Best Hearing Aids in 2019

What Seniors Should Know About Hearing Aids

It’s estimated that 48 million Americans have some form of hearing loss. Thirty-three percent of individuals between the ages of 65 and 74 report hearing difficulties. By the age of 75, approximately half of all seniors report hearing loss according to the National Institute on Deafness and Other Communication Disorders.

Hearing loss is serious and can have serious repercussions. There is mounting evidence that hearing loss, left untreated, is linked to depression and a decline in memory and concentration, and perhaps even dementia.

How to Pick the Best Hearing Aid

With so many brands of hearing aids, and each brand offering sometimes more than 20 models, it can be difficult to determine which hearing aid is best for you.

Here are a few factors you may want to consider when it’s comes time to purchase a hearing aid.

• Brand accessibility – Your options may be limited if certain brands aren’t accessible in your area.
• Hearing loss severity – The hearing aid you choose should be able to provide adequate amplification. If your hearing loss is severe, you need one that can produce higher sound levels.
• Lifestyle – If your lifestyle frequently takes you to more complex listening environments, you may need to purchase a hearing aid that has higher technology levels. Advanced hearing aids are designed to meet the needs of those who have a more active lifestyle.
• Ability to hear speech in noise – Hearing aids are likely to help you in noisy environments if you perform well with speech in noise testing with amplification. This testing should be performed at every hearing evaluation.
• Important features – After discussing your listening needs and concerns, your hearing health professional should be able to help you find the hearing aid that has the features that will provide you with the greatest benefit and most satisfaction.
• Best practices – Unless your hearing care professional provides real ear measurement testing, it’s unlikely that you’ll receive the most from your hearing aid, any hearing aid, even if it’s top-of-the-line.

Keep in mind that your hearing professional has been trained to help you better understand the options that are available to you.

How Hearing Aids Work

Although it can’t reverse hearing loss, a hearing aid can drastically improve your hearing by amplifying sounds and reducing background noise. A hearing aid is composed of three parts – a microphone, an amplifier and a speaker.

Hearing aids work by collecting sound, analyzing and adjusting it to accommodate factors like levels of hearing loss, surrounding sound levels and listening requirements. Then it delivers the adapted sound back to the ears. Hearing aids have a learning curve when it comes to learning how to use them and acclimating to the way noises sound, but the payoffs can be significant.

The most common types of hearing aids and common abbreviations include:

• Open fit
• BTE – behind-the-ear
• RITA – receiver-in-the-aid
• RITE – receiver-in-the-ear
• RIC – receiver-in-canal
• ITC – in-the-canal
• ITE – in-the-ear
• CIC – completely-in-the-canal
• CRT canal receiver technology

Each type has clear-cut advantages and disadvantages. For example, smaller hearing aids may be less noticeable and enable the consumer to feel less self-conscious, but they often lack advanced functionality, such as volume control or directional mics. Additionally, seniors who have problems with fine motor skills experience difficulties changing the small batteries they require.

There are two types of hearing aids – analog and digital – and each of them works differently.

Analog Hearing Aids

With analog hearing aids, sound waves are converted into electrical signals that are then amplified. Analog/adjustable are personalized to satisfy the specific requirements of each customer. It’s programmed by the manufacturer to the audiologist’s recommended specifications. Analog/programmable hearing aids have more than one program or setting. Using a computer, the audiologist programs the device. Analog/programmable hearing aids enable you to change the program for different listening environments, quickly and easily. Analog hearing aids are typically less expensive than digital hearing aids.

Digital Hearing Aids

Digital hearing aids transform sound waves into numerical codes (kind of like a computer’s binary code) before amplifying them. Using the information contained in the code, the hearing aid is programmed to intensify some frequencies such as loudness and pitch. A hearing professional can adjust the hearing aid’s digital circuitry to accommodate certain listening environments and to further adapt the device to the consumer’s needs.

Digital Hearing Aid Styles

In a 2018 survey, 71% of Consumer Reports members said they wore the mini-behind-the-ear style. Digital hearing aids come in five common styles.

mBTE (Mini-Behind-the-Ear) Hearing Aid

The mBTE includes various types of hearing aids including RIC, RITE, RITA and CRT. With these devices, the receiver (the speaker that transfers sound to the inner ear) is located in the ear canal. These devices are attached to the ear with a thin wire and an earmold (soft material that fits snugly in the ear and channels sound) that is custom-made or with a non-custom-made dome-style ear-canal piece.

Pros

• Comfortable
• Discrete
• Larger styles are easier to insert
• Prevents plugged-up feeling

Cons

• Doesn’t permit significant amplification, particularly in low frequencies
• Moisture buildup (such as sweat) and wax can limit the life of the receiver

BTE (Behind-the-Ear) Hearing Aid

With traditional BTE hearing aids, all electronic components reside in a plastic case situated behind the ear. Sound is transmitted through tubing that connects a custom earmold located in the ear canal and its receiver to the plastic case.

Pros

• Effective for severe hearing loss
• Accommodates larger batteries for more power
• Flexible features
• Significant low- and high-frequency amplification
• Controls are easier to manipulate on larger models
• Custom-made earmold is easily cleaned
• Due to a snug fit, feedback is rare

Cons

• Vulnerable to moisture (such as sweat) and wax buildup
• Some molds are visible
• Can cause a plugged-up feeling

ITE (In-the-Ear) Hearing Aid

All electronic components reside inside the case that rests in the bowl of the outer ear.

Pros

• Fairly easy to insert
• More room for features
• Less plugged-up feeling when the device is vented

Cons

• Devices may be more visible
• Telecoil may not be as powerful (compared to BTE hearing aids)

CIC (Completely-in-the-Canal) Hearing Aid

The entire device is located deep inside the ear canal and is removed with a removal string.

Pros

• Low visibility
• Fits deep and tight in the ear canal
• When used with a phone, provides minimal feedback
• Less sensitive to wind noise

Cons

• Vulnerable to moisture and wax buildup
• Too small for a directional microphone
• May cause a plugged-up feeling, unless vented
• Small battery with short battery life
• Small size can make it hard to handle and adjust

ITC (In-the-Canal) Hearing Aid

Although not as discrete at the CIC hearing aid, the ITC hearing aid remains barely visible.

Pros

• Barely visible
• Less plugged-up feeling than CIC hearing aid
• Larger devices may include directional microphones

Cons

• Some people experience discomfort
• Vulnerable to moisture (such as sweat) and wax buildup
• May cause a plugged-up feeling, unless vented
• Small battery with short battery life
• Small size can make it difficult to handle and adjust

Adjusting to the Hearing Aid

When you first begin to wear a hearing aid, noises can sound strange to you. Remember to give yourself time to adjust to your hearing aid. In the long run, it will be worth it. Do everyday activities as you adjust to your new hearing aid. Some sounds might seem loud at first because your brain is processing sounds it hasn’t heard in a while. If you’re not sure your hearing aid is working as well as it should, consider taking it in for an adjustment. This is especially important if your ear feels clogged or your voice sounds strange.

Hearing Aid Care and Maintenance

Ongoing maintenance is required to keep your hearing aids working at the levels they are intended. Make sure to select a hearing aid company that backs their products, provides customer support, offers ongoing service and provides a warranty or guarantee. Ongoing service ensures your hearing aids will better deliver the sounds you need to hear.

Proper care and maintenance will extend the life of your hearing aid; therefore, you should make a habit to:

• Clean hearing aids as instructed on a daily basis
• Turn hearing aids off when not in use
• Keep hearing aids away from moisture and heat
• Don’t use hairspray or other hair care products while wearing hearing aids
• Immediately replace dead batteries
• Keep hearing aids and their batteries away from pets and children

Approximately every seven to ten years, your hearing may change. This means that your hearing aids may need to be reprogrammed to continue providing the best hearing experience.

Top Features of Hearing Aids

Hearing aids no longer have to be clunky devices that whistle, pop and distort the sound of your voice. If you haven’t looked at hearing aids recently, you may be pleasantly surprised to learn that modern hearing aids have many incredible features, and with some models, someone may not be aware that you’re even wearing one. Today’s hearing aid is smaller and more user-friendly than ever before.

Fifty-three percent of people who wear hearing aids indicate that rechargeable batteries are most important to them when looking for a new hearing aid. Forty-two percent indicate that automatic noise level adjustment is important. Forty-three percent felt that tinnitus masking or smartphone capabilities are very important. Multiple program settings were important to 41%. Thirty-seven said wireless connectivity to other devices was important to them.

Let’s look at some of the top features that make wearing a hearing aid so much more different than it was just a few years ago, then you decide which is most important to you.

Digital Noise / Feedback Reduction

Provides a crisp, natural listening experience. Filters out background noise from speech and the environment, preventing communication issues while also providing the rich sounds of nature.

Directional Microphones

Directional microphones make the person talking right (the audio signal) in front of you louder than noises coming from your rear or sides. They work best when you’re near the sound source. With directional mics you can tune out the noise around you, isolating the sound of the person you are talking to. Advanced models can focus behind and to your sides as well. Directional mics come with a negative – they’re prone to pick up wind noise.

Multiple Channels

Hearing aids featuring multiple channels allow you to customize the equalizer in the hearing aid for peak listening quality in a particular environment. After saving the setting for later use, you simply return to the saved channel when you find yourself in the same or a similar environment. This reduces the time you find yourself adjusting your hearing aids in public.

Bluetooth Streaming

These features allow you to connect to countless audio sources with the push of a button, causing high-quality audio to be streamed directly into your ear. This is accomplished by pairing your hearing aids with a smartphone, television, laptop or other device using built-in Bluetooth technology.

Telecoil / T-Switch

The Telecoil / T-Switch feature enables you to connect to an audio induction loop, or hearing loop, in places of worship, museums, sporting arenas, concert halls, conference rooms, taxis, subway trains and more. Consider asking for a manual T-switch which will enable a seamless connection to loop systems.

The Assisted Listening Device Locator provides a list of locations in the United States that offers hearing loops.

Automatic Programming

Automatic programming allows your hearing aid to analyze the acoustics of an environment and make automatic adjustments. With the help of AI (Artificial Intelligence), your hearing aid learns your lifestyle and listening habits, then makes automatic adjustments for you, providing crystal-clear sound. Automatic Programming is currently only available on higher-end devices.

Binaural Processing

When you’re fitted with two hearing aids, binaural processing causes both devices to communicate and synchronize their settings with each other. For example, if the wind is blowing in your left ear, both hearing aids will mirror the clearer audio signal of the right ear into both devices.

Feedback Suppression

Feedback suppression, also referred to as digital feedback reduction, helps to suppress high-pitched whistling sounds. Most modern devices have this feature, but it’s more effective for some devices than others. It helps to minimize feedback when your device is slightly dislodged when you move your jaw or when close to a telephone. Some users experience greater comfort, better sound and more venting. A properly fitted hearing aid is less likely to have feedback.

Digital Noise Reduction

Digital Noise Reduction blocks out some background noise in noisy environments. It doesn’t work in all situations.

Costs and Paying for Hearing Aids

Hearing aids are a serious investment, some costing as much as $10,000 and more per pair depending upon which brand, device and features you choose. The overall average price paid for a single hearing aid is around $2,300. That’s $4,600 for a pair. Most people require a pair.

Be sure to also look for hidden costs. When comparing hearing aids and their brands, check out the following to make sure you understand the real cost:

• Warranties – what is covered and length of coverage
• Trial periods
• Cost of ongoing office visits and services
• Features

Be sure to ask about bundled services. It might save you some money.

Medicare doesn’t cover the cost of any hearing aid devices. They do, however, cover the cost of diagnostic evaluations for specific diagnostic purposes if they’re ordered by a doctor to assist in the development of a treatment plan. Some Medicare supplement plans and Medicare Advantage plans do offer limited hearing aid benefits. Additionally, some states provide medical assistance for hearing aids and veterans may be eligible to receive hearing aids free of charge.

Some organizations, such as the Miracle-Ear Foundation and the Starkey Hearing Foundation, provide hearing aids to those who cannot financially afford the cost of the devices. Other nonprofit organizations offer financial assistance in the purchase of hearing aids. And others may provide refurbished or used devices.

The National Institute on Deafness and Other Communication Disorders (NIDCD) Information Clearinghouse provides information and resources, including financial assistance for hearing aids.