What hearing aids can – and can’t – do

There’s misconceptions floating around regarding hearing aids, so let’s take a look…

It’s not surprising that people who don’t wear hearing aids, and don’t have experience of them, can make assumptions about them. You won’t know otherwise unless you start wearing them yourself, or someone a friend, colleague or family member does. But it takes time to get know what they do based on experience – so to give you a head-start, based on my experience, here’s what hearing aids can and can’t do.

They aid

And that’s a really important thing to bear in mind, and it’s where the misconceptions come from. If you need to wear glasses, you put them on and, as long as you’ve got the right prescription (and if it’s a new prescription, you’ve got used to them), you can see perfectly straight away. So people assume that a hearing aid is just the same.

But they’re not. Because a hearing aid can only aid. In other words, it can only help a bit. Unless someone has slight hearing loss, wearing a hearing aid won’t given them the same hearing as a hearing person. And to be honest, if you only have slight hearing loss, you might not need a hearing aid anyway.

They amplify

If you go to a gig, there’s gigantic amplifier stacks beside the stage, and a hearing aid is, sort of, a miniature version. It’s amplifying the sound straight into your ear canal. This is why hearing aids can feedback, just like when a guitarist stands too close to a microphone at a gig. If you don’t need your hearing aids amplified by a lot, you’ll have a dome on the end of your hearing aid (like my first one), but if it needs to be amplified a lot, then you get a mould. These are made to fit perfectly in your ear, after you’ve sat with something that looks like Play-Do in your ear for five minutes. They seal off the amplified sound from escaping – both to hold the sound in so you can hear it better, and to stop it leaking out and causing feedback.

And because they amplify, this means: do not SHOUT at deaf people! It’s horrible! It doesn’t make us able to hear you because the sound distorts and it’s just a big loud noise. It can actually cause us additional problems – loud noises make my tinnitus worse for a while afterwards, and this can sometimes cause me earache, too.

They are configured very carefully

I’ll write another time about what happens at a hearing aid appointment (well, what has happened to me, at least!), but one of the things that happens is that your hearing test gives an indication of which sounds you have trouble hearing, and the settings on the hearing aid reflect this. So where you can hear a sound perfectly, there’s no need for the hearing aid to amplify it. Everyone’s hearing loss differs, and some sounds will need to be amplified a great deal, and others not so much. My hearing loss pattern (cookie bite, caused by a rare genetic fault) means that I need lots of amplification in the middle, where human speech lies.

But it’s not just lots of amplification in the middle, it’s carefully tweaked. Initially, it’s based on your hearing test, which gives a pattern showing what sounds you do and don’t struggle with, and at which pitches. Unfortunately, as I have tinnitus, I struggle knowing if the bloops and bleeps are the test or are tinnitus. So this means that my HAs need a lot of tweaking to get it spot on.

At my last audiology appointment, I did a test where random words were played at me. The audiologist then tweaked my settings based on which sounds I was having trouble hearing. I went from 50% to nearly 80%.

They can’t make you hear perfectly

As you will have gathered from the last paragraph, even with careful tweaking, my results from the random word test isn’t 100%. I was pleased to get nearly 80%, but this means I need to lip read and know the context of what is being said to understand.

There was one word, which sounded like mermer-mermer-mer before tweaking: it still sounded like mermer-mermer-mer afterwards when I asked the audiologist what the word was and she repeated it. I have absolutely no idea what this word was. Memory? In the context of a conversation when I’m getting most of the other words and I’ve got context and lips to read (although the audiologist was looking straight at me and I was looking at her lips as she spoke), I might be able to figure out. But this should show you very clearly that hearing aids cannot make a deaf person hear perfectly.

My audiologist explained that she can’t turn my HAs anymore, because all this amplified noise will damage what’s left of my hearing. For instance, if someone insists I make a phone call, I turn my phone up as loudly as I can. But I really struggle to hear them, and I can’t turn the volume on my phone up any louder, because I get a message warning me about noise damage!

How to have a conversation with someone wearing HAs

So hopefully by reading this, you’ve already started to think about the way you have conversations with deaf people. In the same way that you would clear a path of random bits and bobs for someone coming into your house who is blind or has a mobility issue, there are small things you can do which will make a big difference.

  • As mentioned above: DON’T SHOUT!
  • Don’t ask us to keep turning our HAs up if we’re having trouble understanding you. Firstly, we will do this if we feel we need to, and if it’s comfortable for us to. When I was learning to drive, I turned my HAs up by one in order to hear my instructor better over the engine, but turning them up by two wouldn’t have helped. Turning HAs up, and up, and up will damage our hearing, and it won’t help with clarity – in fact, it’ll be more distorted. Our HAs have been configured as well as they can be, but will never be 100%. Unless we think our hearing has got worse, and we’re waiting for an audiology appointment to get our HAs adjusted, turning the HAs up won’t make a lot of difference.
  • Think about how you speak – do you have a soft or quiet voice? Do you speak quickly? Were you looking at the deaf person when you were speaking? Had you suddenly said something random so there was no context to what you were saying? Was there background noise? (background noise is a nightmare!) If you answer yes to any of these questions, then when you’re talking to a deaf person, alter your speech. Speak a little louder, speak a little slower, move your lips, avoid mumbling, avoid “false starts” (“Erm… well, actually… no, hang on, I went to… I did… have you ever…?” Please get to the point!), look at us, get rid of the background noise (in restaurants, for instance, you might want to pick a table off to one side, or away from the annoying table full of loud people. To be honest, just don’t sit near the annoying people anyway!).
  • Use a bit of sign. You don’t have to take sign language lessons, but knowing a few basic signs can be helpful. My partner signs “Do you want a cup of tea?” to me first thing in the morning before I’ve put my HAs on, and my stepmum and I invented our own for gin and tonic! Knowing the deaf alphabet (or drawing the shape of a letter on the palm of your hand) can be helpful – just knowing what letter a word begins with can help us to understand what the word is, or even the whole sentence that you’ve just said.
  • Be aware of listener fatigue: listening for deaf people is hard work. Remember the last time you tried to have a conversation with the person standing next to you at a gig, during the really boring but very loud support band? Studies have shown that deaf people tire quickly when they have to listen, as it takes us more effort. We even use part of our short-term memory as well, which can mean that if you tell a deaf person something, they’ll hear you when you say it, but may well forget it!
  • Use tech: Phonak, for instance, have table microphones, and portable microphones, which feed sound directly into HAs. These can be so useful, and I have some for meetings at work, but they are expensive if you have to buy them to use at home. They are also not a magic wand. If you need them for your job, then (people in the UK!) get an Access to Work assessment to find out what kit is best for you, and training on how to use it.
  • Be patient: yes, I know it’s frustrating when the person you’re talking to doesn’t get what you’re saying, but getting annoyed and upset doesn’t help. It can cause us a great deal of hurt.
  • Ask us: if you think a deaf person is struggling to hear you, ask us if there’s anything you can change about the way you’re speaking, or the environment, to make life easier. We may well have already told you, but if we haven’t, please just ask us.