Reviewing new hearing aid options.
My patients are always asking: “How often should I replace my hearing aids?” The answer isn’t as straightforward as you might think. There are many factors that you may need to consider when replacing and/or upgrading your hearing aids. Here are the top 6 questions to ask yourself before upgrading:
1. Are your current hearing aids functioning well?
To perform well, hearing aids require regular maintenance and occasional technical repair. Hearing aids are worn on the body, and they go wherever you go. They aren’t like your cellphone, sitting securely in your pocket or in your purse. They are exposed to the elements, just like anything else on your body, and may be exposed to rain, excessive humidity, extreme temperatures, dust, dirt, etc. Remember, at least part of every hearing aid sits inside the ear canal. Seeing that most ear canals contain a mixture of moisture and earwax, it’s clear that hearing aids aren’t residing in the most hospitable of environments.
Depending on the type of hearing aid you wear, your lifestyle, and your ear canals (some are drier than others), your hearing aids may require a lot of maintenance, or none at all. I have had some patients wear their hearing aids for 5 years without requiring any significant repairs, and others who are in and out of the clinic every few months with moisture (or wax) related issues.
Earwax in a hearing aid speaker. Photo Courtesy Jodivac.
Without regular maintenance, the performance of your hearing aids may change gradually over time, as microphones, speakers, and other important technical components become “clogged up” with moisture, wax, and other debris. Here’s the kicker: I have encountered a number of patients who just “live with it,” without realizing they can actually do something to improve the situation. Sometimes the solution is as simple as changing a wax filter on the speaker, or brushing debris out of the microphone ports. Other times it may require sending the hearing aid to the factory for disassembly and internal-cleaning or (worst case scenario) a complete overhaul (new microphones, speakers, amplifiers, etc).
If your hearing aids aren’t performing well, you should consider cleaning and/or repairing them before purchasing new hearing aids. Ask your provider to perform a “test-box measurement” to see if your hearing aids are performing to the manufacturer specifications. If they aren’t, they probably need some attention.
2. Are your current hearing aids fully meeting your hearing needs?
Try this. Write down at least 5 specific hearing needs. These could be anything from “hearing on the phone while in the car,” to “hearing my best friend while we’re at a party together.” Now, think about each of these hearing needs. Are your hearing aids delivering a significant benefit to you in the situations you listed? Are you somewhat satisfied, but still looking for more?
If your hearing aids are delivering benefit in the situations that matter to you, it may be premature to consider new hearing aids. On the other hand, if you see room for improvement, it may be time to look at newer technology.
3. Are your current hearing aids meeting your hearing prescription?
To get the most from your hearing aids, they need to be set to your hearing prescription. There are a number of methods for calculating a hearing prescription (don’t worry you can leave this to your hearing provider), but broadly speaking, more hearing aid volume is prescribed for worse hearing levels. To verify that your hearing aids are meeting your prescription, your hearing provider should perform a real-ear measurement to measure the sound levels produced by your hearing aids, inside your very own ear canals. Without performing this type of measurement, no one (including your hearing provider) can be certain that your hearing aids are doing their job.
Real-Ear Measurements (REMs) being performed
If your hearing aids are not meeting your hearing prescription, you should ask your hearing provider to improve the fitting. This may require an adjustment of your hearing aids’ digital programming, or some type of cleaning or repair of the devices. If the fitting cannot be improved, your hearing aids may not be adequate for your hearing loss, and you should consider replacing them (especially if they aren’t meeting your hearing needs!).
Some hearing providers provide real-ear measurements for every single patient, as a part of their clinical protocol. The provider must match the output of the hearing aid (in your ear) to a target which is set on the computer screen. A hearing aid “test-box” is used for testing the hearing aid against its specification.
4. Is it worth upgrading to take advantage of new hearing aid technology?
So let’s assume your hearing aids are performing to their optimum level, meeting your hearing prescription, and without any hardware faults. Should you look at upgrading your hearing aids, just to have the latest technology? It turns out this is a difficult question, and one that will depend on whether your current hearing aids are meeting your hearing needs.
Let’s assume your hearing aids are working well, with the exception of taking phone calls in the car. Identifying your hearing need(s) is the first step.
Now you can investigate the new technologies and see if there is anything available that might help. After researching online, you discover a hands-free Bluetooth hearing aid that streams phone calls to both of your hearing aids simultaneously. Bingo. That sounds like it might help!
Now, make an appointment to discuss things with your hearing provider. They should suggest a specific hearing aid with the new technology, and (importantly) one that suits your hearing loss needs. You’re getting close to figuring things out; now you have a product recommendation and a price.
Weigh up the cost of the new hearing aids against the benefits you expect receive. Do the math, and make your decision. If you’re still not sure, ask your hearing provider about their policy on hearing aid evaluations.
5. How do you plan on financing your replacement/upgrade?
If you are receiving funding from the government (or another 3rd party), there may be limitations on how often you can replace your hearing aids. For example, Medicaid regulations in Florida dictate that “hearing aids are limited to one per ear every three years,” while Idaho’s dictate “one hearing aid in a lifetime.”
Private insurance companies are less likely to help with the cost of hearing aids, but if you’re lucky enough to live in New Hampshire or Rhode Island, you may be entitled to regular hearing aid upgrades through your insurer. In Arkansas, insurers are required to offer coverage to employers in the state.
If you’re personally financing your hearing aid replacement, and you can afford to upgrade, upgrade whenever you feel the need. Otherwise check with your 3rd party funder, to see how often you’re able to receive funding.
6. When should I consider cochlear implants?
Your hearing ability will gradually deteriorate over time. If you reach the point where hearing aids can no longer restore your ability to understand speech, you may need to consider the option of cochlear implants. As a rule of thumb, you would be considered a cochlear implant candidate if you have severe to profound hearing loss, and understand less than half of what's said in everyday conversations (in quiet scenarios)—with your well-tuned hearing aids activated.
If you've tried everything else, and still can't perform well with hearing aids, consider seeking a professional opinion on cochlear implants. For help finding a clinic to advise you, check the website for Cochlear and Advanced Bionics, the two leading cochlear implant brands.
Founder and President
Dr. Bailey is a leading expert on consumer technology in the audiology industry. He is a staunch advocate for patient-centered hearing care and audiological best practices, and welcomes any technological innovation that improves access to quality hearing outcomes. Dr. Bailey holds an Au.D. from Vanderbilt University Medical Center.