Have you ever dreamed of helping your patients hear better in all situations? How many times have your patients told you they cannot hear the fast-paced dialogue on TV or in a public place? It would be great if the hard of hearing could hear clearly in a grocery store, at a service counter window, at an airport or in a place of worship. Many of us have explained FM systems, but how many times have you discussed loop systems with your patients?
People with hearing loss struggle to hear speech clearly at a distance, in rooms with poor acoustics (reverberation and sound distortion) and/or distracting background noise. Working hard to hear clearly can be fatiguing and discouraging. Moreover, many hearing aid wearers blame their hearing aids. When in reality it can be difficult to hear clearly in many situations even if you have good hearing. How many times have you struggled to hear an important message delivered over a public address system? Can you imagine the added burden if you had a hearing impairment?
By fitting our patients with telecoils, we give them a built-in receiver and the potential to hear clearly in all listening situations. Residential loop systems can provide improved hearing on the phone, with the TV or stereo and even in the car. Commercial loop systems can improve hearing in public places.
An induction loop system consists of an amplifier and a loop. The amplifier is connected to a sound source such as a TV, stereo, public address system or a dedicated microphone. It then amplifies the sound signal and sends it through the loop to create a magnetic field. A hearing aid telecoil or a loop receiver (headset) then picks up the fluctuations in the magnetic field. By delivering the sound directly to the hearing aid or headset, the sound is pure and undistorted. Using ones own personal hearing aid is appealing to patients because it is less conspicuous than a headset receiver is and eliminates concerns about hygiene with public headsets. In addition, loop systems operate in settings with bright light and on a universal frequency thus eliminating the problem of operating in multiple frequencies as with FM systems.
Here in the United States we hear little about loop systems. However, with the mandates of the Americans with Disabilities Act along with increasing awareness from social, welfare, and public health authorities we can be hopeful to see more and more induction loop systems installed in public places.
In the meantime, we can assist our patients right now with residential loop systems. A pilot study conducted in HearUSA centers focused on two systems, a neck loop by Sennheiser, and a room loop by Phonic Ear. The loop systems were initially discussed during hearing aid evaluation and annual appointments. Demonstrations were provided during HELP Class as well as all hearing aid check appointments. Patients commented about how the loop systems would enhance their TV experience and improve the quality of their lives.
Disclaimer for Pacemaker Wearers:Under normal circumstances, a correctly installed induction loop system does not interfere with pacemakers. However, a minimum of two inches should be maintained between the loop cable and the pacemaker to remove any potential interference.
I’m a fairly new Hearing aid technician, so sitting with patients and discussing their recently acquired hearing aids is a rewarding, fun, and a challenging experience for me. I would like to think that the challenge is less for me than for most hearing professionals because I also wear the product; or at least a similar product to what each patient is wearing when they come into my office for instructions on how to use their new hearing aids.
I start the conversation by asking them if they are new wearers or experienced; this is important because I want to find out how much they know about hearing aids. I want to make sure that I can help them become satisfied hearing aid wearers. Typically the beginning point is to discuss and practice inserting and removing their hearing aids so they build a comfort level for taking them in and out.
Once we have accomplished this, we then move into how to use hearing aids; changing their programs and hearing aid settings. This is where the fun begins! I get to find out the different types of activities and events my patients partake in, and how much they feel they have been missing prior to their hearing aid purchase. Then I compare my experiences in similar situations and throw in a few antidotes to lighten up the tension in the room. I understand that someone wearing hearing aids for the first time may feel uncomfortable about not knowing what to expect or how to manipulate them in front of someone they don’t know.
I also understand that even an experienced wearer can be uncomfortable because they have been in their comfort zone with their existing hearing aids and now, with new technology, they are learning about a whole new product – in most cases, with many more features. So if I can tell some funny things that happened to me in the beginning and then give them some wonderful experiences with my newer hearing aid, it lightens the mood in the room and makes it much more comfortable for them to express their feelings to me.
By the way, if you’re wondering, I went from wearing Phonak hearing aids from 2006-2010, to now wearing the Siemens Pure 500 in the right ear. I am profoundly deaf in my left ear (no hearing aids would help me) and a slight hearing loss in my right ear. The Pure is a wonderful device and allows me to hear a lot more then I ever heard with my other product.
New hearing aid technology is amazing and being given the ability to share that with our patients is the most rewarding thing I’ve done in my career.
Truth be told, I have never been a believer in extended warranties. If you ask the so-called experts, most will advise you to avoid them at all costs as a waste of money. When it comes to hearing aids, I make an exception. All too often, I have seen costly repairs and worse lost or damaged hearing aids that are expensive to replace. It is not cut and dry though. Extended warranty coverage for hearing aids is not necessary for all hearing aid users. So, how do you know? Does it make sense for you to invest in this protection? I have adapted a 7-question guide of things to consider before purchasing an extended warranty and help you decide when if this coverage is for you.
Question 1: Are you buying a high-reliability product?
There’s a big difference in product reliability rates. Believe it or not, the style of your hearing aid has a lot to do with the frequency of repair. Why, you ask? Hearing aids are some of the most miniature, complex, and fragile devices. They are constantly subject to environmental wear and tear, in addition to heat, moisture, and the ever constant battle with wax. Thus, as a general rule, the smaller the aid and the further in your ear canal the electronics are seated, the higher the rate of repair. Thus, the average rates for different styles of hearing aids are:
CIC (completely-in-the-canal) – every 7-9 mos.
ITC (In-the-canal) – every 9-12 mos.
ITE (In-the-ear) – every 12-15 mos.
BTE (Behind-the-ear) – negligible, lowest repair rate of all styles
(Hearing Aid Repair Rates, Michael Block, 2001)
The question becomes, how much risk are you willing to live with?
Question 2: Is the person using the hearing aid likely to be careless, forgetful, or treat it in a rough manner?
To pick up where I left off before about how hearing aids are the most miniaturized, technological devices…very simply, they don’t stand a chance of survival when they’re in the hands of a klutz. Even the biggest of hearing aids is a small device. They can be easily, lost or misplaced. If you have protection against such instances, you will be able to use the hearing aids without worry.
Question 3: Is the cost to replace or repair the product less than the cost of the extended warranty?
Consider these estimates:
Cost to repair a digital hearing aid: $189 to $230.
Cost to replace a digital hearing aid: $1600 (US avg/aid)
Cost of a !-year extended warranty: $200 (HearUSA cost/unit)
At HearUSA, we offer extended warranties for up to two additional years after the manufacturer’s original one-year warranty. This includes coverage for repair, as well as a one-time loss. There is a deductible in the event of loss – typically $450…but for less than the cost of one repair, your warranty will have paid for itself.
Question 4: Does the cost of the extended warranty exceed 20% of the product’s purchase price?
This is a nobrainer! See the above estimated expenses.
Question 5: What is exactly is covered under the extended warranty?
Read the contract. Extended warranties can be different from every hearing provider. Check to see if the protection is for repair, loss, damage, and if there are deductibles.
Question 6: Do I already have coverage?
Most new hearing aids come with a standard one-year manufacturer guarantee at the initial purchase. It is possible if you had an insurance discount or other provider program (such as the AARP Hearing Discount Program from HearUSA) that you already have extended coverage. For instance, members of the AARP program, already receive with every new hearing aid purchase a full 3-year repair, 3-year loss, and 3-year supply of batteries automatically.
Question 7: Is my hearing aid indispensable?
How do you replace irreplaceable? Fact: We know that hearing aids improve not only the quality of life for the person with hearing loss, but also for those around this person. We know that hearing aids can truly make a difference socially, physically, mentally and emotionally when used and working in the optimal condition. I believe that if you are willing to make the decision to get help for your hearing, you owe it to yourself to make sure you invest in the best protection and reliability available. You owe it to your ears!
Have you ever wondered what the inside of a hearing aid looks like? One of my patients accidentally stepped on her hearing aid, unfortunate for her, but it gives us a chance to show you what the inside of a Siemens hearing aid looks like.
You might be surprised how many patients ask this question. My greater concern is the number of people who want to ask, and yet are afraid to broach the subject. Why? Doesn’t it seem like a reasonable question?
Here’s the truth: Yes and no. Let’s look at this a little more closely.
Physically, it is now a lot easier to wear someone else’s hearing aids. Many styles of hearing aids (Behind-The-Ear, Open Ear, Receiver in the Canal) are now separate from the custom-molded piece placed in a patient’s ear canal. Since these styles are the vast majority of all digital hearing aids fit today, it is now plausible to wear someone else’s hearing aids as easily as putting on someone else’s glasses. However, just like wearing someone else’s glasses it does not mean that the prescription is accurate and we are not surprised when the vision is not quite clear. My father wore my mother’s old glasses for years, until finally his employer asked him not to return to work until he had his own pair. This doesn’t even take into account the fact that he did indeed look a little funny. To which my mother’s response was bewilderment because of course, the glasses were Gucci’s. Knowing this, I am not sure why we would expect to put on someone else’s hearing aids and hear clearly, but people do.
We are fortunate in that technological advancements in digital processing has enabled us to make specific changes within a hearing aid to alter a prescription. Thus, I had a long-time patient whose personal friend passed away, and inherited a pair of almost new top of the line Behind the Ear hearing aids. I was able to change the programming in the hearing aids to that of my own patient’s hearing test results, and he could utilize them just like they had been purchased for his own hearing loss. Ask your optometrist if they can do that!
It is not always quite that cut and dry. There are a few other important considerations. Even a Behind-the-ear hearing aid has technological specifications and is designed to fit a certain range of hearing loss. For example, I once had a fellow come to see me with a request to fit his mother with a hearing aid he had purchased on Ebay. I had tested his mother and sure enough she had a moderate hearing loss in both ears. However, the hearing aid the son had purchased was only appropriate for someone with a severe to profound hearing loss. In essence, fitting this particular hearing aid on this particular individual could actually result in further damaging the hearing she had left.
By comparison, custom fit hearing aids (such as In-the-ear, In-the-canal, and Completely-in-the-canal styles) offer quite a different picture. I have seen more people than I would like to admit who had in some way managed to force hearing aids originally molded for someone else’s else into their own ear canals, and despite the odd setting reported that they “fit.” In fact, this is hardly ever the case. Even one’s own ears are asymmetrical. There is very little similarity to the size and shape of one person’s ears to another—regardless of heredity. I can best describe this by something one of my professor’s in graduate school said: “I am a size 8 pant. I would love to be a size 2 pant, but I have never been a size 2 pant. Now, can I squeeze into a size 2 if my life depended on it? Yes, probably under grave threat. But I promise you, it would be neither comfortable nor pretty.”
One consideration which is foremost on the minds of hearing care professionals rather than a patient’s is the matter of cost. As hearing care professionals, we are always looking for what will be most cost-effective, provide long-term reliability, and satisfaction to our patients. Most hearing aid purchases are bundled (meaning the cost of the device plus the follow-up care, testing, and fitting are included in the initial purchase). Unfortunately, I have heard of professionals who outright refuse to entertain a plausible solution when fitting a patient with perfectly appropriate hearing aids due to fear of charging appropriate service fees. This type of mentality, in my opinion, is outright shameful. Your hearing treatment is as much about the service and quality of care as it is about the total price. If the hearing care professional is providing an appropriate fitting, I believe both patients and healthcare professionals will find the fees are reasonable and fair.
Many professionals can find it difficult to explain what exactly the fees consist of. So, if you are fortunate enough to find yourself with a pair of appropriate Behind-the-ear hearings, which can indeed be fit to your hearing loss, know that the following charges might apply:
Initial Dispensing fee (per ear) – includes fitting, programming, and verification that the hearing instruments are functioning to the level of your hearing loss
Hearing Aid Evaluation—Not just a hearing test, but includes specific information that is important for determining speech understanding, and your success with amplification
Follow-up Services—This may include subsequent service fees for programming, office visits, and future service that might be necessary
Earmold(s)—In the case of Behind-The-Ear instruments, these devices often require a custom molded piece which is attached to the hearing aid itself for fitting.
The best advice I can provide to someone who might be wondering “Can I wear someone else’s hearing aids?” is to feel comfortable asking a certified hearing healthcare professional, and to listen to the response. A qualified hearing care professional will provide a reasonable explanation specific to your situation. That individual will consider the type, degree and requirements of your specific hearing loss with the capabilities of the hearing aids in question. They will also take into account the needs based on your lifestyle, and compare the warranty vs. upfront costs to that of something which might be new.
Any hearing care professional who truly has the best interests of your hearing and quality of life will find the appropriate balance between what is available and what is necessary. The small and short of it – Can you wear someone else’s hearing aids? It’s not always a yes, but not always a no.
Have you ever considered purchasing hearing aids on the internet? Ever wondered if you could use someone else’s hearing aids? Are you uncomfortable asking your hearing professional these questions? You are not alone.
Know that these are fair and valid question that you should feel comfortable at the very least asking, and that any rational human being would be silly not to explore or at the least consider. The problem is our fault. As hearing healthcare professionals, we have done a lousy job of inviting these questions or at the very least opening them up for debate. The same taboo questions can make hearing care professionals and patients alike feel equally uncomfortable.
Throughout this series, I hope to provide some practical advice to the questions you might have been afraid to ask:
Should I buy my hearing aids from the internet?
Can I use someone else’s hearing aids?
Why can’t I program my own hearing aids?
Why do hearing aids cost so much?
What is the best hearing aid?
Why can’t I use Q-tips and Ear Candling?
Part 1: Should I buy my hearing aids from the internet?
We live in a world where information and technology are truly at our fingertips. The internet and ecommerce has made the availability of almost everything incredibly accessible. We buy contacts, prescriptions, and other health-related products online. So why not hearing aids? It makes sense. I am a huge proponent of internet shopping, and believe that it is often easier and more cost-effective. But, I strongly urge anyone who might be considering the purchase of hearing aids from the internet to use extreme caution. Here is why:
Hearing aids are prescriptive, individually programmed digital devices that require not only consistent qualified professional care, but also guidance through the process of rehabilitation for your auditory system. Not quite the same as buying vitamins, right? The investment of hearing aids is equally a service and the product for which you are paying. The initial purchase is bundled, meaning that the cost typically includes the product in addition to the fees for office visits, adjustments, fitting, and follow-up care.
So, you’ve had a hearing test performed by an audiologist, and received a recommendation for a specific hearing aid model. You’ve researched this model and found it much for much less online. Why is there such a price discrepancy?
The proper hearing aid fitting and programming requires direct interaction between you and the healthcare provider, which all too often is unavailable from the purchase of hearing aids on the internet.
Hearing aids come in a variety of styles with each having its own advantages. Selecting the best style depends on the severity of hearing loss, the size and shape of the individual’s ear, personal preferences, lifestyle and other factors.
Behind-The-Ear (BTE)
Behind-the-ear (BTE) hearing aids fit neatly and comfortably behind the ear offering a secure fit with wide flexibility. People with a wide range of hearing losses, from mild to severe, can be fitted with BTE hearing aids.
Open Fit Behind-The-Ear
(BTE)/Receiver in the
Canal (RIC) BTE
Open Fit and RIC BTE’s combine a virtually invisible behind-the-ear design with all the modern advances of high-end digital technology. This style offers a discrete look with exceptional performance providing some of the most natural sound available.
Comfort Styles
Comfort styles are also referred to as “semi-contour” or “contour” and typically offer more features and options than smaller instruments.
Cosmetic Styles
Cosmetic styles are tiny and virtually invisible when placed in the ear canal.
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I’m a fairly new Hearing aid technician, so sitting with patients and discussing their recently acquired hearing aids is a rewarding, fun, and a challenging experience for me. I would like to think that the challenge is less for me than for most hearing professionals because I also wear the product; or at least a similar product to what each patient is wearing when they come into my office for instructions on how to use their new hearing aids.
