by Neil Bauman, Ph.D.
A lady asked,
Why must we wear our hearing aids all the time? I mean, lots of times they are not needed—when cleaning house, reading a book, at the gym, etc.
This is an excellent question. There are two schools of thought regarding the “right” answer. One school of thought—promoted by doctors, audiologists and people who have normal hearing—is that they have listen to everything all the time. That’s the way God made us. Therefore, why should hard of hearing people be any different?
Thus, they tell us (hard of hearing people) to wear our hearing aids all our waking moments. In addition, they drag out the argument—”use it or lose it”—meaning that if we don’t actively use the hearing we have, our auditory systems will atrophy and thus we will lose the little hearing we now have.
The second school of thought comes from those of us who have to live with our hearing losses every moment of every day. We know that hearing aids do not give us normal hearing. Furthermore, we know that neither our ears/brains nor our hearing aids can filter out background sounds so that we can hear in noise like people with normal hearing can.
Compounding this problem, is the fact that we also typically have to put up with conditions such as recruitment, hyperacusis, dead spots in our cochleae and “fuzzy” hearing that people with normal hearing don’t have. All this can cause auditory overload resulting in extreme fatigue, headaches and other problems. Therefore, we feel we should be able to choose the times when we wear our hearing aids and the times when we choose “deafness” in those situations where the toll on our bodies is greater than the benefit we derive from the additional limited hearing we gain.
Let’s look at both of these arguments, because both have some merit.
First, let’s look at the argument that you should wear your hearing aids all the time you are awake. Yes, God did make our ears to hear, so when we lose hearing, it seems right that we should wear hearing aids to restore hearing to as near as normal as possible.
This argument would be valid if hearing aids gave us normal or near normal hearing. If you have a mild hearing loss, this may be close to possible. However, for those of us with severe hearing losses, what we hear via our hearing aids is a far cry from what people with normal hearing hear.
Because of the various factors mentioned above, we need relief from the barrage of sounds that so often assaults our ears. Simply put, we need “down time” in order to recharge. If that means taking off our hearing aids and living in a world of silence for a time, so be it.
For those of us that choose to be proactive, we may choose in advance not to wear our hearing aids when we know we will be in an environment that will cause undue wear and tear—not only on our bodies—but also on our emotional health. That way we can work longer and not require so much “down time”.
One of my “rules of thumb” is that if wearing hearing aids significantly helps you in a given situation, then wear them. If wearing them doesn’t significantly help you hear better/understand more, then don’t wear them. And if you understand worse with them on, then definitely take them off. There is no point in wearing hearing aids in situations where noise assaults your ears and you get no benefit from wearing them. This makes the decision-making process pretty easy.
I wish more hearing people could experience what we hear (and the way we hear it), so they would understand why wearing hearing aids all the time is not necessarily good for us.
The argument that we must “use it or lose it” is basically a scare tactic in my opinion. Yes, to some (small) degree it is true, but in reality, it is largely a bogus argument. You see, we all hear some sounds (after all, we are hard of hearing, not deaf)—and those sounds, as small as they are, are enough to keep our auditory circuits running quite well. Besides, we do wear our hearing aids (or assistive listening devices) some or much of the time and again this keeps our auditory circuits in good working condition. We do not have to be exposed to amplified sounds from dawn to dusk in order to keep our auditory systems in good shape.
When I was a boy, I was fitted with a body-style hearing aid. I was given two ear molds and told that I had to switch ears or I’d lose the hearing in the unamplified ear.
What was the reality? For some reason, maybe because I was left-handed and thus could more easily put the ear mold in my left ear, I chose to only wear a hearing aid in my left ear for the next 20 or more years. (Now I wear hearing aids in both ears.)
If the “use it or lose it” rule was correct, then you would expect that now I hear better in my left ear than in my right ear, right? Guess what? Instead of losing more hearing, my right ear is now my better ear! In my case, I lost more hearing in my left ear from wearing a hearing aid and using amplified devices in that ear!
Nevertheless, there is a valid reason for wearing hearing aids as much as possible. You see, it takes our brains several weeks, and up to three months, to learn how to process the new sounds we now hear when wearing our hearing aids. Our brains actually grow new neuronal connections in order to process the sounds coming through our hearing aids. Therefore, the more we wear our hearing aids, the better our brains adapt to the sounds we hear.
In the process, we learn how to tolerate louder sounds so that they do not bother us the same as they’d did when we first began wearing hearing aids. This is a strong argument in favor of wearing hearing aids more rather than less.
I notice this phenomenon each time I put my hearing aids on. For the first few minutes, everything sounds too loud, but soon my brain adapts and things become more normal. Therefore, unless you’re in the noisy environment that’s causing undue wear and tear on your system, side with your audiologist and wear your hearing aids as much as possible.
At the same time, remember that you are in control. When wearing your hearing aids begins to wear you out, there is nothing wrong with taking your hearing aids off and giving your ears a break, thus giving you a chance to unwind and recover. By the same token, if you want to relax and read a book, there’s nothing wrong with taking your hearing aids out and letting your ears relax at the same time. This way you can have the best of both worlds.