It starts small, almost imperceptible. Subtle changes that creep up on you slowly. By tiny degrees, your hearing begins to decline. You find yourself saying, “Excuse me?” and, “Huh?” more frequently. Your significant other finds themselves saying, “Didn’t you hear me?” You need to turn up the television in order to hear the news. You have to pay much closer attention in conversation to be sure you don’t miss anything. Phone conversations are more difficult for you to understand. Eventually, your get to the point where you can’t ignore it any longer, and you find yourself asking, “Do I need a hearing aid?” It can be a scary question for some people - the kind of question that raises a host of other questions:
  • How do you know if you need a hearing aid?
  • What types of hearing aids are available?
  • Are you going to have to wear something big and blocky?
  • Will wearing a hearing aid diminish your quality of life?
  • Can a hearing aid really help all that much?
That’s where we come in. In this in-depth guide, we’re going to answer all your questions about hearing aids. We’re going to break down the how, what, and why of hearing aids so that you can make an informed decision. We’ll cover:
  • Just how common hearing loss really is
  • The causes of hearing loss
  • The signs and symptoms you need to know
  • How a diagnosis is made
  • The benefits of hearing aids
  • The different types of hearing aids available
  • Things you need to consider when selecting a hearing aid
Let’s get started.

Hearing Loss: A Common Malady

Unfortunately, hearing loss affects millions of people around the world. In fact, approximately 33% of adults in the United States over the age of 65 have some degree of hearing loss, and nearly 50% of adults over the age of 75 have difficulty hearing. The reasons for this decrease in hearing are numerous, including:


As you age, your ability to hear often declines, just as many other abilities do (eyesight, movement, etc.). It’s simply an unfortunate side-effect of aging.

Prolonged Loud Noise Exposure

If you’ve spent a significant amount of time in an extremely loud environment, whether occupationally or recreationally, it can damage the tiny sensory hairs in your ears that allow you to hear. This is why so many rock stars of years past now find themselves struggling to keep up with everyday conversations. What constitutes “loud” noise that can damage hearing? The Mayo Clinic notes:
Decibel LevelExample
60Normal Conversation
78Washing Machine
At Risk
80 to 90Heavy traffic, lawn mower
100Snowmobile, hand drill
110Chain saw, rock concert
120Ambulance siren
140Jet engine at takeoff
16512-gauge shotgun blast
180Rocket launch
If you’ve been regularly exposed to noises in the “At Risk” or “Injurious” level, you have a higher chance of dealing with hearing problems later in life.

Medical Conditions and Medications

Some medical conditions, such as consistent high blood pressure or diabetes can also lead to hearing loss. Additionally, certain medications, such as chemotherapy, can also damage the sensory hairs in your ears, leading to hearing loss. Typically, hearing loss in older adults is caused by some combination of the above factors. The simple, rather unfortunate fact is that hearing loss is a common thing, especially as you age. And even if you’ve taken all the precautions in the world, it’s still not a guarantee that you won’t experience some decrease in your auditory abilities as you get older. But don’t fret. Thankfully, there are numerous solutions available. No, science hasn’t yet discovered a way to reverse hearing loss, but that doesn’t mean you need to live in a silent movie.

Signs and Symptoms of Hearing Loss

Hearing loss usually creeps up on you slowly, almost imperceptibly. In fact, many of the symptoms may be recognized by others first. Hearing loss usually starts with having difficulty hearing higher-pitched sounds, such as the voices of women and children. For example, if your grandchild is talking to you from across a room, you may have a difficult time making out what they’re saying. Other symptoms you may begin to notice are:
  • Having trouble understanding phone conversations
  • Ringing in your ears
  • Turning up the television or music to the point where people complain
  • Regularly asking people to repeat themselves
  • Struggling to follow conversations that are happening in noisy places
  • Feeling exhausted or having headaches at the end of the day from straining to hear
If you are experiencing these symptoms, it’s absolutely essential that you seek treatment. If you don’t, it can have significant negative effects on your life. Again, to quote the Mayo Clinic: Unfortunately, most people affected by hearing loss live with these difficulties for years before seeking treatment — or never seek treatment at all. This may also cause lasting problems for those who love you, if you try to cope by denying your hearing loss or withdrawing from social interactions. Bottom line: don’t put off getting tested if you suspect you may have hearing loss. If you do, it not only hurts you, it hurts those around you.

Diagnosis Of Hearing Loss

There are a variety of tests that can help determine the amount of hearing loss you’re experiencing, the type of hearing loss, as well as what may be causing the problem. These tests, which can be performed by an ear, nose, and throat doctor (ENT) or audiologist, can include:
  • Air Conduction, Conventional, or Standard Audiometry - In this test, you put on a set of headphones and then a range of test tones are transmitted through them. You are asked to respond when you hear each sound, which allows the audiologist to determine which frequencies of sounds you can hear and which are causing problems.
  • Bone Conduction - If it’s determined that you have hearing loss, this test allows the audiologist to know whether your hearing loss is conductive (located in the outer ear, eardrum, or middle ear), sensorineural (caused by damaged cochlear hair cells), or both.
  • Word Recognition - This test evaluates your ability to differentiate between speech sounds. You will be asked to listen to and repeat various words, which will allow the audiologist to know how clearly you’re hearing various types of speech.
There are several other tests that may be performed, depending on the outcome of the first tests. These tests may be used to evaluate the integrity of the eardrum and middle ear structure, determine if the cochlea is functioning properly, and rule out any neurological problems that could be causing the hearing loss. It’s understandable why you might not want to seek help for your hearing difficulties. It may be embarrassing to you or you might feel like you’ll lose some of your personal freedom. For many people, it’s simply hard to admit that they’re getting older. But what many people fail to understand is that being able to hear well significantly improves their quality of life.

The Benefits of Hearing Aids

We rarely think about the benefits of being able to hear clearly, but it truly can be life changing to go from poor to excellent hearing. In fact, those who wear hearing aids report numerous significant benefits.

Improved Social Life

One of the most negative side effects of hearing loss is that it often causes you to withdraw from relationships. Of course, this makes sense. You have trouble hearing what people are saying, often leading to embarrassing situations. You don’t want to keep asking people to repeat themselves or have to pretend to follow along with conversations you can’t actually hear. So you start to withdraw. In turn, you become isolated, lonely, and even depressed. Being able to hear again allows you to actively engage in the social activities you love, whether that’s working out at the gym, playing cards with friends, or going out for a cup of coffee with your significant other.

Improved Job Performance

It’s no surprise that when your hearing suffers, your job performance does too. You can’t hear well during meetings and conference calls, you withdraw from your coworkers, and you even find yourself missing out on critical details in conversations. If this goes on for a significant length of time, you could even lose your job due to unsatisfactory performance. Hearing aids, on the other hand, can keep you performing at a high level on the job.

Improved Mental Function

A recent study done at the University of Colorado showed that when hearing loss occurs, the brain must, in essence, “rewire” itself to make up for the lost hearing. This rewiring process can then contribute to mental decline. As researcher Anu Sharma noted: These compensatory changes increase the overall load on the brains of aging adults. Compensatory brain reorganization secondary to hearing loss may also be a factor in explaining recent reports in the literature that show age-related hearing loss is significantly correlated with dementia. In other words, the rewiring process places increased strain on your brain, which can then lead to mental decline and possibly even dementia. Wearing hearing aids nips this process in the bud and allows you to continue functioning at a high mental capacity.

Improved Emotional Well Being

There is a distinct link between hearing loss and increased chance of depression. A study done by the National Institute on Deafness and Other Communication Disorders (NIDCD) noted that the rate of depression in those with poor hearing was more than double that of those without hearing problems. As Dr. Chuan-Ming Li noted: [We] found that prevalence of moderate to severe depression was 4.9 percent for individuals who reported excellent hearing, 7.1 percent for those with good hearing and 11.4 percent for participants who reported having a little hearing trouble or greater hearing impairment (HI). Depression rates were higher in women than in men. The prevalence of depression increased as hearing impairment became worse... In other words, as hearing impairment grows worse, so do the odds of becoming depressed. Wearing hearing aids allows you to maintain a positive sense of well-being and avoid falling into the depression which traps so many. Losing your hearing is serious and can have a significant negative impact on your life. Those who neglect treatment are placing themselves at risk for isolation, mental decline, and depression. On the flip side, those who get treatment for their hearing loss are able to continue living the life they love.

How Do Hearing Aids Work?

Even if you know you need a hearing aid, you probably still have numerous questions, starting with the most obvious: how do hearing aids even work? A hearing aid has several basic parts:
  • Microphone - Sound enters the hearing aid through the one or more microphones.
  • Digital Processor - The digital processor analyzes the sound coming through the microphone and then optimizes it, improving the quality and making it easier for you to hear. It can also eliminate background noise and remove feedback.
  • Amplifier - The amplifier takes the improved sound from the processor and increases the volume.
  • Speaker - The speaker takes the sound from the amplifier and sends it into your ear.
It’s important to note that modern hearing aids don’t simply amplify all sounds, which could actually increase your problem. If you’re already having trouble distinguishing noises and speech patterns, making everything louder won’t necessarily solve the problem. Rather, using directional microphones, background noise filters, and even direct streaming from electronic devices, hearing aids deliver the best quality sound to your ears. It is important to have a hearing aid that can be programmed by your audiologist to your prescribed hearing loss. They allow you to hear what you want to hear and cause the rest to fade into the background.

Types Of Hearing Aids Available

There are numerous types of hearing aids available, depending on your needs and lifestyle. If you’re worried about being forced to wear a bulky piece of plastic on your ear, fret no more. Advances in technology have made hearing aids increasingly small and unobtrusive.

Behind-The-Ear (BTE) Hearing Aids

As you would imagine, these types of hearing aids feature a plastic case that sits behind the ear and a small molded plastic earpiece that goes in the ear canal. The electronics are housed in the plastic case and deliver the sound through the plastic earpiece into the ear itself. There are also “open fit” BTE hearing aids, which feature only a small tube going into the ear canal instead of a molded earpiece. These allow the ear canal to stay open, which prevents wax buildup and can present a more natural, “open” sound. These hearing aids are easy to use and extremely reliable.

Reciever-in-the Canal (RIC) Hearing Aids

In fact, there are now BTE devices in which the receiver is placed in the canal, which means that the behind-the-ear piece is even smaller. Receiver-in-the Canal hearing aids are one of the most flexible options as they can be used for various degrees of hearing loss. Like BTE hearing aids there is a piece that sits behind your ear, a small wire the runs flush against your ear, and is connected by a dome piece which covers the speaker which sits in your ear. RIC hearing aids are extremely discreet and fit seamlessly with many lifestyles.

In-The-Ear (ITE) Hearing Aids

These hearing aids fit completely in the ear, and depending on the size, can be almost completely invisible. So called “invisible” hearing aids fit deep within the ear canal, and are nearly impossible to see. However, some versions of these hearing aids don’t have wireless capabilities, which can be a downside. Completely-In-Canal (CIC) hearing aids are slightly larger, and are mostly invisible. There are both wireless and non-wireless CIC devices, with the wireless being slightly larger and more visible. There are also full-shell and half-shell hearing aids, which are made to sit in the bowl of the ear. In recent years, these have become less popular as smaller aids have become available, but these still do have a few advantages. Their size makes them easier to handle for those with dexterity issues and the battery life is typically longer as well.

Considerations When Choosing A Hearing Aid

There are a number of things to consider when choosing a hearing aid. Your choice is going to depend on a number of factors, and you need be sure you have a thorough understanding of the features of each aid before choosing one. Things to consider are:


Hearing aids with more advanced technology are going to cost more than basic models. For example, hearing aids with more advanced technology are more automatic and do a better job in difficult listening environments like restaurants, auditoriums, crowds, etc. Of course, this technology also costs more money. Ask your audiologist if the increased price is worth it, given your lifestyle and hearing needs. You may not need a higher technology level if you do not find yourself in various listening environments. There are also features such as rechargeable batteries, iPhone compatibility and additional bluetooth accessories to connect to TV and/or phones which can affect price. If you want a more expensive model but find yourself unable to afford it, there are often financing options available. Additionally, if you are a veteran, you may be able to get assistance from the Veterans Administration.


The hearing aid you purchase should come with a warranty. Be sure you understand what components are covered by the warranty and which ones you’ll need to cover yourself.


Your hearing aid should last at least five years, if not longer. Obviously, the better you care for it and the better the model, the longer they’ll last. Your audiologist should be able to give you at least an estimate of when you’ll need to replace it.

Trial Period

Ideally, you’ll be able to try your hearing aid for some time before making a final payment. This allows you to ensure you’ve purchased the hearing aid that works best for you and meets all your needs. It also allows you to determine whether you may want to go with a more or less expensive aid.

Adjustments and Additional Services

To ensure that your hearing aids are always giving you the best results, you’ll need to come in somewhat regularly for check ups. Some audiologists also offer additional services, such as battery and case replacement, as well as ongoing education about your hearing aids. Ask how often they recommend check ups, what additional services they offer, as well what you need to do if problems arise.

Accessories Needed

In order to keep your hearing aids in fine working order, you may want to purchase a few accessories, such as a cleaning kit, a dehumidifier (to remove excess moisture), or sleeves to protect them from sweat and dust. Ask your audiologist about what accessories they recommend.

Conclusion: Better Hearing Is Possible!

Hearing loss doesn’t have to be the end of the world for you. Yes, it’s frustrating. Yes, you’ll probably need to make a few changes. Addressing your hearing loss sooner than later provides you a chance to regain control of your relationships, social life, and hearing health. Those who find themselves struggling to hear can end up isolated, lonely, and even depressed if they don’t take the necessary steps. Avoid the frustrations that can come from unaddressed hearing impairment like affected job performance, strained relationships, and increased difficulty with TV or social gatherings. While hearing aids can’t repair your impaired hearing, they certainly can dramatically, if not completely reduce the side effects. They can allow you to continue living an active, social, joyful life. And with hearing aid technology constantly improving, they are both smaller and more powerful than ever. You can even customize your hearing experience with your smartphone! Don’t let hearing loss keep you from enjoying the sound of your grandchildren laughing or your favorite jazz album or the birds chirping on a summer morning. If you suspect you may be experiencing hearing loss, contact us today to set up an appointment.