Stop Resisting Hearing Aids and Enjoy a Better Quality of Life

Hearing loss often shows up in ordinary moments. Someone across the table seems to mumble, or the television volume keeps getting louder. These experiences become increasingly common with age. According to a U.S. government health survey, about 5% of adults ages 45-54 have disabling hearing loss, and it gets worse with age:

• 55-64 10%
• 65-74 22%
• 75 and older 55%

Untreated hearing loss also carries health risks. Research has associated it with an increased risk of cognitive decline and dementia. Another study found that participants treated for hearing loss experienced 27% fewer falls than a control group.

Despite these findings, many people hesitate to consider hearing aids because of concerns about appearance or inconvenience. Modern devices are smaller and more advanced than many expect. Understanding the signs of hearing loss and the available options can help you decide if it is time to get your hearing checked.

Do You Have Hearing Loss?

Sometimes people wonder if they really have significant hearing loss. Here are some telltale signs that you might:

• Asking people to repeat themselves frequently during normal conversations.
• Perceiving people as mumbling rather than speaking clearly.
• Missing words in TV or movie dialogue.
• Struggling to hear conversations in noisy settings like restaurants.
• Turning up the TV or phone volume higher than other people prefer.
• Missing high-pitched sounds, such as children's voices, birds, or doorbells.
• Staring at faces or reading lips to keep up with what people say.
• Pulling away from social gatherings because listening is too hard.
• Hearing a constant ringing, buzzing, or hissing sound in the ears (tinnitus).

Getting Your Hearing Checked

If you suspect hearing loss, you have several options. You could start with your primary care doctor, particularly if the problem appeared suddenly or you have symptoms such as ear pain, drainage, dizziness, or significant hearing differences between your ears. Your doctor can check for potentially treatable causes such as impacted earwax or infection.

You can also make an appointment directly with an audiologist for a comprehensive hearing evaluation. An audiologist can determine the type and degree of hearing loss and discuss whether hearing aids or other treatment might help.

A comprehensive hearing evaluation usually includes pure-tone audiometry (PTA), in which you respond to tones at different pitches and volumes. The results are plotted on an audiogram, which shows the degree and pattern of your hearing loss. The audiologist may also test how well you understand speech and perform other tests to evaluate the eardrum, middle ear, or inner ear.

Aside from the primary care physician, other professionals can also administer these tests and related tests depending on their expertise and credentials:

• Otolaryngologist - a physician, also known as an ENT, who provides medical and surgical care, diagnosis, and treatment of the ear, nose, throat, and neck.

• Audiologist – a licensed hearing-health professional trained to evaluate hearing and balance disorders. Audiologists perform comprehensive hearing tests, help patients select hearing aids, and program and adjust the devices to an individual's hearing needs. Most newly trained audiologists hold a Doctor of Audiology (Au.D.) degree.

• Hearing Instrument Specialist - a state-licensed non-MD professional who conducts basic hearing tests, fits and dispenses hearing aids, and educates individuals and their family members about their hearing loss. Training and licensing requirements vary by state.

If Hearing Aids are Recommended

If, after testing, hearing aids are recommended, what are your options? Today’s digital technology enables innovations such as sophisticated frequency-specific amplification, directional microphones, noise reduction, feedback cancellation, multiple listening programs, Bluetooth connectivity, and automated sound processing, with many of these functions being controlled from a smartphone.

Hearing aids are like eyeglasses in that, after an eye exam, you get glasses from an optometrist to properly correct your vision. However, if your eyesight is not too bad or you want to save money, a pair of “cheaters” available at many retail outlets might be enough.

In the hearing aid world, those with more profound hearing loss or those who want more features and performance will seek out more sophisticated (and expensive) devices that require precise adjustment and fitting to a person’s unique hearing needs. These higher-end products are most often offered by “hearing centers” run by audiologists. These outfits often bundle the product with a suite of services to provide maximum hearing aid performance.

Those with less severe hearing loss, or those willing to forgo advanced features, can now buy less costly over-the-counter (OTC) hearing aids. In 2022, a new FDA rule allowed adults with perceived mild-to-moderate hearing loss to purchase approved OTC hearing aids directly from stores or online. The change opened the market to more competition and gave consumers a much wider range of prices and purchasing options.

At this product level, Apple entered the OTC hearing-aid market in 2024, when the FDA authorized its Hearing Aid Feature for compatible AirPods Pro. The software allows eligible AirPods to function as OTC hearing aids for adults with perceived mild-to-moderate hearing loss.

An interesting “in-between” case is Costco and other retailers, which offer hearing testing, fitting, and follow-up services while selling prescription hearing aids at prices that can be considerably lower than those at some traditional hearing practices. Audiologists who operate hearing centers would argue that their level of service is well worth the extra cost to achieve optimal hearing aid performance.

Knowing What Type to Get

How do you know what type of hearing aid to buy? That depends on a few factors. Beyond the severity of the hearing loss, your choice may also depend on how comfortable you are making adjustments to the technology yourself, whether you want Bluetooth connectivity, how important rechargeable batteries are to you, and how much professional assistance you want.

If you have mild to moderate hearing loss, you may only need an OTC product that you can buy without a prescription.

There are two types of OTC hearing aids: self-fitting and preset. “Self-fitting” does not refer to the physical fit in your ear. Rather, it means customizing the product’s settings to your unique hearing loss. This is typically handled through a smartphone app, which not only adjusts settings but also starts the customization process by performing a simplified hearing test. Apple AirPods are an example of this type.

Preset OTC hearing aids generally offer fewer features and less adjustability. Their big advantage is that they are less complicated to use and less costly than self-fitting products. Some consumers confuse OTC hearing aids with inexpensive personal sound amplification products (PSAPs) sold online and elsewhere. OTC hearing aids, both self-fitting and preset, are FDA-regulated medical devices intended to compensate for hearing loss. PSAPs are consumer electronics intended to amplify sounds for people with normal hearing.

If your hearing loss is more serious, as diagnosed by a PTA or other tests, or if you want more expert guidance, a prescription hearing aid may be more appropriate. A hearing professional can help select a device and program to match your audiogram, communication needs, and lifestyle.

The Advantages of Hearing Aids

After testing, purchasing, and fitting, what can you expect from your hearing aids?

• Better Communication – From face-to-face meetings to noisy restaurants, hearing aids should help you understand more of what those around you are saying.

• Greater Social Connection – Hearing aids can make it easier to stay engaged with other people.

• Better Emotional Well-Being – Improved communication and greater social participation may reduce feelings of isolation and frustration and improve overall quality of life. You can also derive more enjoyment from entertainment like TV, movies, and musical events.

• Improved Safety - As noted above, research has shown that people with untreated hearing loss are more likely to fall. As a result, wearing hearing aids can help you avoid potential accidents.

Getting Past the Resistance

Many people resist getting hearing aids because they perceive it as a negative sign of aging. They also may believe that wearing and maintaining them will be an unwelcome inconvenience. These concerns are understandable, but modern hearing aids are much different from the large, conspicuous devices many people remember from earlier generations. Current versions are smaller and less noticeable, reducing the need to be self-conscious about wearing them. Also, they are easy to maintain, especially because most products feature rechargeable batteries. Other features such as automatic adjustment, Bluetooth, smartphone control, and improved sound processing can help overcome aversion to these often life-changing devices. Instead of viewing them as a sign of aging, it may be more useful to think of hearing aids as technology that helps you remain engaged and independent.

If you're frequently asking people to repeat themselves, struggling to keep up with conversations in restaurants, or annoying others with the volume level on your television, don't simply assume it's an unavoidable part of aging. Start by finding out how well you actually hear. A hearing evaluation can tell you what you're missing and whether hearing aids could help. With today's combination of professionally fitted, lower-cost retail, and OTC products, improving your hearing is easier and sometimes less expensive than it once was.

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