Which Hearing Aid is Right for Me?

Please note - the following are my personal opinions and experiences accumulated over the last 30 plus years fitting hearing aids. While some of them are not backed up with research studies many have been over the years.  Please take them for what they represent, one person's personal views and opinions.  I hope they help you to understand what we are attempting to do through amplification and hearing aid fitting.

Question: How do I know which hearing aid is right for me? 

A simple question most of my patients ask and one that is extremely hard to answer simply.  With so many styles, models, and technology levels available today, I use five technology levels, and a price range between $800 to over $4,000 an aid it is a daunting task to find the right fit for a person's listening needs.  This section will attempt to lead you through the maze of prices, technology and style to find the ideal hearing aid to match your listening needs, degree of hearing loss, and configuration of hearing loss.  To arrive at the correct hearing aid we will go through the following steps.

1: Lifestyle evaluation

The Lifestyle evaluation is designed to let you see what your listening needs are in a variety of soundscapes (listening environments).  Your lifestyle is composed of your activity level plus a determination of how many different soundscapes you are in and must carry on a conversation in along with how often you are in those environments.  

2: Technology Levels

Choosing the Proper level of hearing aid technology is very important.  This effects many different aspects of the hearing aid; its longevity before the instrument will have to be replaced (the more robust the feature set means the aid can meet more changes in hearing and listening actives as time passes before it must be replaced), the price point of the aid itself (the more robust and the more fitting flexibility means the more sophisticated the instrument and the more expensive the instrument is, cost of professional services (the more feature rich an instrument the longer it is going to take to fit the aid and the more expertise is needed by the dispenser thus increasing the cost of the fitting.  But the higher the technology level the more listening environments it will function in better than its lower technology level cousin.  Think of the hearing aid as a jack-of-all-trades which means it is a master of none.  The basic hearing aid is a whole series of compromises  since it must work some in every soundscape the hearing aid finds its self in.  As the technology level goes up the number of programs also go up meaning each program has to make less compromises for the soundscape it is designed to work in.  Think of each program as an individual hearing aid within the master hearing aid that are being swapped out in the ear as the listening environment changes. 

1. The Tier One of technology provides hearing aids with the fullest feature sets and greatest flexibility in fitting (generally between 16 to 20 channels {provides flexibility in fitting a hearing loss} and 5 to 9 programs {used to meet listening needs in varying soundscapes} with a premium master program composed of a subset of 4-programs and/or a blend of the subset <{meeting an individual’s listening soundscapes automatically})  and meeting individual’s personal listening needs today and probably for the next 5 to 8 years and maybe longer.  This level also provides the best automatic adjustment to match listening soundscapes  as they change around an individual to insure they continue to enjoy the conversation and sound around them with the least amount of work and adjustment.  These hearing aids also employ the most sophisticated decision making abilities in choosing which speech you want to listening instead of who is just in front of you.  Also includes all of the feature sets of the lower tier levels within this tier.  Warranty coverage for Tier One is generally 3-yrs Parts & Labor plus 3-yrs Loss & Damage (each aid will be replaced once).
   Designed for those individuals leading an active lifestyle with varied soundscapes and listening needs that they must carry on conversations within.  Also for those who enjoy or work with music.  Hearing loss configuration can be gentle to radical falling or rising

2. Tier Two technology provides hearing aids with a rich feature set and good flexibility in fitting (generally between 12  to 16 channels <{provides flexibility in fitting a hearing loss} and 3 to 5 programs {used to meet listening needs in varying soundscapes) along with a advanced master program composed of a subset of 3-programs <{meeting an individual’s listening soundscapes automatically}) and meeting individual listening needs today and probably for the next 4-6 years, possibly longer.  The automatic adjustment features are good but with a more limited selection of settings for listening environments.  These hearing aids can make some distinction between speech and noise in the soundscape and enhance speech some while reducing unwanted noise.  Also includes all of the feature sets of the lower tier levels within this tier.  Warranty coverage for Tier Two is generally 2-yrs Parts & Labor plus 2-yrs Loss & Damage (each aid will be replaced once).
   Designed for those individuals leading active lifestyles but whose soundscapes are not as demanding on conversations.    Hearing loss configuration can have sharply falling or rising audiograms.

3. Tier Three technology provides hearing aids with a good feature set and flexibility in fitting (generally between 6 to 10 channels <{provides fair flexibility in fitting a hearing loss} and 2 to 3 programs {used to meet listening needs in varying soundscapes) along with an basic master program composed of a subset of 2-programs <{meeting an individual’s listening soundscapes automatically}) and meeting individual listening needs today and probably for the next 3-5 years.  The automatic adjustment features are okay but mainly designed for more sedated listening environments.  Some noise limiting features are available in this level but speech enhancement features are limited.  Also includes all of the feature sets of the lower tier levels.  Warranty coverage for Tier Three is generally 2-yrs Parts & Labor plus 1-yr Loss & Damage (each aid will be replaced once).
   Designed for individual’s with a less active lifestyle and whose soundscapes are mainly on the quieter side.  Hearing loss configuration should also have gentler slopes without sharp drops or rises.

4. Tier Four technology provides hearing aids with a basic feature set and some flexibility in fitting (generally between 3 to 4 channels <{provides basic flexibility in fitting a hearing loss} and 1 to 2 manual programs {used to meet listening needs in varying soundscapes}) and meeting individual listening needs today and probably for the next 3 years.  There are no automatic adjustment features.  Some noise limiting features are available in this level.  Warranty coverage for Tier Four is generally 1-yrs Parts & Labor and sometimes 1-year loss and damage.
   Designed to meet a person’s basic listening needs if the person’s listening environment is more limited and their activity level is low.  With a limited number of channels the loss configuration should be gently falling or rising without rapid changes between octaves in the speech range.

5. Tier Five technology provides a very basic yet cost effective hearing aid without any real feature sets.  This will meet the basic listening needs of many people if they have a more sedate lifestyle.  Because of the lack of features the individual will probably replace this aid within 3 years.  This aid has a single program that is designed to provide hearing in every soundscape the person is in.  Warranty coverage for Tier Five is generally 1-yrs Parts & Labor only.

3: Individual Needs

This includes things like manual dexterity (can they handle certain types of aids effectively), do they have feeling in their hands or fingers to know when they are touching a button or control, do they have the mental acuity to understand that a listening environment has changed and they need to change programs.  The answers to these questions may limit us to certain styles or levels of technology.