that can be worn in or behind the ear. Hearing aids improve the lives of those who have mild to significant hearing impairments. But, as I counsel my patients, they aren't  a cure for hearing loss. Rather, they improve the quality and level of sound around you. This increases your ability to comprehend human speech and enjoy the sounds of life while they're being worn. Once you pop them out, your hearing will revert back to its natural state.

The moral of the story? You have to wear hearing aids to reap their benefits. That's why buying the right type is so important. Hearing aids that don't work tend not to be worn.

Now that you have some general knowledge about the hearing aid types from the previous section. Take a moment to check out this video on the Types of Hearing Aids from the Senior Living YouTube Channel. In this video, we cover all of the major hearing aid types, how they work, and some of their functionalities. Hear all of this information directly from our resident audiologist Brad Ingrao, Au.D.

Hearing aids fall into two major categories — in-the-ear (ITE) and behind-the-ear (BTE) — and a few subcategories in terms of style or shape. In general, the internal electronics are the same across styles of a given model, but some features may not be available in certain styles due to size. The currently available styles are as follows:

As you can see, there are a lot of options when it comes to the size and shape of hearing aids. As an audiologist, I've noticed that most of my patients prefer not to advertise their hearing loss. The exception is typically younger folks who opt for bright and obvious BTE versions. People who prefer very discreet hearing aids should see if the invisible-in-the-canal (IIC) or extended wear (EW) options are appropriate for their hearing loss level and needs.

Unless you're completely bald, the receiver-in-canal (RIC) style, when color-matched to the hair, is nearly invisible in most cases. Hearing aids that look good (or at least acceptable) are very desirable; however, it’s essential to realize that going that small means you may have to compromise on some features.

Take a moment to check out our video on types of hearing aids below. In this video, we cover all of the major hearing aid types, how they work, and some of their functionalities.

Now that we know what types of hearing aids there are, let's talk about hearing anatomy; it will help you better understand what causes hearing loss and how to address it. The human hearing system has four parts:

• The outer ear collects, directs, and amplifies incoming sound. This part of the ear includes the Pinna (where you hang your glasses), the ear canal, and the outer surface of the eardrum (tympanic membrane).
• The middle ear is a mechanical amplifier. Behind the eardrum, the three smallest bones in the body: the hammer, anvil, and stirrup (or malleus, incus, and stapes for you Latin aficionados) amplify the sound energy in the ear canal; they also deliver those enhanced vibrations to the inner ear. Collectively, these bones are known as ossicles. An often-neglected part of the middle ear is the Eustachian tube. This structure connects the middle ear to the back of the nose and allows your ears to “pop” on an airplane or when scuba diving.
• The inner ear includes the cochlea and vestibular, or balance system. The cochlea contains roughly 30,000 tiny receptors called hair cells; these receptors convert the vibrations in the cochlear fluid into nerve impulses. The inner ear’s balance components convert movement into nerve impulses.
• The central auditory system is the “computer” of hearing. It includes a sophisticated group of structures in the auditory nerve, brain stem, and several areas of the brain — these brain areas decode the nerve impulses from the inner ear into perceptions of pitch, loudness, and duration. This system combines with memory to allow us to hear and understand speech and other sounds.

Now that we know a little about what might cause hearing to decline, let’s talk about how to find out if your hearing isn’t up to snuff.

People with hearing loss tend to exhibit or notice one or more of these behaviors:

• Asking people to repeat themselves, particularly in settings with background noise (restaurants, stores, offices, etc.)
• Listening to television or other media at a louder volume than family or friends
• Avoiding social situations that require listening (meetings, houses of worship, parties, etc.)
• Missing the punch lines of jokes
• A decreasing level of confidence that you understand what people say
• Monopolizing conversations to avoid having to hear and understand other people
• You've started to notice tinnitus sounds, like humming, ringing, or buzzing, in one or both ears

In the video below, I further discuss how to spot the early signs of hearing loss with SeniorLiving.org's Editor-in-Chief Jeff Hoyt.

If you do any of these things more often than you change the oil in your car, you should have your hearing evaluated. There are two basic forms of checking out your hearing: a screening and an evaluation.

Making an appointment to visit the doctor can be stressful, but going to your first audiologist visit doesn't have to be! Audiologists are trained professionals who specialize in hearing and the ear, and they can provide you a thorough assessment of your hearing loss. By the end, in terms of your hearing and your knowledge of your ears, things will be crystal clear. Check out the video below to learn what to expect during your first audiologist visit.

That depends on the level of hearing loss you have. In October 2022, new legislation was passed that allows hearing aids to be sold over the counter. These over-the-counter (OTC) hearing aids are designed for adults with mild to moderate hearing loss and can be purchased online or from a drug store. Check out our guide to OTC hearing aids to learn more.

There are not currently any OTC solutions available for severe to profound hearing loss; those with higher levels of hearing loss need a prescription for hearing aids suitable to their needs. Prescription hearing aids require an in-person visit to a hearing care professional to assess your hearing needs and help you find the best solution for your hearing loss.

There are several places to buy hearing aids, including audiology clinics, retail chains, VA medical centers, and online. Below is a full list of where you can buy hearing aids:

• Private-practice audiology clinics
• Otolaryngology offices
• Manufacturer-owned retail chains such as Miracle-Ear, Beltone, Audibel, Connect Hearing, and Hearing Life
• VA medical centers
• OTC retailers such as Walgreens, CVS, Walmart, Best Buy, and Hy-Vee

Hearing aids are miniature computers that process sound digitally in real time. They offer many features that can be confusing, and there is no standard lingo for them. Instead, each manufacturer has its own catchy name. Below are the most common hearing aid features described in as generic terms as possible.

Whether you buy them OTC or get them by prescription, hearing aids can be a heavy financial burden. Keep these things in mind, before you buy:

• Only buy hearing aids that come with a risk-free trial period and free return option.
• Look for long-term warranties that cover repairs, loss, and damage claims.
• Don't buy hearing aids secondhand or from unknown manufacturers.
• Prices may vary between providers; if possible, shop around.
• Original Medicare doesn't cover hearing aids, but more and more insurance providers are getting on board with coverage. Keep your hearing needs in mind when comparing insurers, including Medicare Advantage (Part C) plans.
• To reduce their cost, consider purchasing your hearing aids from a community clinic at an audiology training program.

As you can see, getting hearing aids is not as simple as grabbing a pair of readers off the rack at the drugstore. Nor is it an insurmountable task!

Hearing is one of our primary senses because it connects us with the thoughts and emotions of those in our lives. As such, it's worth doing your research, asking hard questions, and being patient to find a solution and provider that matches your needs and personality.

After the devices hit your ears, a process or neural rewiring begins that can take up to three months, so be patient. Seek the advice of others who have walked in these new and louder shoes. On the lighter side, remember that the volume control on your new hearing aids gives you the superpower of reducing the rhetoric and amplifying the awesome!