Why must I wear hearing aids when I am totally alone at home? There is nothing to listen to. I may hum to myself but that's it!

Great question! I hear this one all the time. Hearing happens with more than just your peripheral ear. Your brain needs auditory stimulation for soft sounds (like the hum of the dishwasher, the ice machine dropping ice, your own feet walking on the floor etc.) that you should hear all the time if it is excepted to function in noisy environments. If you don’t wear hearing aids in quiet and allow your ears and brain to normalize to environmental sounds, when you ask them to function in a noisy environment with hearing aids-where you will hear much more than you are used to-they don’t function as well. 

That is my short answer and I think there is some good information in lay terms here: https://www.healthyhearing.com/report/46306-Hearing-loss-auditory-deprivation

Having Hearing Loss and not Wearing Hearing Aids can Contribute to Dementia. Really? Yes.

Frank Lin, M.D. Neurologist at Johns Hopkins University took MRI images of hearing impaired non-hearing aid users brains. 

People with hearing impairment compared to those with normal hearing had a higher rate of gray matter decrease. 

The areas that are shrinking are your hard drive for your brain’s memory. So when you can’t hear well, and you do not use your hearing, the memory areas could shrink by as much as 1 cubic centimeter per year.

The brain weighs 3 to 3.5 pounds. Your entire personality is in there. By wearing your hearing aids all day, everyday, even when you are alone, you are  protecting your brain. That’s why you should wear your hearing aids even when you are alone.

Follow this link to see Dr. Lin’s research for yourself https://lnkd.in/dhdFYNx

The simplest way to explain this is that your brain needs to hear all sorts of sounds, even in quiet environments.  You likely have not heard certain sounds in a while, and the brain needs to re-learn how to prioritize sounds in your environment.  For example, soft sounds like your walking, clothing rustling, running appliances, etc.  When I first give a paitent a hearing aid, I warn them that these sounds are going to be at the forefront of their attention, so they need time for the brain to adjust and eventually the brain simply tunes them out.  

By not wearing your hearing aids all the time, you rob yourself of the benefits of such a marriage.  Besides, your hearing loss does not cease to exist at home.  Wearing your hearing aids will benefit you in so many ways.  

I would advise you to maybe invest in a TV device (if you like to watch TV) that will stream the sound directly to your aids.  My patients love this feature, and find that they wear the hearing aids more often than they did without the device.

We hear with our brain and bathing your ears in sound is one of the best things you can do.  Stimulating your ears, even in the quiet of your home helps with reconnecting the fibers and cells that have not been used in a long time. Even in the quiet of our homes there are a multitude of sounds.   We take for granted the heat kicking on and off, fingers tapping on a keyboard,  the hum of the refrigerator, turning the pages of a newspaper or the creak of floorboards.  You are retraining your brain and the more you wear your hearing aids, the easier it becomes when you find yourself in difficult listening environments.  If you were running a marathon, you would not show up the day of the race without intensive training.  Putting your hearing aids on only when you think you need them is usually not the best strategy.

I think that several others have addressed well the cognitive elements of this question. I want to respond with a sometimes more practical element. If you have a quiet lifestyle at home, and don't wear your hearing aids there, your ears/brain is used to the world being Very Quiet. Not much furnace sounds, fan sounds, traffic sounds, body sounds, cooking sounds, eating sounds, moving sounds, pet sounds ... you get the idea. That doesn't seem like a terrible thing, and I'd sometimes like my life to be quiet like that too. But what happens then when you head out for a social activity and want to use your hearing aids? You put them on, and ... kaboom, all the little less-important things around you that you haven't had to think of as having sounds are now producing sounds that your brain is focusing on instead of being able to just focus on the speech. That isn't a hearing aid fault, that's a neural filtering fault. Without experience with the idea of daily life having daily noise, social life/social noise can't be as natural and effortless.

It is important to retrain your brain to accommodate to sounds with your hearing aids. Think of learning to ride a bike: you begin on an easy surface and then move toward more challenging terrain like hills and curves. No one would learn to ride a bike starting on the Tour de France race. Begin in less challenging situations and then as you move into more challenging ones you will be more accustomed to all sounds around you.  

I hear this often and explain this routinely to inquiring patients. First, you have to accept that hearing is directly connected to brain function.  If you don’t hear correctly, your brain also is impacted, lacking the needed stimulus to function as it should.  Simply put, if your brain doesn’t get the commands from your ears, it can’t respond appropriately to needed information. For example, if you don’t hear your footsteps appropriately there is a greater chance of you stumbling and falling. You need the hearing cues in order to maintain positional awareness.  Ever heard the statement “use it or lose it”?  It applies directly to hearing and brain function.  You need to hear all sounds to keep your aural pathway active (by hearing frequencies correctly). If not, there is greater propensity for decline in brain function (understanding and resulting action/reaction). The less you hear, the less activity is required by your brain ... cognitive decline results!  Early onset dementia and Alzheimer's are related to hearing loss.  Be smart and wear your hearing aids to keep your brain active. Hearing aids help in many ways other than just hearing! 

We hear with our brain. Not our ears.

If you let your hearing go without aids for too long, your brain loses the ability to help you recognize and hear sounds correctly.   Once this is lost, it might never be regained. The ability to reproduce certain sounds goes also. 

In one study, mild, moderate, and severe hearing loss made the odds of dementia 2, 3, and 5 times higher over the following 10-plus years.

For optimal hearing health - It’s a good idea to begin with a schedule in which you wear your hearing aids part time and gradually work up to wearing them from the time you rise until the time you go to bed.