November 3, 2016

Five Considerations When Purchasing Hearing Instruments

The other day my husband was sharing a conversation he and his co-workers had regarding ways someone can invest their money. He works for a financial services firm in the Chicago area that focuses on how to differentiate what their financial advisors offer compared to other financial services available.

Basically, you can either invest in a “do-it-yourself” style approach, on the internet with a discount provider or with a credentialed financial advisor. As you can imagine you’ll get more sophisticated, customized advice from a financial advisor than you will from the discount provider—and the do-it-yourself investor is left to figure it out on their own.

Since I don’t completely understand his world of finance, I can easily get lost in the investment process which is why I rely on a credentialed financial advisor. But I can see a strong parallel between his world and mine when it comes to our clients.

When someone decides they are ready to take the plunge and purchase hearing instruments, the first place they go is the internet. Early in the process a consumer will realize there are multiple ways to obtain a hearing instrument. Someone can choose the “do-it-yourself style” of over-the-counter hearing instruments, a discount provider i.e. hearing aid dispenser or a Doctor of Audiology.

  1. The do-it-yourself instruments available are cheap because they are one size fit all (or so they claim). Since they are sold over the counter, the sizing and programming are not customized. The instruments rarely have directional ability which will not help dilute background noise. Many clients who have gone this route state they thought it would be a good starter aid. Sadly, most had a poor experience and ended up putting the instrument in a drawer, or worse felt that was how all instruments were going to work and put off hearing instruments for a few more years.

A hearing aid dispenser will help size and program a hearing instrument to fit your ear. However, dispensers receive minimal training (some programs can be completed in 12 weeks) so their skills vary. Dispensers are typically employed by discount vendors that tend to push one product or manufacturer on everyone, regardless of that patient’s hearing loss, anatomy or specific needs. Because they have less training, they are selling instruments at a lower cost which can be enticing to some.

A Doctor of Audiology (Au.D.), such as myself, has seven to eight years of training in every aspect of the ear from development of the auditory system and diseases of the ear to the prevention and treatment of hearing loss. When you see an Au.D. they are looking at each client as a whole person rather than just a hearing instrument sale.

  1. Once you have decided between the do-it-yourself, discount provider or audiologist, you need to consider the professional. This is similar to selecting a primary care doctor—it’s a long-term relationship. The initial consultation should give you a good feel for how you’ll work together. Is the professional pushing a hearing instrument or are they taking the time to listen to you?

When I meet with a client for the first time, I want to hear their story. Why are they looking to have their hearing tested or considering a hearing instrument? Once I’ve completed the hearing test and taken their concerns into consideration I am able to customize advice to them. Believe it or not, hearing instruments are not always my recommendation. Sometimes the better option is an assistive listening device or a referral to an ear, nose and throat (ENT) doctor due to an ear disease that can be corrected medically.

  1. Once you have found the right professional consider where their office is located. When I worked in the hospital many clients had all of their doctors in one place. However, they may live an hour or more away—which is fine when you are seeing your doctor once a year—but typically you see your audiologist more often.

The hearing test and consultation are typically completed in the first visit followed by the initial fitting and two or three follow-ups for adjustments based on your experience. All of these visits need to take place during the trial period so you may end up going to this professional four or more times. Once the instrument is set you will be seen for cleanings or repairs as needed. If the instrument stops working how quickly can they find time get into the office for a repair?

  1. Based on the hearing test results professionals should give a thorough explanation along with all of your treatment options. There are three types of hearing loss; conductive, sensorineural and mixed. A conductive hearing loss can be due to diseases of the outer or middle ear. Some common conductive losses are due to cerumen (ear wax), middle ear fluid or otosclerosis (a stiffening of the middle ear bones) and can often be treated with medical intervention. A sensorineural hearing loss is due to damage of the eighth nerve. This is the most common type of hearing loss due to genetics, noise exposure or aging. It cannot be treated with medical intervention and the only help would be hearing instruments. A mixed hearing loss is a combination of these two; conductive and sensorineural. The recommendation for a mixed loss would be two part; first to be seen by an ENT to address treatment of the conductive loss and second a hearing instrument consultation to treat the remaining sensorineural part.
  2. Once you have been cleared for hearing instruments it is time to select one. Unless you have gone the do-it-yourself route, hearing instruments are not one size fit all. When I chat with clients I describe the decision process in two categories: cosmetics and technology. Cosmetics entails how the instrument will look when you are wearing it. Will it fit completely in your ear or behind-the-ear? Will the hearing instrument color match your skin tone or hair color? This is typically the easy decision.

The more complicated decision is technology. This is the computer chip that will be inside the hearing instrument and will control how it functions in various environments. Basic entry level instruments will amplify sound in the environment the same as your high-end instrument if you are in a quiet environment. However, once you step into a restaurant, church, conference room, meeting or any other environment with background noise the high-end instruments start differentiating between speech and background noise whereas the entry level instrument continues to amplify everything.

This is when the professional should take into account the results of your hearing test (your ability to discriminate words, your initial concerns and your lifestyle.) Not everyone needs a high-end instrument but not everyone will do well with an entry level instrument either.

We’ve come to the end of the process. You are feeling good about the professional you’re working with and you’ve found the right hearing instrument for you. But before you sign the dotted line you need to consider the service package that comes with your purchase.

How long is the repair warranty on the instruments? What is the loss and damage policy? Is there a charge for future office visits? Are in-office cleanings and adjustments included with the purchase or are they billed separately? If there is a problem with the hearing instrument how quickly will you be able to get an appointment?  If the instrument is sent out for repair is a loaner instrument available? Are supplies such as batteries, wax traps and cleaning tools included or an additional charge?

Navigating the world of hearing loss and hearing instruments can seem overwhelming but with the right professional you will find the instrument best suited for you. Of all the considerations, the professional you select is the most important. Your hearing health is like your investments; you would not invest money with someone you did not feel was knowledgeable nor should you trust your hearing health to just anyone.