January 12, 2016

How to tell if it’s time for a hearing aid

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There’s more to the decision than merely buying a hearing device.

You suspect your hearing is fading based on how often you ask people to repeat themselves, or other signs. What’s your next step? Don’t run out and try to get a hearing aid just yet.

First, find a certified audiologist. A full communication needs assessment – not just a hearing test – is crucial. Choosing hearing aids and other devices that can help you communicate better is a highly individualized process.

Gina P. Angley, an audiologist and Associate Director of the Adult Hearing Aid Program at Vanderbilt Bill Wilkerson Center, said testing can be completed in one visit, but it’s not as simple as considering volume alone.

Assessments start with evaluating the health of the ear itself to detect blockages and explore the health of the space behind the eardrums for signs of infection, all to determine if there’s a need for evaluation by an ear, nose and throat specialist.

Next, the hearing test takes into account the softest sounds people can hear at different pitches and evaluates the ear’s ability to discriminate different sounds (for example, the difference between hat, cat and sat). People have huge differences in how well they understand speech and noise. Also included in testing is the patient’s ability to repeat sentences in background noise.

The results of the full assessment, combined with what the patient independently reports, come together for a personalized care plan that can take into account a customized hearing aid and any accessories that can also help improve hearing, Angley said.

Whether a hearing aid is suitable depends on how much the loss is impacting the person’s day-to-day life and other individualized needs, Angley said. Some people function fine with some degree of loss – for example, if they have boisterous families or there’s no one in the home to be bothered by loud televisions. “There is no magical degree of hearing loss that says ‘now you have to have a hearing aid’,” Angley said.

Ensuring the right fit

Hearing aids can be good options for people who need help with their general hearing, and who want to put a device in in the morning and leave it in all day. But choosing a hearing aid isn’t as simple as placing an order.

“Hearing aids aren’t cars,” said Todd Ricketts, Ph.D., Professor and Director of Graduate Studies in the Department of Hearing and Speech Sciences at Vanderbilt University Medical Center. “The best one for you is not the best one for someone else. You’re not car shopping; you’re shopping for something to address your communication needs. That might be a hearing aid, that might be counseling, that might be a combination of a lot of different things.”

Once a person decides to get a hearing aid, the most important next step is getting a proper fit, so you will get the most benefit from this tool. Bill Wilkerson Center’s Hearing Aid Clinic, for example, uses the latest in evidence-based practices, including “real-ear measures,” which Angley calls the gold standard for fitting.

The clinic’s service and a set of hearing aids combined can cost $2,000 to $6,000, depending on the device chosen. More insurance companies cover hearing aids now than in the past, Angley said, but most people still must pay the cost out of pocket unless they can find other assistance. It’s more important to choose the device that works best for you rather than thinking you’re getting the Cadillac of hearing aids if you pay more.

“People think the more you spend, the better you will hear, and that’s not necessarily true,” Angley said.

Another important point: Hearing aid technology has advanced dramatically within in the last decade – hearing aids are rechargeable with the ability to sync to devices using Bluetooth, communicate with wireless microphones, adjust with smartphone apps and more. But the devices can’t fully return hearing to “normal.”

“Even the best device in the world can’t do that,” Angley said, “and sometimes a combination of devices are needed to help compensate for hearing loss. But ultimately, communication takes at least two people working together and clear communication strategies are crucial.”

Two people talking on a couch

Vanderbilt Bill Wilkerson Center

If you suspect hearing loss, Vanderbilt Audiology and Hearing Aids can help.

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