by Neil Bauman, Ph.D.
A man explained,
I have tried hearing aids, and was disappointed in the results, so I returned them to the provider for a refund. Now I am going to try a different brand. Could you please give me some suggestions for some specific actions I could try (out in the real world) to test and evaluate the new aids. I asked the audiologist for some suggestions, and he said to just wear them and see how I like them. That is not very helpful because when I am having a conversation (for example), I have no way of knowing how well I could hear without the hearing aids. I am concerned that perhaps my expectations may be unrealistic, and I want to be fair.
When you say you were disappointed with the results, exactly what do you mean? Was it that sounds were too loud? Was it that noise drowned out speech? Did you not understand as much of speech as you thought you would?
Different brands can give a different quality to the sounds you hear. Thus, you may like one brand and not like another, although both hearing aids are essentially similar to each other. As a result, it is a good idea to try different brands if you are not happy with the first one you try.
Before you go out into the real world, your audiologist should do two things. First, your audiologist should use real ear measurements to confirm that your hearing aids are reaching the target amplification goals. If your audiologist is not using real ear measurements, then he has no way of knowing whether he has set your hearing aids correctly or not. Therefore, if your audiologist does not do real ear testing, dump him, and find somebody that does. Don’t buy hearing aids from somebody that only does half the job.
Second, have your audiologist redo the speech discrimination tests (often called word recognition tests) but this time with your hearing aids on. You want to know that you understand speech as well as, or better than, you do with your bare ears. If you don’t understand as well as, or better than, you do with your bare ears, then those hearing aids are not set properly for you. Numbers of people have told me they can’t understand speech well with their new aids, so this additional testing is necessary.
Your audiologist’s advice to “just wear them and see how you like them” is good advice, but it only goes so far. You see, your brain takes somewhere up to 90 days to adapt to hearing with your new hearing aids. Therefore, just going out and listening to sounds isn’t going to be very helpful at that point. For example, initially you may find everything sounds too loud when you step out into the street, but after you have been wearing your hearing aids for a couple of months, you will find that those same sounds now seem perfectly normal.
If you have not worn hearing aids before, you need to learn how to wear them. I wrote an article called “Becoming Friends with Your New Hearing Aids“. You should read this article as it gives you a lot of insight into what you have to do in order to get your brain to adapt to them.
You can easily tell how well you can hear without your hearing aids on. Just take your hearing aids off and compare. You should hear much better, or more correctly, understand much better, with your hearing aids on than with them off. If you don’t, your hearing aids are not set correctly for your hearing loss, or they’re not the right hearing aids for you in the first place.
You need to have realistic expectations of what your hearing aids can and cannot do for you. The real problem is knowing what your expectations should be. As a general rule, in quiet situations with only one person present, you should pretty well hear everything, as long as the person speaking to you is no more than 6 feet or so away from you.
In groups, it is always going to be more difficult to hear a given person because people typically talk on top of each other. Furthermore, some people have soft voices; others speak very loud. Your brain never gets time to get used to one person’s voice before another one jumps in. Therefore, you need to lower your expectations in groups. If you hear most of what the group says you’re doing well.
Once you get into really noisy situations, understanding speech becomes much more difficult. Most of it is because of the way our ears work in noise. When we can no longer hear well, our ears no longer are able to filter the background noise from the foreground speech like they could when we had normal hearing. Thus, everything is jumbled together in the foreground, and we have trouble understanding much of anything. Your hearing aids cannot change what is going on in your brain. They can only bring you the clearest sound possible to your ears.
Most modern hearing aids have noise reduction circuitry built in. Basically, they filter out a lot of the noise, but in doing so they process the speech and may make it less intelligible. Thus, you may not hear the noise as much, but at the same time, you still aren’t understanding as much of the speech as you should. Sometimes this can be improved by tweaking the hearing aids.
Expect to go back to your audiologist several times in the first few weeks to have your hearing aids tweaked. The chances of having your hearing aids set up perfectly the first time is almost nil. Thus, go back as often as you need to. When you identify something that is not sounding quite right, get your audiologist to tweak your aids to try and fix that.
Finally, remember that it takes time for your brain to learn to hear with your new hearing aids. This creates a bit of a tricky situation. Your brain may take 60 to 90 days to get used to your hearing aids, but you typically only have 30 days in which to decide whether to keep your hearing aids or return them and get your money back. Thus, you have to make up your mind whether you want to keep the hearing aids before your brain has completely adapted to them.
If, near the end of the 30-day period, you are reasonably happy with the quality of the sound that your hearing aids are giving you, and every time you go to get them tweaked things are improving, then you may decide to take a chance and buy them. However, if near the end of the 30-day trial, you’re still having a lot of trouble understanding speech in various situations, I’d turn them in at that point. You don’t want to get stuck spending $6,000.00 for hearing aids that are not really going to help you.
At that point you may choose to try a different brand, or go to a different audiologist. Some are just better at fitting certain hearing losses than others are, so feel free to shop around. After all, it is your hearing that is at stake.