Learning to love our hearing aids. The good, the bad, the ugly and the evidence

Sarah Chapman looks at the Cochrane evidence on interventions to improve hearing aid use, and reflects on her own and others’ experiences to consider some of the reasons why people given hearing aids don’t necessarily wear them, and what support is available.

Page updated 24 August 2016 and last checked 28 March 2023

WHY AREN’T YOU WEARING YOUR HEARING AIDS? Sorry for shouting; I know that’s not helpful, actually. I’m wearing mine, but then I can’t hear a thing without them, and if you can then it’s all more complicated. So far from straightforward, in fact, that up to 40% of adults with acquired hearing loss who are issued with hearing aids fail to use them, or don’t use them to best effect. Important? You bet.

jewellery and hearing aids
My accessories

Adult acquired hearing loss is common, long-term, increases with age and is mostly not something that can be helped by medicines or surgery. It’s potentially isolating and disabling; in fact the World Health Organization lists it as the second leading cause of ‘years lived with a disability’. So what helps people to wear their aids and get the best use out of them? The Cochrane Review Interventions to improve hearing aid use in adult auditory rehabilitation (August 2016) pulls together the best available evidence on interventions which aim to improve hearing aid use.

Before I looked at what the research said, I asked people on Twitter to tell me reasons why they don’t wear theirs and they came up with this selection.

The good:

  • The ability to choose silence in a noisy place is a huge bonus

The bad:

  • They’re uncomfortable – ears ache/hurt/get sore
  • They whistle
  • Not useful in a large crowd
  • Overstimulated/hearing overload
  • Getting used to them takes effort
  • Lack of support after being given them

and (additions from my household) the ugly:

  • Beige bananas are unattractive and some of us are vain (me, though I get round this with long hair)
  • “I’d rather sit quietly with a pint of beer than talk to people” (my husband, whose recent loss of both hearing and the ability to remain upright at times, thanks to Ménière’s disease, has increased his preference for solitude!)
Ernest Gulbis
At least we got the correct version too!

There’s also the possibility that we rather enjoy an alternative reality from time to time. Take captioning, often bizarre (and more often missing, which has nothing going for it at all). Yes, I know it’s frustrating but sometimes vastly more entertaining than what’s actually being said. Things haven’t improved since the announcement of a ‘moment’s violence’ at the Queen Mother’s funeral. My one evening watching ‘Today at Wimbledon’ saw me goggling at players with such names as Ernest School Bus and Tennis Burdick (ambitious parents, then), whilst Andy Murray’s answer to why he likes being a tennis player was apparently that he gets to “play in nice ladies” (‘places’ to you hearing folk – see, boring).

This is the lighter side of hearing loss but of course it’s also isolating and frustrating. Thank goodness for initiatives such as yourlocalcinema and the charity STAGETEXT, providing captioning and speech-to-text services in cultural venues. But most importantly, successful use of hearing aids potentially offers vast improvements in people’s ability to function well and enjoy life.

Is there evidence that certain interventions help? 

This is what the review set out to establish. The main outcomes of interest were hours of hearing aid use and ill effects such as inappropriate advice or clinical practice, or patient complaints. The reviewers also hoped to find evidence on the effect of interventions on quality of life, hearing handicap, benefit of aids and communication. They classified interventions to promote hearing aid use according to the ‘chronic care model’. The 37 included studies (with over people) tested interventions that fell into either or both of two categories: self-management support – ways to help people manage their hearing loss & aids, such as giving information or opportunities to practice listening/communication, and delivery system design interventions – changing how the service was delivered.

Here’s what they found:

  • Some evidence that self-management support reduced hearing handicap and improved verbal communication in the short term
  • When self-management strategies were combined with changing how support was delivered, people reported slightly more hearing aid benefit over a longer period
  • No evidence that interventions helped people wear their aids for more hours per day
  • No evidence that interventions encouraged more people to wear their hearing aids (but only two studies measured this)
  • Studies mostly didn’t look for adverse effects; there was no evidence of any in those that did
  • Few studies measured how many people use hearing aids compared to how many are fitted, and many things that might increase daily hours of hearing aid use or encourage more people to wear the hearing aids they have been fitted with have not been tested

How good was the evidence?

The evidence was ‘low to very low quality’ and we can’t be confident about the results, which might well change if there are better studies to include when the review is updated again. The results might also be different if studies included a different population; most of these participants were over 65 and almost half were military veterans. What’s more, measuring hours of hearing aid use is a start but we need to know other things, like how these interventions affect people’s quality of life and what happens over the long term – few studies looked at how people were doing after a year or more. Lots of things that might help people wear the aids, and for longer, have not been tested. Future research has the potential to be a lot more useful if researchers agree a set of outcome measures to use in this type of study.

What kind of support is on offer?

Richard Turner
Richard offers peer support for other hearing aid users

My tweets about hearing aids connected me with a number of helpful people and one of them was Richard Turner (@RichardTurner), who suddenly lost much of his hearing a few years ago. He told me about his voluntary work with deaf-related charities, including the ‘Hear to Help’ initiative from the UK charity RNID, a form of  self-management support. He explains:

“I have worked on a ‘Hear to Help’ service in Redbridge run by Action on Hearing Loss [now RNID] for over three years. I work as a volunteer in my local area. We offer a support service for people who wear NHS hearing aids. We provide weekly clinics and drop-in sessions and support people to get the most out of their hearing aids by helping them with any problems and checking their hearing aids, tubes and providing batteries.

I know from my own personal experience how important it is for people to get the most out of their hearing aids, how much they improve your quality of life, your confidence and help prevent the feelings of social isolation and depression that hearing loss can cause. I feel that the service we provide in the local community is invaluable. Also, in the service where I work we are all hearing aid users ourselves so we can empathise with service users and give good advice and support. We also signpost users to other organisations and support services, which could help them in other ways.

I have seen this local service grow over the last three years and we have helped many people, who have now taken greater control over their hearing loss. This is the key to better social inclusion and increased deaf awareness, which improves the lives of people with a hearing loss.”

Small things, big difference

I think Richard has hit the nail on the head, talking about helping people have greater control over managing their hearing loss, so important for anyone living with a chronic condition. Something small, like being able to retube your own hearing aid rather than having to get to a clinic so someone else can do it, makes a big difference to our everyday experiences of living with hearing loss. Intuitively, it makes sense to have help from someone who’s got personal experience. I’m sure people leave these encounters with more than just improved knowledge or skills about the thing they went in for. Lack of support after being issued with hearing aids was quickly mentioned when I asked people to tweet their reasons for not wearing them; schemes like Hear to Help are ways of filling that gap. Let’s hope future research can fill the evidence gaps too.

Be a hearing aid!

“How can I help you hear?” I was asked this, I think for the first time EVER (and I’ve worn aids for over 20 years), within moments of meeting the lovely Anne Cooper for the first time yesterday. Possibly after I’d unceremoniously biffed her out of the seat she’d taken on arriving (first), in front of the window, to claim it for myself. I’m so unused to being asked, that we later discovered that I’d forgotten to mention the bit about being able to see my companion’s mouth! How lovely to be asked and what a difference the small things that Anne did to help me hear made to our conversation. I seem to recall hearing clinic posters, from years ago, urging people to ‘be a hearing aid’ and the small considerations really do help, in a big way!

Sarah Chapman has nothing to disclose.

Learning to love our hearing aids. The good, the bad, the ugly and the evidence by Sarah Chapman

is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International

12 Comments on this post

  1. My name is Stephen Beal I run a hard of hearing group in Southampton..I have been working with a group of volunteers trying to get loop systems in place in all shops in Southampton.so far we have completed audits on approximately 190 shops and only approximately 22 have working loop systems. This is a very important piece of equipment for hearing aid users in shops. It is a legal requirement but shops cannot be bothered some of the excuses have been so stupid , like ” oh sorry it’s in the box in the warehouse” any comments please contact me via our Facebook page. Thank you

    Stephen Beal / Reply
  2. That is a pretty good overview on hearing aids. We have an FAQ on hearing loss, which can be found here http://www.nwhc.ie/hearing-loss-questions/faqs The effectiveness in a large crowd depends on the model of hearing aid.

    Hearing Aid Grants / Reply
  3. Interesting perspective. Thanks for sharing your thoughts on the subject.

    hearing aids / Reply
  4. Interesting perspective. Thanks for sharing your thoughts on the subject.

    Hearing Aid Center / Reply
  5. Thanks for sharing your Information,very useful information

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  6. Interesting perspective. Thanks for sharing your thoughts on the subject.

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  7. Very interesting read really made me think

    Tina Foster / Reply
  8. As hearing loss becomes a greater concern for young people, companies like Audicus are providing a more progressive way to ensure you’ll have access to the technology that can preserve your hearing. Check out their blog regarding scientific advancements in hearing loss: http://bit.ly/1MD3IK6 as well as the products featured on their site: http://bit.ly/1FoK8Ic

    Joseph / Reply
  9. I would like to to know if Posit Sciences BrainHQ hearing exercises help. They claim they do. Any ideas?

    Jim Hayward / Reply
  10. You are absolutely right, over half of the people who ask to wear aids don’t like to get into them. I believe there are various elements which creates them into this attitude. These include uncomfortable ear mold issues, expense, etc. One of the usual reasons why people don’t wear hearing aids is that they feel humiliated and self conscious about them. But I guess that was not serious at all, these people need to go for their hearing loss and need to stop embarrassing about their hearing aids. This will resolve the issue for certain extend.

    Rhonda W. Benton / Reply
  11. Well written Sarah, you had me cracking up the whole time. Informative too, I retweeted!

    Jeff / Reply
    • Thanks Jeff. I do enjoy the absurdities – an antidote to the frustrations!

      Sarah Chapman / (in reply to Jeff) Reply

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