Concerns when selecting hearing instruments

By: Dr. Lisa D. Cahill, Ph.D., CCC-A

The hearing evaluation, while critically important in the hearing aid fitting process, is the least important factor in selecting an appropriate hearing aid.  In the hearing industry, our primary concern is helping individuals stay active and enjoy life as much as possible.  Therefore, the predominant consideration in fitting hearing instruments successfully is patient lifestyle.

In many cases, the audiologist or hearing aid dispenser could be already mentally selecting hearing aids for their patient before they are halfway finished with the hearing test.  However, an attentive and caring hearing care provider will take time getting to know their patient, their hobbies and interests, their activities and commitments.  What types of listening situations does this individual experience regularly? Are they in a fairly sedentary lifestyle, just at home with television mostly? Are they working? What type of work environment? Do they attend meetings? Do they attend church or other large social gatherings? Do they spend time in crowded areas? These are questions regarding lifestyle that are important in determining what signal processing and noise control features are necessary to manage the listening environments our patients experience.

Simply matching someone to a prescription and price range is not sufficient. Personalizing the evaluation is key to achieving a maximal results.  We typically request that a spouse, significant other, or loved one attend the evaluation and consult with our patients.  This way, we can get a better picture of this individuals life, needs, and preferences.  Watching them interact and observing their communication style is helpful in figuring out what aspects of the hearing aids might be important to them.  Family members may also assist in the assessment process by offering up information about the patient’s hearing experiences and specific challenges. 

Another crucially important consideration is personality type. Studies have shown that success and acceptance of hearing aids are strongly correlated with personality traits (Cox, R.M., 2007).  Personalities that are open to new experience and willing to adjust to new situations are more likely to be successful than a more conscientious personality type that is less likely to be willing to accept background noise (Franklin, et. al., 2013).  Hearing care providers can use self-report questionnaires and interview techniques to narrow down a personality type.    This information can assist the hearing care provider in developing a treatment plan and an approach to counseling and follow up. 

Physical aspects such as manual dexterity, ability to manipulate small objects, ear canal size, and cognitive ability are also key components in choosing a hearing aid.  The patient must be able to insert and remove the aids, and change the batteries independently, unless a full time caregiver is present.  In some cases the ability to manipulate a certain style of hearing aid may supersede other factors. 

The physical style and appearance of the hearing aid can lend itself to certain acoustical and comfort factors, but has nothing to do with the signal processing or function of the aid.  Any technology can be built inside any shell style, therefore, it is really the “guts” of the hearing aid that truly determines the overall listening experience.  In some cases a less expensive technology can work for an individual that can adjust well to the way a hearing aid sounds.  However, advanced noise control and complex signal processing capabilities are often needed to accommodate normal human auditory adaptation.  With a simpler, less advanced circuit, the hearing care provider has less control over adjusting the features when the patient has listening complaints.

Patient preference is given much consideration in the selection process.  Typically the provider will show a number of options to the patient based on lifestyle, personality, financial factors, and cognitive ability, but ultimately, the patient’s personal preference will carry much weight in the success of the overall experience and use.  We will make strong recommendations, but if the patient is not going to wear the hearing aid we recommend, there is no point in fitting it! In this sense, the interview process is quite important in determining the answers to many of these questions. 

The decision to get new hearing aids, or to wear them as a first-time user, is not an easy one to make, and is a considerable investment of finances, time, and effort.  A successful experience is dependent on coordinating a number of elements including but not limited to lifestyle, personality, learning style, cognitive ability, finances, and preference. It is imperative that your hearing care provider considers multiple factors about your personal needs in recommending options for you in the important decision.

References:

Cox, R.M., Alexander, G.C., Gray, G.A. (2007).  Personality, hearing problems, and amplification characteristics: contributions to self-report hearing aid outcomes. Ear and Hearing, 28(2):141-62.

Franklin C., Johnson L.V., White L., Franklin C., &Smith-Olinde L. (2013).  The Relationship between Personality Type and Acceptable Noise Levels: A Pilot Study. ISRN Otolaryngology, 2013, Article ID 902532. doi:10.1155/2013/902532