Published February 24, 2023

Hearing loss can oftentimes be a sensitive and nuanced topic. It is an individual choice whether or not to address it, and how you go about doing so varies from person to person. At Keiro, one of the five elements of quality of life is autonomy. If you are experiencing hearing loss, you should be able to choose what to do about it. However, the ability to hear is crucial to both your physical health and maintaining individual, family, and community connections. Fortunately, technology has advanced enough to help those with aging-related hearing loss, including hearing aids and cochlear implants, and new innovations continue to develop.

In December 2022, Keiro conducted an anonymous survey of 46 participants of all ages to learn about the different perspectives on hearing aids in Our Community.

Most respondents indicated that they did not have hesitations about getting hearing aids or potentially getting hearing aids in the future. Of those who do wear hearing aids, 30% of participants indicated that they were happy to wear them. However, most indicated that they were not particularly fond of wearing hearing aids but were satisfied with the results they produced. 

One respondent also identified that there may be a stigma to getting hearing aids. “So many seniors deny or refuse to address hearing loss [due to] cost, discomfort, and embarrassment of having to wear them,” they noted. “Also, many truly are unaware that their hearing has declined. It’s easier to blame sound quality or someone [being] very soft spoken.”

Hearing From Experts

To further understand the survey results, Keiro interviewed Dr. Raymond Goldsworthy, PhD, an associate professor of otolaryngology at the University of Southern California.

Dr. Goldsworthy is an expert in cochlear implants, which are surgically placed in the ear to provide hearing to individuals who are profoundly deaf or severely hard of hearing. Cochlear implants electrically stimulate the auditory nerve directly, whereas hearing aids amplify sound to a volume that can be detected by the damaged ear.

Dr. Goldsworthy was able to offer insight into the stigma associated with hearing aids. “It’s a recognition of your own mortality. You have to acknowledge that you’re losing your hearing, and if you associate that with getting older, it’s hard to admit that,” Dr. Goldsworthy said.

In addition, he explained that hearing aids cannot restore perfect hearing like glasses can with poor vision. “If you put on glasses or contacts — boom! — you can have 20/20 vision,” Dr. Goldsworthy said. “That is not true at all with a hearing aid or a cochlear implant. If you get a hearing aid or a cochlear implant, your hearing is not as good as normal.”

This rang true in our survey, in which one respondent commented, “I can’t get along without [hearing aids]. However, it’s not 100% satisfaction.”

Dr. Goldsworthy said the way to reduce stigma surrounding hearing aids begins with conversation and raising awareness around the issue. “You’re going to be in a situation, if you have hearing loss, where you’re not able to understand what people are saying. You need to understand that’s okay,” he said. “You need to be in a position where psychologically you’re getting over the stigma so you can say, ‘I need you to slow down, repeat yourself,’ — you need to be able to self-advocate.”

Keiro also interviewed Dr. Marcia Blank, AuD, who has been practicing for over 40 years. Dr. Blank also recommends a mindset shift for individuals who associate hearing aids with old age. In her work, she tries to gently steer her patients toward reconciling this stigma within themselves. 

“If you wear hearing aids, you’ll give off a more youthful impression to others because you’ll be hearing correctly, you’ll be engaging, and you won’t be seemingly ignoring people because you didn’t hear them,” she said.

What to Expect with Hearing Aids

While these are not perfect solutions, hearing aids, cochlear implants, or different combinations of the two are some choices a medical professional may suggest to you. However, being diagnosed with hearing loss is just the first step in a long process.

“You have to set the right expectations that it is going to be a process,’” Dr. Blank said. “The fitting is a process — you have to do something called real ear verification — there’s often a lot of fine tuning that needs to go on to get [the hearing aid] optimized for the individual.”

Dr. Blank also emphasized the importance of follow up visits to the audiologist after the initial fitting to make sure that the hearing aid is working properly in the real world.

There may be hesitations to jump into this long process, especially because hearing aids can be expensive. In this case, Dr. Blank assures patients that there is a trial period. California state law requires a 45-day trial period for hearing aids.

“I’m never shy about telling patients there’s a trial period. We’re going to work together through this trial period. Together, we’re going to be sure by the end of it that you’re satisfied because if you’re not, I want you to give them back to me!” she said.

The Future of Hearing Aids and Cochlear Implants

The COVID-19 pandemic transformed our lives drastically, and hearing aids were not left out of the equation. Several survey respondents mentioned that wearing face masks made wearing hearing aids more difficult. Not only must people with hearing aids be very careful to not knock them out of their ear when removing a mask, wearing masks makes voices more muffled and reading lips impossible.

“One [hearing aid] manufacturer has [a button] in their app with a person wearing a face mask, and if you’re struggling with a person wearing a mask, you touch that and it gives you a little bit more of a boost to the high frequencies,” Dr. Blank said. “Even if you don’t use that manufacturer, we can give [patients] an alternative setting that gives them the same little boost.”

There are many new technologies on the horizon. People with normal hearing can use their two ears to selectively listen in one direction, but people experiencing hearing loss are not able to do that as easily, which makes listening in noisy environments particularly challenging. 

Smart room technology may address this issue. In the future, people with cochlear implants may be able to choose which person in the room they want to hear with the click of a button, allowing for a much clearer signal in a noisy location. Farther in the future is regenerating the hearing organ itself. Noticing that certain birds and reptiles can regenerate their inner ear organs after damage, biologists are looking into how they may be able to tap into this for humans. 

One large barrier to hearing aids is the cost. “[My hearing aids] cost as much as my first car!” said one survey respondent. Over 50% of our survey respondents identified affordability as a key factor when considering hearing aids. There are several efforts to improve accessibility of hearing aids.

As of October 2022, hearing aids are available to purchase over the counter, making the average price of hearing aids several thousand dollars cheaper than that of prescription hearing aids (Everett, 2023).

“One of my concerns is that if they have a bad experience, they may not want to move onto something that is more professionally fit,” Dr. Blank said.

Since over the counter hearing aids can be purchased without having a hearing test, Dr. Blank worries that some people may have trouble adjusting the fit and manipulating the technology to their individual needs.

Despite this, Dr. Blank hopes that hearing aids going over the counter will be able to improve accessibility of hearing aids, even if they are used casually, similar to reading glasses.

The Importance of Hearing to Quality of Life

There are many reasons why hearing is vital to having a good quality of life. Recent studies have shown correlation between hearing loss and cognitive decline in aging populations (Lin, n.d.). 

To combat that, Dr. Goldsworthy urges people to get properly fitted hearing aids and cochlear implants.

“It’s not hearing loss per se, it’s how you use the hearing [ability] that you have left,” he said. “Communicating is working the mind in a way that is uniquely human. If you have hearing loss to the point where you’re withdrawing from society, that’s a slippery slope that can lead to depression and a reduction in cognitive capacity, such as working memory.”

The solution to hearing loss is an individual one. It can be hearing aids, cochlear implants, or a combination of the two, and there are many things to consider for each of these options. At the end of the day, the decision to get hearing aids or cochlear implants remains yours to make. However, one thing is clear: 

“The key thing is to be able to communicate with one another, your loved ones and to stay in that conversation,” Dr. Goldsworthy said.