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What makes a better hearing aid?

If you are considering purchasing hearing aids you need to know the factors that determine a good hearing aid versus one of poor quality. Despite the brand or manufacturer, there are certain things that all hearing aids should offer. You need to know some basics of what to look for to ensure that you are indeed buying the best device for your specific hearing needs.

First of all, we are talking only about Hearing Aids here, not Amplifiers. Hearing aids are FDA regulated and are custom programmed by a licensed hearing professional to the meet the specific needs defined by your professional hearing test. Amplifiers not custom programmed – they simply amplify all the sound in your environment making things louder, but not clearer. Amplifiers cost anywhere for $25 - $500. Programmed Hearing aid start at about $650 each.

Who makes hearing aids?

Despite the many different brands of hearing aids, there are only five manufacturers that make the vast majority of high-performance devices. Each one puts their technology into several different brands. They are:

  • Sonova (makes Phonak, Unitron and Hansaton).
  • Starkey
  • GN ReSound (makes ReSound and Beltone)
  • Sivantos (makes Siemens, Signia, Rexton and Widex)
  • William Demant (makes Oticon and Bernafon)

Each of these brands offer multiple performance or technology levels of hearing aids. The lower end levels offer good performance in quieter settings and watching TV, while the higher end levels perform better in environments like noisy restaurants, meetings and large open spaces. Some hearing aids are focused simply on enhancing your ability to hear while others may offer expanded functionality like streaming music and fitness apps. Not all of these extra functions enhance hearing. In fact, they may confuse matters for some individuals. Reliable technology that enhances hearing and can automatically adjust to, and isolate, conversations in noisy environments is the baseline for quality. It makes for the most satisfactory hearing experience.

It all begins with your hearing test

Like a car that is built around a good engine, hearing aids are built around a clinically sound audiology exam conducted in person by a trained and licensed audiologist or hearing professional. The data from the hearing test will be used to custom program your hearing aids. Although there are a few basic hearing screening tests available online, they are not clinically reliable and often lead to under-performance of hearing aids. Hearing aids should be calibrated only with clinically exacting data which can only be achieved by a licensed specialist in a properly sound proof setting with calibrated equipment. The point to remember is this: hearing aids are only as good as the audiology test upon which their programming is based. Need help finding a test location? Ask a friend or your regular doctor for a recommendation.

Once the hearing test has generated accurate results, the hearing aids are programmed to those exact specifications.

The different types of hearing aid styles

Hearing aid design can enhance the performance for your needs. There are two main types of hearing aids:

  • Behind-the-ear (BTE): The hearing aid electronics sit behind the ear.

    • BTE Receiver-in-the-Canal (RIC): The electronics are behind the ear but the speaker is at the end of a very thin wire inserted directly into the ear canal

    • BTE “Slim Tube”: The electronics and speaker are behind the ear and the sound is sent to the ear via a hollow tube. This looks a lot like a RIC but the hollow tube delivers much lower sound quality and is very tough to keep clear of wax.

  • In-the-Canal (ITC or CIC): The entire hearing aid fits into the ear canal. The “In-Canal” models are preferred by many wearers because they are very discreet but they also can initially give you a bit of a plugged-up feeling. You can read more about BTE versus CIC hearing aids HERE.

The most popular choice of hearing aid design is the a BTE “RIC” model.  It looks similar to the design of the slim tube but does not have the same sound reception issues. With the Receiver in Canal style, the sound is much clearer and the “RIC” is much more easily kept clean and in top performance.

With each “Style” you will find that there are a number of performance levels. The lower end models work well in quieter, 1 on 1 settings and watching TV. The higher end models perform much better in tougher situations like restaurants, large group events or meetings.

Some important features to look for:

Dual Directional Microphones: High-quality hearing aids always come with dual directional microphones – two microphones on each hearing aid that face forwards and backwards to give you a 360-surround sound effect and help you hear people behind you (e.g. In a car). With higher end self-adjusting hearing aids in areas with a lot of background noise, voices coming from the front of the user will be enhanced while sounds coming from the back will be reduced.

How many hearing aid processing bands or channels do you need? Not as many as you might think. A processing channel isn’t like a TV channel that can be changed. It is a band that covers a range of sound frequencies that are processed by the hearing aid. The amplification within each channel is set by the audiologist to meet the specific needs defined by the user’s hearing test. A lower end model might have four to eight channels while higher end models will have approximately 20. Some budget hearing aids claim to offer 40 or more channels but data shows that beyond 20 channels your brain can’t tell the difference. That is why most audiologists will program only up to 24 channels.  

Automatically adjust to your environment: In the past, when you went into a restaurant or crowded area, you could change the program of your hearing aid to be a little more suitable for that area. Most hearing aids still offer this but the best hearing aids actually self-adjust, automatically to the environment around you. For example, if you move from a quiet car into a noisy restaurant the hearing aids will detect the change in background noise and adjust for it automatically. When you leave the noisy area, they will adjust back to normal. You can still do this manually, but you won’t have to.

What about service and adjustments?

Like many other industries, customer service has evolved in the hearing aid industry. Today, storefronts may not offer the best service. You will have to book appointments several days in advance and although you can talk to someone face to face about the hearing aid, that singular privilege can cost up to $4,000 more than purchasing, and servicing, hearing aids online.

Purchasing online is a much more affordable option. You start by getting a hearing test locally and then the programming is done by licensed professionals using precisely the same software as used locally, it is just not done across the table from you.  Technology has advanced to the point where most hearing aid adjustments and repairs can be made remotely, over the phone or online. If there is any issue at all, in a simple phone call, the hearing aid technician can direct the hearing aid user to make the minor adjustments that are needed to improve hearing aid performance – 24 hours a day, 7 days a week with no appointment needed. These advances have greatly improved hearing aid performance and customer satisfaction while significantly reducing cost. Higher cost for hearing aids does not necessarily indicate higher quality performance.

We are going to examine the cost of hearing aids at length in our next blog. Keep an eye on this space.

 

 

Embrace Hearing Couple

We like to stay in touch with our patients. We are eager to learn how Embrace Hearing technology works for them and improves their quality of life. Recently we had the opportunity to discuss this with a customer who purchased hearing aids for her husband, Frank C. from Swampscott, Massachusetts.

What type of hearing loss does your husband have?

My husband lost 100 percent of the hearing in his right ear after receiving stem cell replacement therapy as part of his cancer treatment. There is no way to enhance hearing in that ear because the nerves are dead. It became clear to us that we needed the type of hearing aid that would capture ambient sound from all sides and feed it into his good ear.

How did Embrace Hearing technology help?

We learned that Embrace Hearing had software that essentially gathers sound from 360 degrees around the individual’s head. The software automatically adjusts the hearing aids to find the conversation and focus in on it. Because he has no hearing in his right ear, he has hearing aids with special BiCROS programming. All the sound from the right side, where there is no hearing, is sent wirelessly to his left ear so now he hears everything, all around him. That is important because we love getting together with our grown children and their spouses and it can get pretty noisy!

Another feature that my husband uses all the time is the remote control. It helps him to adjust the hearing aid based on the environment we are in. When we are home he uses one setting. However, if we go out to a restaurant once we are inside he adjusts the hearing. He says it reduces background noise and has made a significant difference in his ability to hear conversations.

What difference do you notice now that he has the hearing aids?

Because the hearing loss occurred in his right ear, talking to my husband while he was driving was nearly impossible. I had to speak at a high volume and it was exhausting. Now that he has the hearing aids I can speak to him at almost a normal level and he can easily hear what I am saying. When we get together with friends and family he can hear and is no longer excluded from the conversation.

Does your husband feel comfortable wearing the hearing aids?

Yes, he does. You can’t see them. A tiny wire runs from the back of his ear into his ear. Sometimes I can’t tell if he is wearing them.

Was there anything besides the technology that drew you to Embrace Hearing?

Yes, the price drew us to Embrace Hearing. We did our research and found that despite the fact that the quality was the same as other manufacturers, the price was far below anything else we had found. It was a low price with high quality and performance.  In fact, it was one-third of the price of the hearing aids recommended to us by the hospital. Hearing is so crucial to quality of life that we would have paid more if we had had to. However, with the cost of ongoing cancer treatments we really didn’t want to have to pay $6,000 or more for hearing aids. Especially because we were uncertain as to how effective they would be.

How was your experience with Embrace Hearing service?

It was great. When my husband had a problem with the quality of the sound, he called customer service. It turned out that the battery needed to be replaced. Extra batteries came with the hearing aid and the problem was solved over the phone right away.

I know that hearing aids used to be sold only through storefronts. I have to say that this is the new way to purchase quality hearing aids and no one should hesitate to purchase them through Embrace Hearing. They calibrated them according to the audiologist’s specifications and there hasn’t been a problem. I no longer have to yell and my husband can hear!

Many customers have questions about buying hearing aids online. Beyond “How much do hearing aids cost?” and “What are good hearing aid prices?”, we get many questions regarding how we handle adjustments after the hearing aids are purchased.

We start with your professionally conducted hearing test. There is no substitute for a professional test conducted in a sound proof room with calibrated equipment. We can help you get this completed locally.

In fact, adjustments are rarely required with Embrace Hearing. Only 1 in every 15 of our customers require adjustments from our initial programming and almost no one requires a second adjustment (until you get a new hearing test and want the programming updated). We do this by working hard to get our hearing aids programmed correctly before they are delivered to the customer.

Getting Amplification Right: All those new sounds can be a little overwhelming at first. To help you adjust, after programming your aids to the results of your test, a local Audiologist will reduce the overall prescribed volume by about 30% and then ask you to come back regularly for 6-20 weeks so they can slowly increase the volume as your brain adjusts to the new sounds. At Embrace Hearing, we do precisely the same thing but we have Acclimatization software that does this automatically. You don’t have to go anywhere. After every 7 days of use, the volume increases a little bit until the optimal level is reached. As you and your brain adjust, you get a little more volume on a weekly basis until the adjustment is reached. This software helps eliminate roughly 90% of all post purchase adjustments.

Getting sizing right: Embrace Hearing aims to get things right the first time and uses numerous fitting techniques to ensure you receive the appropriate aids and the correct programming for your specific needs as defined by your hearing test. Beyond the programming, we determine the “fit” for different ears through a series of proven questions from our Audiology Team after your order is placed. The correct domes and receiver wires as well as any special programming you require (like a Tinnitus Manager) are quickly and reliably determined through this process. We also provide you with a variety of ‘back-up’ items just in case we need to help you adjust something after you receive the aids.

Ongoing customer service: To make sure everything is always 100%, we work with you as long as you own the aids. We help you over the phone or by email to resolve any issues you ever have.  Our phones are answered 24 hours a day, 7 days a week to ensure that we can respond quickly to your needs and concerns.

There will always be ongoing maintenance such as the accumulation of ear wax on the aid. In every order, we include the supplies users need to maintain optimum performance of their hearing aids in just a few minutes a week. Additionally, we have a series of online videos on our website to show you what to do.

At Embrace Hearing, we aim to get everything right the first time and then help you keep everything delivering the high performance results you need.

 

Our customers are sometimes surprised that we insist on using a recent Audiological Evaluation conducted by a licensed hearing professional. After all, and online hearing tests is so convenient. 

We insist on a recent hearing evaluation conducted by a licensed hearing professional for three reasons: 

1. To take full advantage of the high-performance levels of Embrace hearing aids, they must to be programmed to an accurate hearing profile. We only sell highly sophisticated premium hearing aids. These aids come with up to 20 programmable bands and state of the art software. To give you the performance you are paying for, we need an accurate measure of hearing loss at every frequency level. This can only be done with Pure Tone Audiometric testing done under carefully controlled soundproof clinical conditions by a licensed professional. This is rarely the case in a noisy crowed discount store or on your laptop with you ear buds.

2. It’s important to know why you are having challenges hearing. Hearing Aids may not be the right solution for you. A hearing care professional will examine your ears with an otoscope to identify any issues in the ear canal or with the eardrum. Sometimes hearing loss can simply be caused by compacted wax or even water in your ear. A full professional evaluation will also include a Bone Conduction test to check if there is a problem in the middle ear cavity that may be affecting your hearing. A Speech Recognition test investigates the auditory nerve which sends signals from the ear to the brain and could lead to issues understanding speech and sounds in the brain itself. Finally, a Tympanometry test will evaluate the condition of the middle ear and ear drum. If this test detects fluid, this condition is nearly always temporary and medically treatable without hearing aids. None of these important tests can be completed online.

3. Professionally conducted evaluations are complete, reliable and comply with industry regulations and best practices. Home and Online tests and equipment are not regulated and have not been approved by the U.S. Food and Drug Administration and are not recognized by the American Academy of Audiology or State Licensing Authorities. To program hearing aids in most states, licensed hearing aid professionals must require a pure tone audiometric test accompanied with a test for bone conduction loss. 

So, while we may lose some business to other online companies offering "Online” hearing tests, we want you to get the most of your hearing investment so we stand firm behind our requirement for a complete Audiological Evaluation. While a professional hearing assessment may cost $80, hearing aids are costly and your hearing is important - why not start with a proper test? We know you will be happier with hearing aids programmed to the results. 

How to get a test?

To book your test, we suggest that you make your appointment at a local ENT (ear/nose/throat) doctor or a local Audiologist. They have the most experience and give the best hearing evaluations. Avoid chains and big box stores like Walmart.  Click here for instructions on how to book a test.

NOTE: If they say the test is free, they will not likely give you a copy. Be sure to tell them you will want a copy of the test when you book the test. They might charge you $80 for the test but you will be able to have a copy and buy your hearing aids anywhere you like.

 

Need help? Email us a embracehearing.com or call us anytime at (888) 929-9555.

 

 

Asri Maharani, Ph.D., from the University of Manchester in the United Kingdom, and colleagues used data from the Health and Retirement Study to determine whether hearing aid use alters cognitive trajectories in older adults. The 2,040 adults (aged ≥50 years) included in the analysis participated in a minimum of three waves of the study.

The researchers found that hearing aid use was positively associated with 
episodic memory scores (P < 0.001). Compared to before use of hearing aids (P < 0.001), declines in episodic memory scores were slower after use began (P < 0.001). These results were maintained even after adjustment for multiple confounders.

"Hearing aids may have a mitigating effect on trajectories of  in later life," the authors write. "Providing  or other rehabilitative services for hearing impairment much earlier in the course of hearing impairment may stem the worldwide rise of dementia."

[reprinted from The Medical Press]

At Embrace Hearing, we now sell two styles of hearing aids: Behind-the-Ear/Receiver-in-Canal (BTE/RICs) and Completely-in-Canal (CICs).  These are the two most popular styles of hearing aids sold today and both provide high performance coupled with discretion for the user.

Embrace C-650

How do you choose the right style for you?  The best choice is going to be the one which best fits your hearing needs and lifestyle.  As you consider your options, think about the following factors:

  • Your Hearing Loss. While BTE/RIC models are designed to serve all levels, CICs can be a challenge for the most severe hearing loss.  This is because the receiver (or speaker) and the microphone in the CICs are very close together which can create feedback at higher amplification levels.  Below is an image showing the range of hearing loss covered by our CiC and BTE aids. Compare it to your hearing test to see which range you fall into.

Embrace Hearing

If your hearing test fits within the range of either style, there are a few other things to consider:
  • Discretion.  Both BTE/RICs and CICs are highly discreet (as you can see in the image above).  However, for those with very short or no hair around their ears, there is an advantage to CICs, which sit in the ear canal and out of view to the casual observer. 
     
    • Do you need to wear specialized clothing or equipment at work? CIC models do not have a processing unit behind the ear so they are often preferred with hard-hats, hearing protection, stethoscopes, large eye-glasses and other head/ear items that can be required for certain professions. 
    • Dexterity. For hearing aid wearers with dexterity issues or some numbness in the tips of their fingers, the CiC model may be preferred. The CIC aids are smaller and have smaller batteries than the BTE/RICs but because they are a single unit (with no wire over your ear) they are easier to put on and insert into your ear. 

      • Comfort: Hearing aids only work if they are worn - so it is critical you choose a style that is comfortable to wear all day long.  BTE/RIC aids are generally considered the most comfortable. They have thin, flexible ‘open’ ear tips (domes) for most users that allow the natural sounds of your environment to enter your ear along with the amplified sounds from the hearing aid. On CiC models, we use larger 'sleeve' domes that can give you a sense that your ears are a little ‘plugged’. For some, this is quickly adjusted to. For others it can be very bothersome.

      Still have questions?  We are happy to discuss your situation and make a recommendation based on your needs.  Just call us anytime at (888) 929-9555 or send us an email at info@embracehearing.com

       

      Embrace Hearing

      It is very rare that a person with hearing loss self-diagnoses the issue. While hearing loss can begin in your 30’s, the long gradual decline can be barely noticeable on a month to month or even year to year basis. In addition, as hearing declines, our brains adjust and we become remarkably effective lip readers, particularly of those we spend the most time with. We don’t even realize we are lip reading until we see that we can only understand people when they are directly in front of us.

      Some of the signs of hearing loss:

      1. Asking friends and family members to repeat information frequently.
      2. Increasing the volume on the radio or TV to a level that’s uncomfortable for individuals with normal hearing.
      3. No longer enjoying social activities like group dinners at restaurants. Your friends think you have lost interest in them when really its just that you struggle to hear well in groups
      4. You constantly ask people them to repeat what they said or it appears that you forget what was just said (because you didn’t actually hear it).
      5. You miss the beginning of conversations because it’s hard to hear them and then when you jump in, they say “that’s what we were just talking about!” 

      What to do about it? First of all, don’t assume you need hearing aids. Just get a hearing test. This is a good step for your general health. Declining hearing can be an early sign of something more serious. Hearing test are quick and easy to do. They normally take about 30 minutes.

      1. Make your appointment at a local ENT (ear/nose/throat) doctor or a local Audiologist. They have the most experience and give the best tests. Avoid chains and big box stores. We suggest getting a recommendation from a friend or family member but your regular doctor will also know someone locally. If you need help, let us know and we will do some research for you. We usually look at HealthGrades to find local Audiologists. 
      2. If they say the test is free, they will not likely give you a copy. Be sure to tell them you will want a copy of the test when you book the test. They might charge you $80-$100 for the test but you will be able to have a copy and buy your hearing aids anywhere you like. Most Health Insurance companies will cover the cost of test.
      3. Ask them to measure your "Word Recognition" as well as the standard 'tone' test. This should not cost anymore but is very good information regarding how you will benefit from hearing aids.

      After the test. If your hearing level suggests you could benefit from amplification, the audiologist will likely try to sell you hearing aids. You might be shocked at the cost of hearing aids from these local retail outlets. Don’t buy right away – check around, look online. Our prices tend to be about 1/3 of the prices of local retailers. Simply ask them for a copy of the test and say something like “it’s a lot of money, I need to check around”.

      A few common ‘reasons not to buy’ and some responses from hearing professionals.

      I’m not that old. An estimated 50 million people in the United States have a hearing loss but less than 25% of all people who need hearing aids actually get them. The majority (65%) of people with hearing loss are younger than age 65. These people are active in the work force and a lack of hearing can reduce performance and frustrate co-workers.

      I can hear what I need just fine. What are the benefits of getting hearing aids? Beyond the obvious ability to simply engage socially the way you did when you were younger, a study from the Bloomberg School of Public Health at Johns Hopkins University found that hearing aids may slow cognitive decline tied to hearing loss. The study found that estimated 20-year rates of decline in memory and global function were greatest in participants who did not use a hearing aid. Earlier studies have linked hearing loss to dementia and cognitive issues. Another Johns Hopkins study showed that people in middle age (40-69) with even just mild hearing loss were nearly three times more likely to have a history of falling. The intensive listening effort demanded by unaddressed hearing loss seems to take cognitive resources away from what is needed for balance and gait, researchers have suggested. And a 2014  study found that hearing loss is associated with an increased risk of depression in adults of all ages.

      I can’t afford them. Most people that have a hearing test that recommends hearing aids are shocked by how much they cost. While a local audiologist is the best place to get a hearing test, they charge on average $4,500 for a pair of hearing aids. That is clearly a lot of money. Not surprising, just as has happened in many industries, the internet has increased the power of the customer to shop around and pay only what they need to. Embrace Hearing sells the same premium European hearing aids for about 35% of the cost you would pay at retail.

      There is too much risk to buying them online. Embrace Hearing offers a 45 day free trial period and is the #1 Rated Hearing Aid company by Consumer Affairs.

      Hearing aids are ugly. What is available today is ‘not your grandfather’s hearing aid’. You would not be surprised to find that just like everything electronic, hearing aid technology has advanced to the point where the premium aids are almost invisible. Embrace Hearing sells exclusively the latest technology in “behind the ear, receiver in canal” hearing aids. These are tiny, discrete and yet deliver crystal clear, natural sound.

       

      But, first thing is first. Long before you get hearing aids, you just need to get a hearing test.

      Some additional reading:

      1. Why wont they get hearing aids? The New York Times
      2. The Complete Guide To Hearing Aids. Embrace Hearing

       

       

       

       

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