Editors Note: Dr. Mark Ross is a consultant for the Rehabilitation Engineering Research Center (RERC) on Hearing Enhancement at Gallaudet University, he is a Professor Emeritus of Audiology at the University of Connecticut, and has also served as the Vice President of the Hearing Loss Association of America (HLAA), formerly Self Help for the Hard of Hearing (SHHH). As a world renowned author and researcher in hearing rehabilitation and having worn hearing aids for almost 50 years, Dr. Ross is uniquely qualified to write on the topic of hearing loss and amplification and we are so pleased to feature some of his publications here on Healthy Hearing. This article is reprinted in cooperation with HLAA www.hearingloss.org the nations largest organization for people with hearing loss.
Hearing aids are delicate (and very expensive!) instruments. Within their tiny, fragile cases, they pack an enormous amount of highly sensitive, sophisticated electronic circuitry. Unlike eyeglasses, hearing aids need regular upkeep and a lot of tender loving care to ensure continued optimal performance. With reasonable care, the life expectancy of a hearing aid is about three to five years; with care and attention to maintenance, that lifetime may be extended.
Topics Covered in this Article
- Protection and Storage
Hearing Aid Batteries
Earmolds and Tubing
- In-The-Ear Hearing Aid Care
- Hearing Aid Problems / Troubleshooting
Protection and Storage
There are some things hearing aids do not like: shock, temperature extremes, and moisture.
Trauma to the hearing aid caused by being dropped or roughly handled, or parked temporarily on undesirable spots of high or low temperatures such as radiators or air conditioners. Dogs love to chew on hearing aids. Babies also find them attractive, sometimes edible. Any of these can be devastating to the proper functioning of a hearing aid (not to mention the baby!)
Some preventative measures: Provide proper storage for your hearing aid whenever it is not in your ear. Set aside a good place, protected from danger of being knocked off a table or picked up, or subjected to the teeth treatment of a pet or child. A box in a drawer by your bed is a good place and is handy when you rise or retire.
Damage incurred from high heat or cold, which may adversely affect a hearing aid's performance. Much of this damage is caused by the changes in temperature, which causes a condensation of moisture within the aid, rather than the temperature itself. This change can occur many times a day, as someone goes from hot to air-conditioned comfort and back again. High humidity and perspiration exacerbate this problem.
Some preventative measures: Never leave a hearing aid on a radiator or an air conditioner, near a stove, in a sunny window, in the glove compartment of a car on a hot day, or in any other extremely hot or cold place. Do not try to dry the hearing aid in an oven or clothes dryer, or wear it while using a hair dryer or tanning under a sun lamp.
Anything wet, high humidity, perspiration, condensation, accidental immersion in a bath or pool can cause damage to a hearing aid and prevent it from functioning properly. Keep your hearing aid dry. An exception may be made for the few hearing aid models recently marketed as being specifically designed as water resistant. If you are interested in this type, ask your hearing aid dispenser.
Some preventative measures: If you live in an area subject to high humidity or regularly engage in perspiration-inducing activities, consider buying some sort of DRI-AID kit. This is a small, inexpensive kit consisting of silica (desiccating) crystals in a jar. At night, after removing the battery, place the hearing aid down in the jar. During the night, the moisture in the hearing aid will be absorbed by crystals. The silica crystals can be recycled by oven heating when they become moist (indicated by change in color), so the kit has a long life.
A recently introduced product, Dry & Store, is an electrical appliance that uses heat, moving air, as well as a desiccating substance to remove moisture from a hearing aid (as well as from any cerumen that may have infiltrated the sound bore). The unit will accommodate two hearing aids (any type). Once turned on, it is programmed for an eight hour cycle, the first eight minutes of which a germicidal lamp helps kill off bacteria, molds or fungi that may be growing on the surface of the hearing aid shell or earmold. With this unit, it is best not to remove the battery (but keeping the battery compartment open) since the removal of moisture from the battery may slightly extend its life span. A number of anecdotal reports suggest that that the regular use of this device can help ensure the hearing aid's optimal performance over the long run.
Hearing Aid Batteries
Batteries are the lifelines for your hearing aid, so learn how to use them most effectively. Take note of the positive and negative (+ and -) on both the battery and in the battery compartment in the hearing aid, and be sure to insert the batteries properly.
If possible, buy batteries a month ahead to ensure that you will always have a supply on hand and that you never run out at a crucial moment. In the past, it was suggested that a refrigerator as a good location to store extra batteries. Current recommendations are against refrigeration, as moisture and condensation can affect battery life.
Always carry a spare battery or two so you have a workable supply on hand. Your hearing aid dispenser can provide you with a small plastic case that you can use to store several batteries. This case can be attached to a key chain, or placed in a pocket or purse. Be sure to replace any that you may use during the day.
Remove the batteries from your hearing aid at night, or at least open the battery compartment. This will allow air to circulate and help dry out the aid. It will also lengthen the battery life by preventing drainage of power if you accidentally leave the aid on all night, and will eliminate the possibility of leakage from a defective battery damaging the aid.
Invest in a battery tester, to check the power of your batteries. These are inexpensive and will save you money in the long run by ensuring that you do not discard a battery too soon. However, even a slight drop in power may require that the battery be replaced, since hearing aid performance can be adversely affected. How much voltage drop will be discernible depends upon your hearing loss and the unique electrical interactions between the battery and the aid.
Become aware of the average life cycle of your battery. If you notice a sudden decrease in battery life, ask your hearing aid dispenser to check the aid. Excessive drain on batteries usually means a malfunction in the hearing aid.
Keep the battery contacts in the hearing aid clean; poor contacts may mean loss of power or a "frying" noise. Scrape contacts gently with a sharpened pencil eraser or cotton swab dipped in isopropyl alcohol. In humid weather or after heavy perspiration, dry off the contact with a cotton swab. If the contact becomes corroded, ask your hearing aid dispenser to clean them.
Warning: Tiny button batteries have sometimes been swallowed by a person mistaking them for pills or by a small child attracted to a shiny surface. This can be lethal. Store your batteries properly to prevent such unauthorized use. If you suspect that a battery has been swallowed, immediately call a physician.
Earmolds and Tubing (for behind the ear aids)
Keep earmolds clean. If the sound bore seems clogged with wax, clean it gently with a pin, wire-loop, or toothpick. At regular intervals, remove the earmold from hearing aid and wash it with gentle soap and water. Be sure the mold is dry before reconnecting to the hearing aid, as even a bit of liquid can interfere with the sound transmission. A forced-air earmold cleaner (squeezable rubber) is useful for cleaning both earmold and tubing. This can be obtained from a hearing aid dispenser. Also obtainable from hearing aid dispensers are non-alcoholic "audio-wipes" with which the surface of the earmold can be cleaned frequently (every day is not too much!).
The clear plastic tubing connecting the earmold with behind-the-ear types of hearing aids will need to be replaced periodically. Make regular checks to be sure it is not cracked, dried out, or bent. Also, watch out for possible droplets of moisture caused by humidity or perspiration. These should be removed by gently blowing through the tube until it is dry, or using the forced-air earmold cleaner mentioned above. If this is a frequent problem for you, ask your hearing aid dispenser or audiologist about the new moisture-resistant tubing.
In-The-Ear Hearing Aids (Of All Types)
Dried cerumen (earwax) on the hearing aid surface can irritate the ear canal as well as cause infections. It is a good idea to wipe if off with a dry cloth, tissue, or "audio-wipes" whenever you remove it from your ear or before you reinsert it in the morning. Do not use any type of liquid solution to clean an in-the-ear hearing aid.
Cerumen infiltrating into the hearing aid sound bore is one of the most frequent reasons for hearing aid malfunction. What happens is that the earwax gets lodged in the sound bore and either blocks the sound or interferes with the function of the hearing aid receiver (the hearing aid "loudspeaker"). Many hearing aids come with a "wax loop" or other means to keep wax out of the hearing aid. If a hearing aid does not include this feature, then a replaceable, acoustically transparent band-aid ("ad-hear") will protect the sound bore from wax. These can be obtained from your hearing aid dispenser. Or if none of the above is available, then you can use a wire loop to remove the wax (but be careful not to insert the wire loop very far into the sound bore).
Hearing Aid Problems
If the Aid Does Not Work At All
- Make sure the aid is turned on (don't laugh; this happens!).
- Make sure that that the T-switch is correctly positioned (not in the "T" position).
Check if the battery is inserted correctly (+ and in the right place). If you have to
force the battery, you probably have it wrong.
- Check to see that the battery is not dead. If in doubt, try a new one (where you have to remove the sticky paper flap off the battery surface). A dead battery is the most common reason for "dead aids".
- Check battery contacts to be sure they are not corroded.
- Check tubing to be sure it is not clogged with moisture (shown by water or condensation in the tube).
- Check earmold to be sure that sound bore is not clogged with wax.
If Sound is Weaker than Usual
- Check battery. Replace if necessary.
- Check tubing for cracks, fraying, moisture, etc. Replace if necessary.
- Check that the earmold is not clogged with wax.
- Reposition the earmold for a tighter fit; it may have been whistling (feedback) at a pitch you cannot hear.
If Aid Goes On/Off or Has Scratchy Sound
- Flick on/off switch back and forth, in case dust or lint has collected in the controls.
- Check battery contacts.
- Think where you have been. If in a very humid environment or have experienced excessive perspiration from vigorous activities, moisture may clog the aid and distort sounds. Use a hearing aid dehumidifier overnight and try again (see discussion above under "Moisture").
- Check the tubing from earmold to the hearing aid and replace it if bent, cracked, frayed.
If the Aid Whistles ("Feedback")
- Probably an earmold problem. Remove the aid, put a finger over the earmold hole. If the whistling stops, the earmold was not properly inserted in the ear, or is not a good fit. Try it again in the ear; if the whistle continues, consult your hearing aid dispenser.
- Sometimes feedback may occur when you have a blockage of wax in the ear canal, a stiff eardrum (from a cold, for example) or any condition that causes sound to be reflected from the ear canal. In these cases, the earmold may be fine, and the feedback will disappear when the condition is corrected.
- Check volume control; it may have been turned too high.
Insuring Your Hearing Aid
When purchasing a new aid, you may wish to consider insuring it against damages from such as fire or water, accidental breakage or automobile accidents, theft or other disappearance. A policy may be obtained within 90 days of the purchase of an aid. For information about such insurance policies, ask your hearing aid dispenser.
We hope the above tips will help you add years to the life of your hearing aids. Remember, if you have consistent problems, you may need a new hearing aid with a different power range, or new earmold. Hearing levels and even the shape of ear canals DO change, particularly as we move into the later years of life.
One final thought: For people who need them, hearing aids can markedly improve the quality of life. However, a hearing aid is often not enough. Consider the use of other types of hearing assistive technologies (such as TV listening, telephone, and signaling and warning devices). Check these out with SHHH members www.hearingloss.org and with your hearing aid dispenser.
More information on Dr. Mark Ross:
Mark Ross, Ph.D., is an audiologist and associate at the Rehabilitation Engineering Research Center (RERC) at Gallaudet University. He dates his emergence into the field of audiology to the time he attended the Army Aural Rehabilitation Program as a participant in 1952. He received his doctoral degree from Stanford University and taught at the University of Connecticut and worked as a clinical audiologist at Newington Childrens Hospital. Dr. Ross is the former director of research and training at the League for the Hard of Hearing and has served on the boards of SHHH and the International Federation of Hard of Hearing People.
This article first appeared in a 1999 Hearing Loss Association of America (formerly SHHH) publication www.hearingloss.org. This article is supported in part by Grant #H133EO30006 from the U.S. Department of Education to Gallaudet University. The opinions expressed herein are those of the author and do not necessarily reflect those of the Department of Education.