Hearing Aids

What Do You Need To Know About Hearing Devices?

Buying hearing aids is a big decision, it is also an intimidating prospect for someone new to the process. There is a lot of information available but quite often, it is technobabble or difficult to understand for the uninitiated. So we decided to try and help out with a clear explanation of what the process is and what you need to know to make you a better hearing aid buyer. Buying hearing devices is a process, during that process, you will inevitably face information that is technical in nature and for the un-initiated almost seems like it is gibberish. Not just that, as this is your first time to enter into this particular process, you have no terms of reference, nothing to measure it against and no deep knowledge of what should be done. We want to change that. Before we delve into the high-level information that you need about hearing aids, we want to address a couple of things including:

• Important Considerations Before Doing Anything
• When Do You Need Hearing Aids?
• Should You Get Hearing Aids?
• Do You Need a Prescription For Hearing Aids?
• Where To Buy Hearing Aids
• How Much Should Hearing Aids Cost
• The Hearing Test and What Should Happen
• What Are The Financial Details You Need to Know

I will then move onto high-level information of hearing aids, the types, the models and what you need to consider. Each element of the information here will have a link to deeper information on our site so you can get a deeper understanding of the concepts if you like.

Important Considerations

When looking for a hearing aid,there are a couple of important considerations you need to understand before doing anything. We will cover some of them in a slightly deeper manner a little further along in the article. They are as follows:

For people in the UK

• Get a checkup. Have a chat with your doctor to rule out any medical causes of hearing loss, such as earwax or an infection. Then, have your hearing tested by a hearing specialist.
• In the UK, all hearing care professionals are regulated by the HCPC. Many private hearing care professionals in the UK are RHADs (Registered Hearing Aid Dispensers) who qualified under the Hearing Aid Council (now defunct). There are now also foundation level degree hearing aid dispensers who have studied a two year part time foundation degree to qualify to fit hearing aids. On top of those, we have BSC and Masters educated Audiologists who generally work in the NHS but also may undertake private consultation.
• Find a reputable Hearing Care Specialist. If you don't know a good hearing care specialist, ask your doctor can they give you a referral. Alternatively, research local hearing care specialists online, look at their reviews on Google. Ask your friends if anyone knows someone with hearing aids that would be willing to share their experiences and steer you the right way.
• Ask the hearing care professional do they undertake Real Ear Measurements, they are the gold standard in hearing aid fitting, if they don't, tell them you will go somewhere else.
• Ask about trial periods. Generally, in the UK you can usually get a hearing aid with a trial period. It may take you a while to get used to the device and decide if it's right for you. Have the hearing care professional put the details in writing. Ask them if there is a cost for a trial, whether this amount is credited toward the final cost of the hearing aid, and how much is refundable if you return the hearing aid during the trial period.
• Think about future needs. It is really important that the hearing aid you've chosen is capable of increased power so that it will still be useful if your hearing loss gets worse.
• Ask about the warranty. Make sure the hearing aid includes a warranty that covers parts and labor for a specified period. In general, the cost of hearing aids in the UK cover all your future visits, but make sure that is the case.

• Plan for the expense. The cost of hearing aids varies widely — in the UK depending on technology level and the practice you attend. Prices can vary from about £800 to a couple of thousand per hearing aid. Professional fees, remote controls, hearing aid accessories and other hearing aid options may cost extra. Find out everything you need to know and express your needs and expectations.

  The NHS provides free hearing aids and if you are a veteran who has lost their hearing because of your service, the British Legion Veterans Hearing Fund can and will pay for top of the range hearing aids for you privately.

For people in the USA

• Get a checkup.Have a chat with your doctor to rule out any medical causes of hearing loss, such as earwax or an infection. Then, have your hearing tested by a hearing specialist (audiologist).
• In the USA, there are two types of hearing care professionals, Hearing Instrument Specialists and Audiologists. Hearing Instrument Specialists are just that, they are educated to test hearing and fit hearing aids. Audiologists are in fact Doctors and have undergone extensive education in order that they can offer clinical and diagnostic services as well as being able to fit hearing aids. In essence, Audiologists are better educated, having said that, it doesn't mean they are necessarily superior. We have heard as many horror storys about Audiologists as we have about Hearing Instrument Specialists.
• Find a reputable Audiologist or Hearing Instrument Specialist. If you don't know a good hearing care specialist, ask your doctor can they give you a referral. Alternatively, research local hearing care specialists online, look at their reviews on Google. Ask your friends if anyone knows someone with hearing aids that would be willing to share their experiences and steer you the right way.
• Ask the hearing care professional do they undertake Real Ear Measurements, they are the gold standard in hearing aid fitting, if they don't, tell them you will go somewhere else.
• Ask about a trial period. You can usually get a hearing aid with a trial period. It may take you a while to get used to the device and decide if it's right for you. Have the hearing care professional put the details in writing. Ask them if there is a cost for a trial, whether this amount is credited toward the final cost of the hearing aid, and how much is refundable if you return the hearing aid during the trial period.
• Think about future needs. It is really important that the hearing aid you've chosen is capable of increased power so that it will still be useful if your hearing loss gets worse.
• Ask about the warranty. Make sure the hearing aid includes a warranty that covers parts and labor for a specified period. Ask the professional if the price includes office visits or professional services in the warranty.

• Plan for the expense. The cost of hearing aids varies widely — in the USA depending on technology level and the practice you attend. Prices can vary from about $1,500 to a few thousand dollars per hearing aid. Professional fees, remote controls, hearing aid accessories and other hearing aid options may cost extra. Find out eberything you need to know and express your needs and expectations.

  Most insurance in the USA does not cover the cost of hearing aids — check your policy to be sure. Medicare doesn't cover the cost of hearing aids. In many states across the US, private insurers are required to pay for hearing aids for children. If you're a veteran, you may be able to get your hearing aid at no cost through the Veterans Administration (VA).

For people in Ireland

• Get a checkup.Have a chat with your doctor to rule out any medical causes of hearing loss, such as earwax or an infection. Then, have your hearing tested by a hearing care professional.
• In Ireland, many hearing care professionals have become qualified through education provided by I.S.H.A.A (Irish Society of Hearing Aid Audiologists). There are now also foundation level degree hearing aid dispensers who have studied a two year part time foundation degree (usually in the UK) to qualify to fit hearing aids. On top of those, we have BSC and Masters educated Audiologists who generally work in the HSE but also may undertake private consultation.
• Find a reputable hearing care professional. If you don't know a good hearing care specialist, ask your doctor can they give you a referral. Alternatively, research local hearing care specialists online, look at their reviews on Google. Ask your friends if anyone knows someone with hearing aids that would be willing to share their experiences and steer you the right way.
• Ask the hearing care professional do they undertake Real Ear Measurements, they are the gold standard in hearing aid fitting, if they don't, tell them you will go somewhere else.
• Ask about a trial period. Some professionals in Ireland offer trial periods, but many offer money back guarantees. It may take you a while to get used to the device and decide if it's right for you. Have the hearing care professional put the details in writing. Ask them do they offer a trial, is there a cost for a trial, and whether this amount is credited toward the final cost of the hearing aid. If they offer a money back guarantee, ask exactly how much is refundable if you return the hearing aid during the period.
• Think about future needs. It is really important that the hearing aid you've chosen is capable of increased power so that it will still be useful if your hearing loss gets worse.
• Ask about the warranty. Make sure the hearing aid includes a warranty that covers parts and labor for a specified period. In general, the cost of hearing aids in Ireland cover all your future visits, but make sure that is the case.

• Plan for the expense. The cost of hearing aids varies widely — in Ireland depending on technology level and the practice you attend. Prices can vary from about €800 to a few thousand euros per hearing aid. Professional fees, remote controls, hearing aid accessories and other hearing aid options may cost extra. Find out eberything you need to know and express your needs and expectations.

  Most private medical insurance in Ireland does not cover the cost of hearing aids — check your policy to be sure. There is a grant available from the Department of Social Protection for hearing aids worth up to one thousand euro for two. Eligibility is based on your social insurance contributions. The HSE does offer public hearing aids to medical card holders and children.

When Do You Need Hearing Aids?

There is a hierarchy of signs that you need hearing aids, I have based them on the impact of hearing problems in your life. If you have reached number one, you are truly a stubborn person and you need to have a chat with yourself. 

1. You Have Isolated Yourself Because Of Your Hearing
2. You Have Withdrawn From Social Activities
3. You Don't Enjoy Your Social Activities Anymore Because Conversation is Too Difficult
4. You Have Real Problems Understanding Speech in Noise
5. You Have Problems Following A Conversation When Two or More People Are Talking
6. Your Family (or Neighbours) Complain The TV is Too Loud
7. You Say "What" or "Repeat That" a lot
8. You Think People Are Mumbling (they aren't)
9. You Find Speech In-Distinct

If you even get to number 6 on the above list, you need to go and see a professional. Hearing loss can be a bit difficult for the person who suffers with it to recognise. Our cultural understanding of hearing loss is formed by what we see on TV. Most people think hearing loss is about volume, speak up speak up! It normally isn't. In most cases, hearing loss is about the clarity of speech.

Hearing loss is generally not about volume, it is more likely about clarity, you can hear the voice, you just don't know what they are saying

You hear them speaking but what they say isn't clear. Your perception is that they are mumbling or they have bad diction. Sorry about that, but they probably aren't, and they probably don't. You are just not hearing the high-frequency consonant sounds in speech that deliver sharpness. If your inability to make out speech clearly is getting to the stage that it is having an impact on the enjoyment of your life, it is time to get hearing aids.

High-frequency hearing and the consonants in speech

More often than not, hearing loss is more severe in the high-frequency region. This means that people have a hard time hearing the consonants in speech. Those sounds are imperative to understand what words are. When you aren't hearing them it sounds like everyone is mumbling. You can read an absolutely fantastic article that was written on the blog called Common Words That Are Difficult To Understand With Hearing Loss which explains it well.

Should You Get Hearing Aids?

If you are having problems hearing speech that stem from hearing loss, hell yes! Don't waste time, time and social contact are precious, too precious to waste. I have heard all the excuses and all of the lies that we tell ourselves, in fact, I wrote an article about it, Why You Don't Need Hearing Aids, The Lies You Tell Yourself. Have a read of it and see if you recognise a few of yours.

Life is for damn living, don't rob yourself of happiness and the human touch because you have some out dated ideas about hearing aids. 

Do You Need A Prescription For Hearing Aids?

There are two separate answers to this question, the answers are different because of the different contexts of prescribed. So answer one: Yes, for a hearing aid to work well for you it needs to be prescribed. The term prescription, when used for hearing aids is really more about customisation of any hearing aid for you, your hearing loss and your lifestyle. When I speak about prescription in this context, really what I am speaking about is the instructions for customisation of sound. It is this customisation that allows a hearing aid to deliver exactly what you need to hear better. 

Answer two: In the normal context of prescribed, where only a doctor can prescribe medicine. Only a hearing care specialist can prescribe hearing aids in most countries. In order to provide hearing aids, they need to be qualified to do so. 

Where To Buy Hearing Aids

So, we get asked this question a lot, where should I purchase hearing aids and what is the best place to get hearing aids. The to that question depends, where are you, what do you want and are you willing to go private? In the UK, Ireland and other places across the world hearing aids are made available via some sort of public health scheme. The choice can be limited and the service may not be great, but if you have no budget, it is the best option. However, in the USA, there is really no public health service offering apart from the VA (Veterans Administration) who only deal with Veterans. Your only real avenue for hearing aids in the US, is to buy them privately.

Private Hearing Aids

If you are happy to buy hearing aids, start researching private hearing aid sellers in your area. While online searches are a good place to start, make sure you pay attention to online reviews of Practices. Get a good idea of how well they do their jobs. The secret to success with hearing aids is gold standard hearing aid fitting and strong aftercare. Make sure that any place you are thinking of buying hearing aids from has a reputation for that. You can take a look at the Hearing Aid Know Network of trustworthy hearing aid centres here. We stand by them as good places to buy hearing aids. 

How Much Should Hearing Aids Cost?

There is no real rule of thumb on this, different hearing aid outlets charge different prices for the same hearing aids quite often. The price charged normally depends on the level of service provided. In hearing aids, the cheapest option may not always be the best option. Having said that, neither might be the most expensive option. Do your research, look at the price spread and research the reputation of the Practice. I am certainly not the cheapest provider of hearing aids in Ireland. Nor am I the most expensive. However, I set my hearing aid prices on what I deliver and you can expect that to be delivered. You should expect the same from whomever you buy and whatever the price you pay. As a rule of thumb, the average cost of premium level hearing aids in Ireland, the UK and the USA appears to be as follows: 

• Average Hearing Aid Price in Ireland: €2000.
• Average Hearing Aid Price in the UK: £2000.
• Average Hearing Aid Price in the USA: $3000.

The Hearing Test

We have an in-depth run-down on the hearing test and it's components here. It is worthwhile to give it a quick run through of buying hearing aids in mind. The test that is offered to you is important, firstly, it shows how competent the provider is and how interested they are in actually helping you with your problems. The hearing test is the foundation of everything else so it needs to be done correctly and thoroughly. 

Why is a good hearing test important?

 In order to make really good decisions about what is right for you, any professional needs all of the information. A comprehensive hearing test is the basis of any recommendation they will make. A comprehensive hearing test is an in-depth examination of the complete function of your hearing. During the consultation, it is also important that the professional gets a clear understanding of your lifestyle and the impact that your hearing loss is having.

I can't emphasise this enough, if I don't understand your lifestyle needs, how am I to recommend a hearing aid to suit them? With this information they can make good recommendations for you, your hearing loss and your lifestyle needs. They can also explain clearly why one technology level of hearing aids is more suited for you than another. If they don't, ask them, they will have no issues explaining it. 

What Should Happen At A Hearing Test?  

The hearing test involves several different parts that allow a full understanding of your ability to hear and how it is affecting you in your daily life. Those parts should be, otoscopy, case history. lifestyle needs, audiometry, speech in noise testing, possible middle ear analysis. Each of these tests is explained fully on our hearing test page. 

During the testing procedure, the professional will give you a full explanation of all of the tests undertaken and why they are performing them. During the consultation, they should ask you about the effect of hearing loss on every aspect of your life. This is an important part of the assessment because it allows them to make better recommendations. If they do not have a good understanding of your needs, they cannot recommend what is best for you. 

Remember, the test is to find the very softest sound you can hear, so no matter how soft it is, even if you only think you hear it, respond. Don't worry too much, an experienced professional will work it all out.

What is The Audiogram?

The audiogram is a simple graph where test results will be recorded, this document details your hearing test results by frequency. It is a record of the quietest possible sounds that you can hear across the different frequencies that are important for speech. It allows you and the professional to understand what type of hearing loss you have. It is also the basis of the prescription that is programmed into any hearing aids you may purchase. The professional will normally explain:

• What your audiogram means
• What type of hearing loss you have
• Why some sounds are audible but not understandable
• What a hearing aid can do for you and most importantly what it can’t do for you 

If they don't explain it, you should ask them, it will give you a better understanding of your hearing loss and why you are having the problems you are. 

What are the Financial Details You Need To Know?

Hearing aids are expensive items, more than that they are devices that should make a real difference to your life for many years. So this is an important long-term purchase, it is important that all of the financial details are very clear. A professional should provide you with a written contract agreement. The contract agreement should cover the cost of the hearing aids, the length of the trial period if any, the money back guarantees, the included warranty and any long-term service and back-up you are entitled to. As a friend of ours is fond of saying, if it isn't written down, it never happened. 

What are Hearing Aid Trial Periods?

Trial periods are different to Money Back Periods, trial periods are exactly that, the professional will make an agreement with you to trial hearing aids. During the trial, you will be expected to use them to get a clear understanding of what they can deliver for you. You will also be expected to record your perceptions in order that the professional can make any changes that are needed. A trial period gives you the opportunity to decide if a hearing aid is for you. 

What are Money Back Guarantees?

Most privately purchased hearing devices are supplied under a money back period or guarantee. This allows you to make a decision about the aids during a set period when they can be returned and your money refunded. The length of period and the amount of money that is returned varies from company to company and country to country. The professional should give you written information about the following:

• Money Back Guarantee and refund policy
• Money Back period, return time limits
• Fees charged if the hearing aid or aids are returned within the period
• Whether the period is suspended if the aid breaks down during the trial period and needs to be returned for repairs

What exactly should be on your contract?

Your contract with the professional is an important document, you need to make sure you receive a copy of that contract and keep it safe. The document should cover all of the terms and conditions and the ongoing services to be provided to you. it should cover:

• The cost of the hearing aid
• What services and number of follow-up visits are included in the cost
• Date and place of sale
• Trial period if any, Money Back Guarantee period and refund policy
• Money Back period, return time limits
• Fees charged (if any) if the hearing aid or aids are returned within the period
• Whether the period is suspended if the aid malfunctions and needs to be returned for repairs
• Information on any warranties provided by the hearing device manufacturer

Ask Us Anything

If there are any questions that you have that we haven't answered or if there is further guidance you think we should offer, get in touch with us. 

Contact Us

Hearing aids: How to choose the right one

There are many types of hearing aids out there. So which is best for you?

Perhaps you've thought about getting a hearing aid, but you're worried about how it will look or whether it will really help. It may help ease your concerns to know more about:

• How hearing aids work
• The hearing aid options available
• What to look for when buying a hearing aid
• How to get used to it

The first and most important thing you need to know is that Hearing aids can't restore normal hearing. However, a well-fitted set of hearing aids can improve your hearing and allow you to live a full and happy life.

How hearing aids work

Hearing aids use the same basic parts to carry sounds from the environment into your ear and make them louder. Nearly all modern hearing aids are digital, in fact, it is nearly impossible to get the old type analogue hearing aids now.

All hearing aids are battery powered, the battery may be the traditional zinc-air battery or a rechargeable battery that can be lithium-ion or silver-zinc. Small microphones collect sounds from the environment. A computer chip with an amplifier converts the incoming sound into digital code. It analyzes and adjusts the sound based on your hearing loss, listening needs and the level of the sounds around you. The amplified signals are then converted back into sound waves and delivered to your ears through speakers.

Hearing aid styles

The following are common hearing aid styles, beginning with the smallest, least visible in the ear. Hearing aid designers keep making smaller hearing aids to meet the demand for a hearing aid that is not very noticeable. But the smaller aids may not have the power to give you the improved hearing you may expect.

Invisible in canal (IIC)

An invisible-in-canal hearing aid is custom moulded to fit deep inside your ear canal. It is designed for mild to moderate hearing loss.

An invisible-in-canal hearing aid:

• Is the smallest and least visible hearing aid type
• Is less likely to pick up wind noise
• Uses size 10 batteries, which have a shorter life and can be difficult to handle
• Doesn't contain extra features, such as volume control or a directional microphone
• Is susceptible to earwax clogging the speaker

Completely in canal (CIC) or mini Canal

A completely-in-canal hearing aid is custom moulded to fit inside your ear canal. It improves mild to moderate hearing loss in adults.

A completely-in-canal hearing aid:

• Is one of the smallest and least visible type
• Is less likely to pick up wind noise
• Uses size 10 or 312 batteries, depends on the size of your ear canal.
• Some manufacturers can get directional microphones and a programme button on a CIC
• Is susceptible to earwax clogging the speaker

In the canal

An in-the-canal (ITC) hearing aid is custom moulded and fits partly in the ear canal. This style can improve mild to moderate hearing loss in adults.

An in-the-canal hearing aid:

• Is less visible in the ear than larger styles
• Includes features that won't fit on completely-in-the-canal aids such as a programme button, volume control, however, they may be difficult to adjust due to its small size. They would normally be able to have directional mics and even a telecoil.
• Modern ITCs may be Bluetooth enabled depending on the manufacturer
• Is susceptible to earwax clogging the speaker

In the ear

An in-the-ear (ITE) hearing aid is custom made in two styles — a full shell which fills the bowl-shaped area of your outer ear and a half shell which fills only the lower part. Both are helpful for people with mild to severe hearing loss.

An in-the-ear hearing aid:

• Includes features that don't fit on smaller style hearing aids, such as volume control and programme button
• Will always have directional microphones and a telecoil
• Modern ITEs may be Bluetooth enabled depending on the manufacturer
• Is the easiest to handle of all the custom hearing aids
• Uses a larger battery usually a size 13 for longer battery life
• Is susceptible to earwax clogging the speaker
• May pick up more wind noise than smaller devices
• Is more visible in the ear than smaller devices

Behind the ear

A behind-the-ear (BTE) hearing aid hooks over the top of your ear and rests behind the ear. A tube connects the hearing aid to a custom earpiece called an earmold that fits in your ear canal. This type is appropriate for people of all ages and those with almost any type of hearing loss.

A behind-the-ear hearing aid:

• Traditionally has been the largest type of hearing aid, though some newer mini designs are streamlined and barely visible
• Is capable of more amplification than are other styles
• May pick up more wind noise than other styles

Receiver in canal or receiver in the ear

The receiver-in-canal (RIC) and receiver-in-the-ear (RITE) styles are similar to a behind-the-ear hearing aid with the speaker or receiver in the canal or in the ear. A tiny wire, rather than tubing, connects the pieces. These devices are suitable for hearing losses from mild to severe to profound.

A receiver-in-canal hearing aid:

• Has a less visible behind-the-ear portion
• Is susceptible to earwax clogging the speaker

Open fit

A traditional open-fit hearing aid is a variation of the behind-the-ear hearing aid with a thin tube with an open type rubber tip at the end. This style keeps the ear canal very open, allowing for low-frequency sounds to enter the ear naturally and for high-frequency sounds to be amplified through the hearing aid. This makes the style a good choice for people with mild to moderate hearing loss. Most RICs can be fitted with an open tip, so they can also be fitted in an open configuration.

An open-fit hearing aid:

• Is less visible
• Doesn't plug the ear like the small in-the-canal hearing aids do, making your own voice sound better to you
• May be more difficult to handle and adjust due to small parts

Hearing Aid features

Some hearing aid features improve your ability to hear in specific situations, features vary depending on the level of technology but here is the headline hearing aid features available:

• Noise reduction. Most modern digital hearing devices have some sort of noise reduction available. The amount of noise reduction varies depending on the technology level of the hearing aids.
• Directional Microphones. Nearly all modern hearing devices have directional microphones with the exception of the very smallest hearing aids. Directional mics are designed to help pick up of sounds coming from in front of you with some reduction of sounds coming from behind or beside you. Some modern hearing aids are capable of focusing in one direction such as to the front, either side or behind you. Directional microphones can improve your ability to hear when you're in an environment with a lot of background noise.
• Rechargeable batteries. Some modern hearing aids have rechargeable batteries. This can make maintenance easier for you by eliminating the need to regularly change the battery. You can read more about rechargeable hearing aids here.
• Telecoils. Telecoils make it easier to hear when talking on a telecoil-compatible telephone. The telecoil can be programmed to eliminate the sounds from your environment and only pick up the sounds from the telephone. Telecoils also pick up signals from public induction loop systems that can be found in some churches, public buildings or theatres, allowing you to hear the speaker, play or movie better.
• Wireless connectivity. Increasingly, hearing aids can wirelessly interface with certain Bluetooth-compatible devices, such as cellphones, music players and televisions. With some hearing devices you will need to use an intermediary device to pick up the phone or other signal and send it to the hearing aid. However, there are many Bluetooth hearing aids available that will connect directly.
• Remote controls. Some hearing aids come with a remote control, so you can adjust features without touching the hearing aid.
• Direct audio input. This feature allows you to plug in to audio from a television, a computer or a music device with a cord. This type of feature is only available on BTEs
• Variable programmes. Most hearing aids can store several preprogrammed settings for various listening needs and environments.
• Synchronization. For an individual with two hearing aids, the aids can be programmed to function together so that adjustments made to a hearing aid on one ear (volume control or program changes) will also be made on the other aid, allowing for simpler control.

Getting used to a hearing aid

Getting used to hearing aids takes time. Even your own voice sounds different when you wear a hearing aid. However, you will notice that your ability to hear will continue to improve.

When first using a hearing aid, keep these points in mind:

• Hearing aids won't return your hearing to normal. Hearing aids can't restore normal hearing. They can improve your hearing by amplifying soft sounds.
• Allow time to get used to the hearing aid. It takes time to get used to your new hearing aid. But the more you use it, the more quickly you'll adjust to amplified sounds.
• Practice using the hearing aid in different environments. Your amplified hearing will sound different in different places.
• Seek support and try to stay positive. A willingness to practice and the support of family and friends help determine your success with your new hearing aid. You may also consider joining a support group for people with hearing loss or new to hearing aids.
• Go back for follow-ups. Providers may include the cost of one or more follow-up visits in their fee. It's a good idea to take advantage of this for any adjustments and to ensure your new hearing aid is working for you as well as it can.