Selecting the Right Hearing Aid

"Dad, turn down the TV, it’s too loud!" This is often the first sign that an older loved one is experiencing hearing loss. Hearing loss can shut seniors out of conversations and make it difficult to hear instructions or even the doorbell. Almost a third of people older than age 60 have reduced ability to hear—yet many older adults are resistant to using hearing aids.

We’ve known for a long time how devastating hearing loss can be for older adults. Loss of hearing, if uncorrected, leads to isolation and depression. These seniors no longer feel like active participants in routine conversations, and their self-esteem suffers accordingly. And here is new data for family members who are trying to convince their loved one to have a hearing evaluation: Earlier this year, a study appearing in the Journal of the American Medical Association reported that hearing loss is associated with mental decline in older adults. In a second study, University of Pennsylvania researchers used MRI scans to confirm that even mild hearing loss can cause brain atrophy. Lead author Dr. Jonathan Peelle cautions, "As hearing ability declines with age, interventions such as hearing aids should be considered not only to improve hearing but to preserve the brain."

These new studies should convince older loved ones to be fitted for a hearing aid, right? It isn’t that simple. Family members with normal hearing seldom understand the resistance seniors feel to being fitted with hearing aids. Some seniors fear that there is a stigma attached to wearing these devices. Others balk at the cost, which can be considerable. And sometimes seniors who do purchase hearing aids find them difficult to adjust to and use, and end up leaving them in a drawer. Therefore, it is important to be evaluated by a professional who can prescribe the right device and monitor its effectiveness during the breaking-in period, making adjustments as necessary.

Here is an overview of hearing aid technology from the National Institute on Deafness and Other Communication Disorders:

There are three basic styles of hearing aids. The styles differ by size, their placement on or inside the ear and the degree to which they amplify sound.

Behind-the-ear (BTE) hearing aids consist of a hard plastic case worn behind the ear and connected to a plastic earmold that fits inside the outer ear. The electronic parts are held in the case behind the ear. Sound travels from the hearing aid through the earmold and into the ear. BTE aids are used by people of all ages for mild to profound hearing loss. A new kind of BTE aid is an open-fit hearing aid. Small, open-fit aids fit behind the ear completely, with only a narrow tube inserted into the ear canal, enabling the canal to remain open. For this reason, open-fit hearing aids may be a good choice for people who experience a buildup of earwax, since this type of aid is less likely to be damaged by such substances. In addition, some people may prefer the open-fit hearing aid because their perception of their voice does not sound "plugged up."

In-the-ear (ITE) hearing aids fit completely inside the outer ear and are used for mild to severe hearing loss. The case holding the electronic components is made of hard plastic. Some ITE aids may have certain added features installed, such as a telecoil. A telecoil is a small magnetic coil that allows users to receive sound through the circuitry of the hearing aid, rather than through its microphone. This makes it easier to hear conversations over the telephone. A telecoil also helps people hear in public facilities that have installed special sound systems, called induction loop systems. Induction loop systems can be found in many churches, schools, airports and auditoriums.

Canal aids fit into the ear canal and are available in two styles. The in-the-canal hearing aid is made to fit the size and shape of a person’s ear canal. A completely-in-canal hearing aid is nearly hidden in the ear canal. Both types are used for mild to moderately severe hearing loss. Because they are small, canal aids may be difficult for a person to adjust and remove. In addition, canal aids have less space available for batteries and additional devices, such as a telecoil. They usually are not recommended for people with severe to profound hearing loss because their reduced size limits their power and volume.

Hearing aids work differently depending on the electronics used. The two main types of electronics are analog and digital.

Analog aids convert sound waves into electrical signals, which are amplified. Analog/adjustable hearing aids are custom-built to meet the needs of each user. The aid is programmed by the manufacturer according to the specifications recommended by the person’s audiologist. Analog/programmable hearing aids have more than one program or setting. An audiologist can program the aid using a computer, and the user can change the program for different listening environments—from a small, quiet room to a crowded restaurant to a large, open area such as a theater or stadium. Analog/programmable circuitry can be used in all types of hearing aids. Analog aids usually are less expensive than digital aids.

Digital aids convert sound waves into numerical codes, similar to the binary code of a computer, before amplifying them. Because the code also includes information about a sound’s pitch or loudness, the aid can be specially programmed to amplify some frequencies more than others. Digital circuitry gives an audiologist more flexibility in adjusting the aid to a user’s needs and to certain listening environments. These aids also can be programmed to focus on sounds coming from a specific direction. Digital circuitry can be used in all types of hearing aids.

It is important to consult an audiologist to select the hearing aid that is best for a person’s needs and lifestyle. Read more about hearing aid technology on the website of the National Institute on Deafness and Other Communication Disorders, which offers extensive, reliable information about hearing loss, hearing aids and other adaptive technologies for people with communication challenges.


Right at Home, Inc. is a national organization dedicated to improving the quality of life for those we serve. We fulfill that mission through a dedicated network of locally owned providers of in home care services.