Educational Consumer Tips
Better Business Bureau
Impaired hearing is the most common health problem in the United States; affecting millions of people. Some people with hearing loss can be helped by medical or surgical treatment. Other people with hearing loss receive considerable benefit from hearing aids.
The Better Business Bureau offers this booklet to help the person with a hearing problem make an intelligent decision about purchasing a hearing aid.
Types Of Hearing Loss
There are two major types of hearing loss involving the inner, middle, or outer ear. In conductive hearing loss, the problem lies in the outer or middle ear. The first sign of conductive loss may be that sounds seem muffled, or the quality of sound may seem the same, but loudness is reduced.
Conductive hearing problems can be caused by any number of things: wax may be blocking the ear canal; the tissue lining the middle ear may be infected; the eardrum may be punctured; or the tiny bones in the middle ear may not move properly. Fortunately, many of these problems can be treated by medical or surgical measures.
Sensorineural or "nerve" hearing loss is generally not medically correctable and hence is the type most commonly offset by use of a hearing aid. Here the problem is in the inner ear and is the result of damage to the hair cells, nerve fibers, or both. There is a loss of loudness plus distortion of sound. It is possible to have adequate loudness but severe sound distortion.
The individual with nerve hearing loss may have difficulty understanding speech, even when it is loud enough to be heard normally. This is especially true in noisy backgrounds. Another common complaint is difficulty in hearing certain sounds such as a watchtick or the high notes of a violin.
There are many causes of sensorineural hearing loss, including: illnesses accompanied by high fever; birth defects; drugs; longterm exposure to noise; head injuries; and the aging process itself. There is no cure for sensorineural hearing loss, except in rare cases. More than 95% of all hearing aids are worn by people who have sensorineural hearing loss.
Where To Go For Help
If you suspect a hearing loss, the first step is to consult a medical specialist. The ear specialist, called an otologist or otolaryngologist is a physician who specializes in the diagnosis and treatment of hearing problems. This physician will seek to determine the cause of your hearing problem and may be able to help you through medical or surgical treatment. A medical evaluation of your hearing is always the first step before selecting or purchasing a hearing aid.
The medical ear specialist may refer you directly to a clinical audiologist or a hearing aid dispenser. The clinical audiologist is extensively trained to measure hearing and to help rehabilitate and counsel people with hearing loss. If the clinical audiologist's test indicates that a hearing aid may benefit you, he may refer you to a hearing aid dispenser. Some clinical audiologists are also hearing aid dispensers.
A hearing aid dispenser may also test your hearing, demonstrate the hearing aids he sells, help you select a hearing aid, take an impression of your ear for the mold, and have repairs of the aid made afterward as needed.
Most states have established regulations, qualifications or standards for medical ear specialists, audiologists and those dispensing hearing aids.
In many areas, there are speech and hearing centers associated with hospitals or universities that can provide assistance in the evaluation and selection of a hearing aid. In these centers you will find a wide range of services which may include an examination by a medical ear specialist, hearing test and a hearing aid evaluation by a clinical audiologist, and additional services such as lip reading training and counseling.
Unless you are immobilized or live in a very remote area, avoid purchasing a hearing aid from an itinerant salesman or through the mail. You require expert assistance in selecting an aid. You may need to make several visits before the ear mold fits comfortably, and you may need continuing assistance for several months in learning to adjust to the aid. This help can rarely be provided by an itinerant salesman. It cannot be provided at all through the mail. Furthermore, the sale of hearing aids by mail is prohibited in some states.
Food and Drug Administration regulations, 21 CFR 801. 421, require that a hearing aid dispenser:
Not sell you a hearing aid unless you have a physician's statement that your hearing loss has been medically evaluated and you may be considered a candidate for a hearing aid.
However, if you are 18 or older and have carefully considered the state of your own health, you may waive the medical evaluation. In such cases, the dispenser must:
- inform you that the waiver is not in your best health interest,
- not in any way actively encourage the waiver, and
- afford you an opportunity to sign a written statement of waiver.
In addition, the hearing aid dispenser must provide you with a copy of a user instructional booklet before you buy an aid, and review its contents with you.
No type of medical treatment or remedies may be offered or provided by a hearing aid dispenser unless he/she is a licensed physician.
The Hearing Aid
The hearing aid consists of:
- A microphone which picks up sound waves and converts them into electrical signals;
- An amplifier which increases the strength of the signal;
- A battery which provides the energy to operate the hearing aid;
- A receiver which changes the electrical signals back to sound waves; and
- A specially fitted ear mold which connects the receiver to the ear canal.
A hearing aid which has been fitted properly will not cause additional loss, will not prevent additional loss, nor will it cure an existing hearing loss.
How To Select A Hearing Aid
There is no single hearing aid suitable for all types of hearing loss. The type of aid best for you will depend on the nature and extent of your hearing loss.
In selecting a hearing aid, you should not be overly influenced by the price or the appearance of the aid. An inexpensive hearing aid of poor quality is of no use if it constantly needs to be repaired.
On the other hand, you may find satisfaction with an aid that is moderately priced. A tiny hearing aid that is inconspicuous will have little value if it does not amplify sound adequately to suit your needs. The main goal is to select an aid that will provide you with maximum help.
Types Of Hearing Aids
A hearing aid can be used for only one ear ("monaural" hearing aid); ortwocomplete hearing aids, one for each ear, can be used ("binaural" hearing aid system).
There are four basic types of hearing aids:
- The "intheear" aid which fits directly into the ear, with part of it extending into the ear canal. These aids have no external wires and are light in weight. The "intheear" aid is generally effective for very mild to severe hearing loss. An ear mold is not required; the aid is shaped to fit the individual's ear canal.
The "canal" hearing aid is a miniature "in theear" aid which is useful for mild to moderate losses.
- The "behindtheear" aid is a small hearing aid which fits snugly behind the ear. The microphone, amplifier and receiver are in one unit connected to the ear mold by a short plastic tube. This type of aid is suitable for hearing losses ranging from mild to severe.
- The "eyeglass" type of hearing aid is similar to the "behindtheear" model except that the aid is built into an eyeglass frame. Boneconduction hearing aids are also available in the "eyeglass" style. In boneconduction, sounds are conducted by vibration through a unit placed against the mastoid bone behind the ear.
- The "body" aid has a larger microphone, amplifier, and power supply in a case which can be carried in a pocket and attached directly to the ear mold. The "body" aid is most suitable for people with severe to profound hearing loss.
Hearing Aid Adjustment
Some individuals are able to put on their hearing aid and hear better at once, while others need time to adjust to the hearing aid. When using a hearing aid for the first time, some people may decide that a hearing aid is a nuisance and a bother and not worth the trouble. As a result, money may be wasted because the hearing aid is purchased and not used. Adjustment is the key here.
To give you adjustment time, most hearing aid dispensers offer a trial period. This period can range from two weeks to several months. This will give you an opportunity to use the aid in different settings. Within a few weeks you should know whether or not the hearing aid is working adequately for you.
Although some dispensers may charge a small rental fee, which in many cases is applied to the purchase price of the hearing aid, a trial period is the way for you to make an intelligent decision about the aid.
Hearing Aid Costs
The cost of a hearing aid depends on the type of aid, its special features, and possible additional services provided by the dealer. As a result, it pays to comparison shop once you know the make and model of the aid recommended for you. The price of a single hearing aid ranges from $700 to about $1,000, with canal aids costing about $1,000. The cost is about double if a binaural design is used.
Contracts And Warranties
Hearing aids are most often sold with a purchase agreement or contract that may include the following information:
- The make and model of hearing aid;
- Warranty, if any;
- Specific length of trial period;
- Results of any hearing evaluation if performed; and
- Cost of hearing test.
The purchase agreement should contain all conditions of the transaction, including an explanation of verbal promises of cancellation or refund. After reading through your agreement, you may want to ask yourself the following questions:
- Is the cost of the ear mold included in the price?
- How long will the specialist or clinical audiologist provide free service?
- Will he or she loan you another aid if yours needs to be repaired?
- Will he or she give you a written warranty?
Your warranty is your basic agreement with the manufacturer, and it should be backed by the hearing aid dispenser. Know whether the warranty is honored by the manufacturer or by the dispenser. Manufacturer warranties may not be recognized unless the aid is purchased from a dispenser authorized or franchised by the manufacturer.
Service And Repairs
It is estimated that the average life of a hearing aid in daily use is about three years. During this time, it is likely that the aid will need to be repaired and serviced. It is important to know if the hearing aid dispenser can provide servicing and minor repairs. Major repairs are generally made by the factory, but some dispensers have extensive service facilities on their premises.
Tips To Remember
Experts suggest the following for proper care:
- Keep your hearing aid dry.
- Avoid excessively high temperatures.
- Remove dead batteries from your aid immediately.
- Avoid twisting cords or bending tubing.
- Protect the aid from hard knocks.
- Do not use hair spray while wearing the aid.
- Turn the aid to the "off" position each time you remove the aid.
- Do not attempt to repair the hearing aid yourself. If the aid is not working properly, consult your dispenser.
- Check with the Better Business Bureau for a reliability report of any hearing aid dispenser.
- If your state licenses clinical audiologists or hearing aid dispensers as most states do, does your service provider hold such a license?
- You may wish to contact the International Hearing Aid Society, at 20361 Middlebelt, in Livonia, Michigan 48152, to determine if the hearing aid dispenser is a member; or
- The American SpeechLanguage Hearing Association, at 10801 Rockville Pike, in Rockville, Maryland 20852, to determine if the clinical audiologist is a member and holds clinical certification.
Questions and Comments
Comment Submitted 12/9/2013
The sections titled "Types of Hearing Aids" and "Hearing Aid Costs" are very outdated. Eyeglass aids are not fitted in the U.S.; if so, it is extremely rare. Body aids, as well, are seldom fit. If you would like to list the popular styles of hearing aids today, you will need to include these three: CIC or completely-in-the-canal, IIC or invisible-in-the-canal, and RIC or receiver-in-the-canal. BTEs are usually fit on most people with profound deafness. Hearing aid costs are not based on style choice, but rather the technology which is an internal feature. Your pricing is way off and is for basic or economy line hearing instruments. The average price of a good quality hearing instrument can run $2000-$2500. Premium level hearing aids with sophisticated sound processing and adapative microphones usually sell for $3000 each and higher. The section on hearing aid parts fails to mention that hearing aids have microprocessors making them not just basic amplifiers, but have the capability to shape and manage incoming sound.
Question Submitted 1/16/2014
I had *********** test me. I already knew I have a hearing loss. It was determined my right ear was very bad, I already knew that, and my left ear was bad for low sounds. There cost for the correct aid was from $4,400.00 to $5,200.00. I have since looked into ******* aids, their most expensive aid is about $2,900.00 each but it seams it does much more?? I will have another test from another audiologist at the ***** ****** ******* *** ****** in Skokie Ill. suggested by a ******* ****** *********** Are ******* the best Aid in the Market for the $$? thanx for your response, ***...
BBB's Answer:I am not sure what the best hearing aids are on the market per the cost. You will have to do a bit of research to understand cost and features. This link may help a bit to get you started.
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