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Hearing Aids and Consumers

INTRODUCTION:
Wearing a hearing aid for the first time will be a life altering experience for most people. For some, the adjustment to hearing new sounds can be difficult and frustrating. However, knowing what to expect before trying hearing aids reduces common problems. It is normal to have expectations about the benefits and limitations of hearing aids, based on your own or others past experiences. Remember, each hearing loss is different and so is each persons experience with amplification. The best approach to living life with hearing aids is to have positive, yet realistic expectations.

D. J. Schum found that hearing aid wearers expectations exceeded the benefits achieved from the devices themselves. "Insufficient benefit" has been claimed as the number one reason for hearing aid rejection in a statistical analysis of hearing aid returns in 2001. Prior research has shown strong relationships between excessive, unrealistic, insufficient expectations and consumer benefits. A recent example can be found in Jerram et. al. In a recent clinical study, Cox & Alexander found that new hearing aid wearers have the highest level of expectations concerning the benefits hearing aids can provide. Depending on your level of optimism, high expectations may be a positive approach to a hearing aid implementation program orperhaps a way to be disappointed if the devices dont meet lofty hopes! Therefore, realistic expectations are the best way to approach hearing aids.

It is important to consider how you can effectively use amplification devices to your advantage. Hearing aids are not a cure for hearing loss, they are just one solution to the problem. A well-fitted set of hearing aids can dramatically improve the clarity and quality of speech in quiet situations. In some cases, they can even restore a nearly normal perception of sound in the presence of mild background noise. However, the ability to bring lost hearing back up to beneficial and adequate levels depends on the type, degree, and duration of your hearing loss.

One of the most common complaints from hearing impaired people is an inability to hear soft speech sounds. Whether it be family, co-workers, clients, or speakers in a meeting, hearing aid success depends on making sounds audible. It is realistic to expect that sounds which are louder (as long as theyre not too loud) should be easier to understand in a variety of situations; meetings, church, small family gatherings, intimate discussions, and in groups of two or three without sound becoming uncomfortably loud.

However, hearing aids cannot turn a bad sound into a good sound! That is, they dont work well in loud noisy areas such as sporting events or large group situations, such as weddings. If people with normal hearing do well in a specific situation, you should do well with hearing aids in that same situation. If people with normal hearing have a tough time in a particular situationyou will have a tough time with hearing aids in that situation. If people with normal hearing are plugging their earsyou should not be wearing hearing aids! Of course, loud environments can be uncomfortable regardless of a persons level of hearing. Remember, it will take time to adjust to amplified sound and there is a lot to learn.

OCCLUSION EFFECT:

One of the first things new hearing aid users notice is the change in the sound of ones own voice. This phenomenon is attributed to what is known as the occlusion effect. The occlusion effect occurs when the ear canal is blocked off by an object, in this case a hearing aid. Vibrations from your own voice are actually trapped inside your ear canal and may sound like an echo. Your voice sounds different because you have plugged up your ears. For example, try thisCup your palms tightly over both ears. Now say the word "ME" very slowly and loudly so that it goes on for 3-4 seconds. Now remove your hands and try it again. That is the occlusion effect. People often say it makes their voice sound hollow, or like they are talking in a barrel. With time youll get used to this, as long as the occlusion is not too pronounced. If you do not properly adapt to the sound of your voice in a few days, your hearing healthcare professional can make additional adjustments to your hearing aid.

HEARING AID STYLES:

Hearing aids should fit comfortably in your ear. There are many different types of aids. Although all may not be ideal for you hearing loss, you can talk to your hearing healthcare professional about your options.

As hearing aids have developed over the past several decades, making them smaller and more cosmetically appealing has been a high priority. There are four main styles of aids (see figure 1).

Behind-the-Ear (BTE) hearing aids are the largest of the "ear level" hearing aids. Although BTEs provide tremendous power for the wearer, BTEs may be too visible for some. In-the-Ear (ITE) hearing aids place the hearing aid inside the ear and come in several sizes. In-the-Canal (ITC) hearing aids are very popular as they are smaller. Completely-in-the-Canal (CIC) hearing aids sit far down in the ear canal just several millimeters from the eardrum, and these are the smallest available hearing aids.

Making a hearing aid style (BTE, ITE, ITC, CIC) decision that will leave you feeling confident about your hearing will greatly increase your level of satisfaction with the hearing aid. If you know you will not wear this style or that style, speak with your hearing healthcare professional about the best options and please discuss your preferences!

FEEDBACK:

When the aid is not correctly in the ear, or the volume is up too loud, or if the hearing aid microphone or receiver is plugged-up, a whistling noise called "feedback" may occur. This annoying high-pitched squeal can be a problem for some hearing aid wearers. It is important to know the difference between "normal" feedback and "unacceptable" feedback. Feedback may be normal when placing your hand or other object over the aid while in your ear. However, feedback should not occur unexpectedly or persistently when the aid is seated properly in your ear. If this occurs, see your hearing healthcare professional to get this adjusted.

Just like any electronic device, hearing aids need to be taken care of and maintained. It is a good idea to read the owners manual, cover-to-cover. With good user care, the life of the hearing aid can be greatly extended. Hearing aids are subject to wear and tear from normal use. They will occasionally need to be serviced by your hearing healthcare professional and/or the manufacturer.

BATTERIES:

Using high quality zinc air batteries will help ensure your hearing aids operate for the longest time possible. A common concern among new hearing aid users is the life expectancy of their batteries. There are many different types of hearing aid batteries. Different types and styles of hearing aids will require different battery sizes and brands. Battery wear time will vary across different battery sizes and brands, and is also impacted by the hearing aid circuit and options selected for you.

Most full size BTEs will take battery sizes 675 or 13. Most ITEs will take size 13 or 312. And most small CICs will take size 5 or 10. Generally speaking, the smaller the hearing aidthe smaller the battery. Small batteries are more difficult to handle and get lost very easily. Be sure to keep all batteries and hearing aids away from children and pets. Batteries are toxic and should never be kept where a child might find them. If there is a suspicion that a child has swallowed a batterygo immediately to the Emergency Room, or call you physician for instructions.

Depending on the severity of your hearing loss and the power of your hearing aid, batteries may need to be replaced every one to three weeks. If you wish to measure your hearing aids battery life, place the sticker from the new battery on your wall or desk calendar, every time you open a new battery. In a few months you will have a good sense of your battery life, and that can help you predict when youll need a new battery. Regardless of which hearing aid you wear, maximum battery life is attained by making sure the power switch is off and the battery door is open when not in use. Additionally, opening the battery door at night will allow air to pass through the aid, drying it out a little, depending on the situation.

Hearing aids need to be cleaned daily and kept out of wet environments. Many hearing aids have wax guards or protectors to stop wax and dirt from penetrating delicate components. Nonetheless, people tend to perspire and of course, air contains moisture (humidity). Virtually all hearing aids will develop moisture inside of itwhere you cannot see it.

The best way to store a hearing aid that is not in use, is to keep it in a "dry aid kit." These are special containers designed to help remove moisture from the hearing aid.
Dry aid kits come in various sizes and qualities, please discuss this with your hearing healthcare professional. I usually recommend that you get the best dry aid kit possible, because it is very important for extending the life of the hearing aid and the life of the battery.

CONCLUSION:

Being open and honest with yourself (and with your hearing healthcare professional) about your hearing loss and your hearing aids will allow the hearing aid to compliment your lifestyle and satisfy your specific hearing needs as an individual. Setting realistic goals and discussing these with your hearing healthcare professional will ensure a more productive adaptation to new amplification devices and provide you with the greatest possible satisfaction.

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1Schum, Donald J. (1999). "Perceived Hearing Aid Benefit in Relation to Perceived Needs." Journal of American Academy of Audiology. 10:40-45.

2Wiegand et al (2002), "By the Numbers: A Statistical Analysis of Hearing Instrument Returns". The Hearing Review. 1:22-28;49

3For Example, Jerram, J. Christopher K. and Suzanne C. Purdy (2001). "Technology, Expectations, and Adjustment to Hearing Loss: Predictors of Hearing Aid Outcome." Journal of American Academy of Audiology. 12:64-79.

4Cox, Robyn M & Genevieve C. Alexander (2000). "Expectations About Hearing Aids and Their Relationship to Fitting Outcome." Journal of American Academy of Audiology. 11:368-382.

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