All about hearing aids

In this leaflet we tell you everything you need to
know about hearing aids.
It is written for people who think they may need
a hearing aid. It will also help you if you have just
got your first hearing aid and want to know more
about it.
If you already have a hearing aid, you will also
find helpful information about using and looking
after your hearing aid.
The following information is included in this leaflet:
• What is a hearing aid?
• How to get a hearing aid
• Getting a hearing aid on the NHS
• Buying your own hearing aid
• What types of hearing aid are available?
• Digital hearing aids
• How to use your hearing aid
• Looking after your hearing aid
• When something goes wrong
3
What is a hearing aid?
A hearing aid makes sounds louder so that you are
able to hear them. It is battery-operated and you
usually put it in or around your ear. Hearing aids
are available in different shapes, sizes and types.
However, all hearing aids work in a similar way.
Very simply, all hearing aids have a built-in
microphone which picks up sound. This sound
is processed electronically either by analogue
circuits or digitally to make the sound more audible.
The resulting ‘signals’ are then passed to a receiver
or earphone in the hearing aid where they are
converted back into sounds for you to hear.
A hearing aid also has an earmould – the part that
goes in your ear – tubing and batteries for power.
The type of hearing aid you get will depend, for
example, on your hearing loss and what you find
comfortable. We tell you more about different
types of hearing aid later.
All hearing
aids have a
built-in
microphone to
pick up sound
Microphone
Volume control
Telecoil
Switch
Battery
Elbow
Electronic processor
Receiver
Illustration: Cyrus Deboo
4
What you can expect from your
hearing aid
A hearing aid won’t give you perfect hearing. It will
make sounds louder and may help you to hear on
the telephone, make conversations easier and, as
a result, increase your confidence when talking to
other people.
A hearing aid will not make your hearing worse.
If you have tinnitus – hissing, buzzing or other
noises in your ears or head – you will probably
hear it less when you use a hearing aid.
It takes time to get used to a hearing aid.
However, it pays to persevere with your hearing
aid until you are happy with it. Until you get used
to using it in a lot of different situations, you won’t
know if it suits you. When you get your hearing
aid, you should be given advice on how to get the
best from it. You will probably need more help as
time goes on. You should also be shown how to
use it and look after it.
We tell you more about this later.
A hearing aid
won’t give you
perfect hearing
but it may make
conversations
easier
5
How to get a hearing aid
The first thing you need to do is get your ears and
hearing checked to confirm you have a hearing
loss and to see if a hearing aid will help. Your
hearing difficulty may need medical investigation
and treatment so it is a good idea to see your GP
(family doctor) first, even if you are thinking of
buying a hearing aid privately.
In the UK you can get a hearing aid free of charge
on the NHS or buy it privately. Buying your own
hearing aid is expensive so you may prefer to try
the NHS route to getting a hearing aid first. We
tell you about the advantages and disadvantages
with both options later.
To get a hearing aid on the NHS, you first need to
visit your GP. He or she will refer you to an ear,
nose and throat (ENT) consultant or an audiologist
at a hospital near you. If you are over 60, your GP
may refer you direct to an audiology department
so you won’t have to go to ENT first.
If you prefer to buy your hearing aid, you can go
straight to a private hearing aid dispenser. He or
she should tell you if you need to see your GP
about your hearing loss.
Getting a hearing aid on the NHS
If your GP refers you to an ENT consultant, you
will usually be seen in a hospital. Here, the ENT
consultant will examine your ears and ask about
your medical history, including any family deafness.
You will then see an audiologist who will test your
hearing using an ‘audiometer’. The audiometer
produces sounds of differing frequencies (pitch)
and levels of loudness. You tell the audiologist
which sounds you can hear and the results are
shown on a chart called an audiogram. From this,
the audiologist will be able to tell if a hearing aid
will help you.
If you need a hearing aid, the audiologist will take
an impression of your ear to make an earmould to
fit in your ear. Some clinics may offer you one
hearing aid for each ear, though policy about this
varies from clinic to clinic. It is a good idea to try
two hearing aids as many people do better with
two aids than just one.
You will get your new hearing aid a few weeks
later when the earmould is ready. The audiologist
will adjust your hearing aid to suit you and show
you how to use and look after it. You will also get
written information about this.
6
Visit your GP
to get your
ears and
hearing
checked
National Medical Slide Bank
7
If your hearing aid is a digital one, you may
be asked to come back to have it fine-tuned
when you have tried it out in different situations.
You should, in any case, be given a follow-up
appointment within three months to discuss how
you are getting on with your hearing aid.
The advantage of an NHS hearing aid is that it is
free. So are new earmoulds, tubing and batteries
and, normally, repairs.
Hearing aids last on average about five years.
At some time, you may need a more powerful
hearing aid – in either case, you will not have to
pay for your new hearing aid. However, if you lose
or damage your hearing aid, you may be asked to
pay something towards repairs or a replacement.
The disadvantages of an NHS hearing aid are
that you may have to wait several weeks or even
months for a first appointment and then some
more time for your hearing aid. You cannot always
choose which style of hearing aid you get. However,
the NHS does have a range of hearing aids, and
you should be able to get one that suits your
hearing loss.
For further information, see RNID’s factsheet,
The NHS hearing aid service.
8
Buying your own hearing aid
To buy your own hearing aid, you need to find a
private hearing aid dispenser. The best way to
find one is to get a recommendation from your
GP or a friend. By law, all hearing aid dispensers
must be qualified – or in supervised training –
and registered with the Hearing Aid Council,
which regulates dispensers’ training and conduct
and handles complaints. The RNID Information
Line can give you a list of hearing aid dispensers
in your area, but cannot recommend one.
In some ways, getting your hearing aid privately
is similar to getting one on the NHS. Your hearing
will be tested and your hearing aid dispenser will
show you how to use and look after your aid.
You will, however, have to sign a contract agreeing
to buy your hearing aid. Make sure you see the
terms and conditions of this contract before you
have your hearing test and find out about any
money-back guarantee. Ideally, you should get at
least 28 days to try out the hearing aid and be
able to return it during this time if you are not
satisfied with it.
For further information, see RNID’s factsheet,
Buying a hearing aid?
9
One advantage of getting a private hearing aid is
that you can choose the style of hearing aid you
want. Some types of hearing aid – such as canal
aids – are not available on the NHS (see later).
At present, digital hearing aids are available only
through selected NHS hospitals (see later).
Your hearing aid dispenser will probably see
you straight away and you will be able to get
your hearing aid within about two weeks.
The disadvantages of buying privately are that
hearing aids are expensive and cost between
£300 and £2,500. If you buy a hearing aid for
each ear, you will have to pay almost double.
Medical insurance may cover part of the cost of
a hearing aid, but check with your insurer first.
When the guarantee runs out, you will also have
to pay for repairs and the costs of this can mount
up. You will also have to buy your own batteries.
Hearing aids last about five years on average so
remember that you will have to pay for new ones
in the future.
You will also need to insure your hearing aid
against loss, theft or damage if you buy it privately.
10
What types of hearing aid
are available?
Hearing aids are described as analogue or
digital, depending on the technology they use
to process sound. Digital hearing aids are the
newest kind of hearing aid. They contain a tiny
computer to process sound. Many types of
hearing aid are available:
• Behind-the-ear (BTE) hearing aids have
an earmould, which sits inside your ear. The
hearing aid itself rests behind your ear and a
plastic tube connects it to the earmould. They
are the most common type of hearing aid and
most people who get NHS hearing aids get one
of these.
• In-the-ear (ITE) and in-the-canal (ITC) aids
have their working parts in the earmould so the
whole aid fits into your ear. They tend to need
repairing more often than BTE aids. Some ITE
aids can be seen from the side. The smallest
canal aids fit right inside your ear canal, where
they cannot be seen. If you have severe hearing
loss, or very small ear canals, canal aids will
probably not suit you.
Very small
hearing aids
fit right inside
your ear and
cannot be
seen from
the outside
11
• Body-worn hearing aids consist of a small
box that you clip to your clothes or put in your
pocket. It is connected by a lead to an earphone
and earmould. They are not often used but are
less fiddly than smaller types. Some body-worn
aids are very powerful.
• Bone conduction hearing aids are for people
with conductive hearing loss or people who
cannot wear a conventional hearing aid. They
deliver sound through the skull by vibrations.
One type involves a small operation behind the
ear to fix a vibrating part.
• CROS/BiCROS hearing aids are for people with
no hearing in one ear. CROS hearing aids feed
sound from the side with no hearing to the good
ear. BiCROS aids amplify sound from both sides
and feed it into the ear that has some hearing.
• Disposable hearing aids may be an option
for you if you are wondering if a hearing aid will
help you. They are suitable only for people with
mild to moderate hearing loss. They can be
thrown away when the battery runs out, usually
after six weeks. You can buy them from some
branches of Boots, the high street chemist.
• Waterproof and water-resistant hearing aids
are hearing aids that have a thin membrane to
stop water – but not sound – getting into the
aid. Waterproof aids are suitable for swimming
and water-resistant ones for other watersports.
12
Digital hearing aids
Digital hearing aids look just like modern analogue
hearing aids but they are different in that they
process sound digitally. Sound is converted into
bits of data or numbers that can be manipulated
by a tiny computer inside the aid. This makes it
possible to process and customise sounds very
precisely to suit your hearing loss and you can
then listen to sound comfortably, whatever the
pattern of your hearing loss. Many digital aids can
be programmed with different settings for different
sound environments that you can select at a touch
of a button. Some adjust themselves automatically.
One of the biggest problems for people with
hearing aids is following what someone is saying
in noisy places. Many digital hearing aids are
designed to reduce steady kinds of background
noise such as the rumble of traffic or the whirr
of a fan. This makes listening more comfortable,
though it does not necessarily help you pick out
one voice when many people are talking.
i
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iii
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13
Directional microphones have made a big
difference to this problem. These are very
sensitive to sounds directly in front of you and
help you to focus on what you want to listen to.
When coupled with digital processing, they enable
you to listen as well as a hearing person in similar
conditions. Some digital hearing aids are also
designed to whistle or squeak less than analogue
aids (see later, When something goes wrong).
Getting a digital hearing aid
Until recently you couldn’t get digital hearing aids
on the NHS. However, after intensive lobbying
from RNID, the Government has provided funding
to introduce digital hearing aids, starting with
selected hospitals in England.
The Scottish and Welsh Executives have also
provided funding for modernising audiology
services throughout Scotland and Wales. This
includes the provision of modern (but not always
digital) hearing aids. RNID is actively lobbying
for the modernisation of audiology services in
Northern Ireland.
It is hoped that, eventually, digital hearing aids will
be provided on the NHS throughout the UK.
Digital hearing aids are also available from a private
hearing aid dispenser and cost up to £2,500 each.
Digital hearing
aids look
like modern
analogue aids
but they
process sound
digitally
14
How to use your hearing aid
Once you get your hearing aid, it is important
to practise putting it in your ear and using the
various controls on it. This will help you get used
to using it and get the most from it. First, check
that the earmould fits snugly but comfortably.
Controls on your hearing aid
Most hearing aids have a switch with different
positions and a volume control wheel. Feel for the
switch with your finger, switch your hearing aid on
and off and adjust the volume to a comfortable
level. Do this until you are used to the feel of your
hearing aid. If you get used to changing the volume
control right from the start, it will make it easier
for you to adjust it when you need to, for example
when you are with other people or if you go from
a noisy environment into a quiet one.
Switch controls differ from one hearing aid to
another. The most common ones are ‘O’ for ‘off’,
‘M’ for ‘microphone’ and a setting marked ‘T’.
Try and get
used to the
controls on
your hearing
aid from the
start
15
Have a look at the switch on your hearing aid.
Normally, you use your hearing aid on the ‘M’
setting, and switch it to ‘O’ when you take it off.
Very small hearing aids may not have an ‘O’
switch. To switch the aid off, you will need to
open the battery door slightly.
The ‘T’ position
Most hearing aids have a setting marked ‘T’.
When the switch is on the ‘T’ position, your
hearing aid will be able to pick up sound from
listening equipment (see later, Listening
equipment). This equipment transfers sound
direct to your hearing aid, cutting out background
noise. When you get your hearing aid, ask if it has
a ‘T’ setting. If it is a very small aid, there may be
no room. This means that you won’t be able to
use listening equipment with your hearing aid.
Batteries
You will have to change the batteries in your
hearing aid regularly. If you have an NHS hearing
aid, you can get free batteries from any hospital
audiology or ENT department that has a battery
service. You can buy batteries from any pharmacy.
The ‘T’ position
is important for
picking up
sound from
listening
equipment
16
Getting used to your hearing aid
Getting used to your hearing aid can take several
months. Start by wearing it once or twice a day
for about an hour in quiet situations. Listen to
everyday noises such as the kettle boiling or
doors opening and shutting to get used to how
they sound. Then try conversations with one
person, again in a quiet room. Make sure the
other person sits facing the light as it will make
it easier to lipread them.
Next, try conversations with two people or in small
groups. Don’t expect to hear everything that is
said, but try to follow the conversation. When you
have practised using your hearing aid inside, try
wearing it outside. To start, be careful not to have
the volume too high when you go out because
sounds, such as traffic, can be loud.
Finally, try using your hearing aid somewhere
where it is noisy such as a restaurant or pub. This
is likely to be the most difficult situation. You will
probably not be able to hear everything that people
say to you, but with time this should get easier.
If you still can’t get used to your hearing aid, talk
to your audiologist or hearing aid dispenser.
It takes time to
get used to a
hearing aid but
it is worth
persevering
17
Looking after your hearing aid
How you look after your hearing aid will depend
on the type of hearing aid you have. You should
have been given written information telling you
how to look after it.
Caring for your hearing aid mostly involves wiping
clean or washing different parts as follows.
If you are not sure about any of the
information given here, ask your audiologist
or hearing aid dispenser for advice.
Behind-the-ear (BTE) hearing aids
Wipe the hearing aid and earmould with a dry
tissue every time you take your hearing aid off.
Ideally, you should wash the earmould only every
night. If you can’t do this, wash the earmould at
least once a week. Do not wash the hearing aid –
the part that contains the battery.
Don’t unscrew the elbow from the hearing aid
(see diagram). Instead, gently pull the plastic
tubing off the elbow but not from the mould.
Wash the earmould and tubing in warm soapy
water, and rinse them. Blow down the tubing to
get the water out, and let it dry overnight.
Tubing
Earmould
Elbow
Volume
control
Off/T/M
switch
Battery
compartment
A behind-the-ear
hearing aid
18
Once it is dry, push the end of the tubing back on
to the elbow. You will need to change the tubing in
a BTE hearing aid when it begins to harden. Ask
your audiologist or hearing aid dispenser to show
you how and give you spare tubing. If the tubing
gets very hard, the hearing aid may not work well.
If it splits, the aid will start to whistle (see later).
If you find changing the tubing difficult, your
audiologist or hearing aid dispenser can do this
for you.
In-the-ear (ITE) hearing aids
There are two types of ITE hearing aids:
Custom ITE aids consist of only one piece. If you
bought an ITE hearing aid privately, it is likely to
be a custom one. You must not wash these. Wipe
them with a dry tissue and use a soft dry brush
to remove wax from the opening. Do not poke
anything into the opening as you may damage the
earphone. These aids often come with instructions
and cleaning tools to help you.
Modular ITE aids consist of an earmould attached
to a hearing aid. You can separate the earmould
from the hearing aid and then wash the earmould
in soapy water. Wipe the hearing aid part with a
dry tissue instead. Don’t ever wash it or get it wet.
19
In-the-canal (ITC) and completely-in-the-canal
(CIC) hearing aids
You must not wash these hearing aids. Wipe them
with a dry tissue and use a soft brush to clean
wax from the opening. ITC hearing aids often
come with special instructions and cleaning tools.
Body-worn (BW) hearing aids
If you have a BW hearing aid, wipe it all over with
a dry cloth every time you take it out. Wash the
earmould only at least once a week. Gently pull
the receiver off the earmould. Put the hearing aid
(the part with the battery in), lead and receiver in
a safe, dry place. Don’t ever get these wet.
Wash the earmould with warm soapy water,
using a soft brush to remove any wax blocking
the opening in the earmould. Rinse and dry the
earmould carefully. Leave it to dry overnight
before you clip it back on to the receiver.
The lead linking the receiver and hearing aid on
BW hearing aids needs to be replaced from time
to time.
Earmoulds
Ask your audiologist or hearing aid dispenser to
make a new earmould if it wears out.
20
Listening equipment
Some equipment is especially designed to be
used with hearing aids.
Loop systems are often installed in places such
as theatres, public halls, post offices and banks.
A sign like the one opposite means a loop has
been installed. Find out if the loop is switched on
and that it works. Loop systems can also be
installed in your home to help you listen to your
television and stereo system.
Telephones described as ‘hearing aid
compatible’ have a kind of built-in loop. When you
use this kind of telephone with your hearing aid in
the ‘T’ position, the sound you hear will be clearer
and without background noise. Practise holding the
telephone earpiece in slightly different positions
next to your hearing aid to get the best sound.
Some listening aids or sound amplifiers –
used to hear television, music or conversations –
can be used with or without your hearing aid.
For further information about listening equipment,
see RNID’s leaflets, Sound and subtitles – making
the most of audiovisual equipment and Equipment
for deaf people.
20
A loop
system has
been fitted
where you
see this sign
21
When something goes wrong
If you are having problems with your hearing aid,
your audiologist or hearing aid dispenser should
be able to help you. However, there are some
common problems that you may be able to sort
out yourself. Try the suggestions below. If they
don’t help, then ask your audiologist or your
hearing aid dispenser.
If your hearing aid doesn’t seem to be working
• Check that you have not switched it to the
‘T’ position by accident.
• Make sure that the volume is at the correct
level for you and not turned right down.
• Try putting a new battery in.
• If you have a BTE hearing aid, take it out, pull
the tubing off the elbow and blow down the
tubing to remove any condensation that may
have collected and be blocking the tubing.
21
22
Whistling or squeaking is caused by ‘feedback’.
This happens when sound amplified by your
hearing aid is fed back into it. It may happen if:
• You have not put the earmould in properly –
push it gently to check.
• You have excess wax in your ears – ask your
GP to check your ears.
• The earmould does not fit your ear closely
enough. Put a little Vaseline on the mould to
see if this helps by sealing the hearing aid in
your ear. Be careful not to block the opening
in the earmould as this will stop sound coming
through.
• You have the volume too high.
• If you have a BTE hearing aid, check the
earmould, the elbow and the tubing. A crack in
any of these will make your hearing aid whistle.
Buzzing noises may mean that you have
switched your hearing aid to the ‘T’ position by
accident. However, if this is not the problem,
buzzing generally means your hearing aid has
developed a fault and needs to be repaired.
22
What is RNID?
RNID is the largest charity representing the 8.7 million
deaf and hard of hearing people in the UK. As a
membership charity, we aim to achieve a radically better
quality of life for deaf and hard of hearing people. We do
this in the following ways:
• Campaigning and lobbying to change laws and government
policies.
• Providing information and raising awareness of deafness,
hearing loss and tinnitus.
• Training courses and consultancy on deafness and disability.
• Communication services including sign language interpreters.
• Training of interpreters, lipspeakers and speech-to-text
operators.
• Seeking lasting change in education for deaf children and
young people.
• Employment programmes to help deaf people into work.
• Residential and community services for deaf people with
special needs.
• RNID Typetalk, the national telephone relay service for deaf
and hard of hearing people.
• Equipment and products for deaf and hard of hearing people.
• Social, medical and technical research.
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RNID Information Line
19-23 Featherstone Street
London EC1Y 8SL
Telephone 0808 808 0123
Textphone 0808 808 9000
Fax 020 7296 8199
informationline@rnid.org.uk
www.rnid.org.uk
August 2002 Registered Charity No. 207720
0141/inf154.0802 Photos: Crispin Hughes, Joe Sheehan
Cover photograph by Chris Kelly.
Some photographs in this leaflet were posed by models.
Published in August 2002.
This leaflet is part of RNID’s hearing aids range.