Hearing aids and assistive listening devices — technology options and costs

This article provides general information about hearing aids and listening devices. Your parent's hearing needs should be evaluated by an audiologist. Over-the-counter hearing aids have different regulations than prescription hearing aids, and what works depends on your parent's specific type and degree of hearing loss.

My father started turning up the television so loud that the neighbors complained. He'd ask "What?" repeatedly in conversations even when people spoke directly to him. He'd claim he could hear fine, just that everyone else mumbled. For years he resisted any suggestion that he might have hearing loss. When he finally saw an audiologist, he discovered he had significant hearing damage in both ears. The question shifted from whether he needed help to which hearing aid would work best for his life.

Hearing loss is one of those conditions that a person often realizes affects everyone around them before they acknowledge it affects themselves. It changes conversations, connection, and participation in life. Hearing aids and other listening devices have come a long way from the boxy, whistling devices of decades past. Today's technology is genuinely sophisticated and can work well if your parent is willing to use it.

The picture of Hearing Solutions

Hearing aids come in several styles, each with different advantages and challenges. Behind-the-ear models rest on the back of the ear with tubing or a wire connecting to a speaker in the ear canal. They tend to be more powerful and handle a wider range of hearing losses. In-the-ear models fit entirely in the ear, either in the inner ear canal or filling the outer ear bowl. They're less visible and often more comfortable, though they can be harder to manipulate for people with arthritis or dexterity issues. Completely-in-canal models are the smallest and most discrete but are also the most expensive and can be uncomfortable for some people.

Beyond traditional hearing aids, assistive listening devices offer alternatives or supplements. Personal amplifiers let someone hold a small device that picks up sound and amplifies it to the user's ears. Smartphone-based hearing assistance uses an app and earbuds to amplify sound. TV listening systems include a transmitter that sends the television audio directly to a receiver your parent wears, eliminating the need to turn up the volume for everyone.

Your parent's doctor might refer them to an audiologist for evaluation. An audiologist tests hearing and prescribes hearing aids. However, there's now an over-the-counter category of hearing aids that don't require a prescription. These are less regulated than prescription hearing aids, which means less standardized quality control. They work for some people with mild to moderate hearing loss but aren't appropriate for everyone.

Understanding Hearing Aid Technology

Modern hearing aids are small computers. They have microphones that pick up sound, processors that analyze and modify that sound, and speakers that deliver it to the ear. The sophistication varies enormously.

Basic hearing aids amplify all sound. That works but isn't ideal because it amplifies background noise along with speech, making the overall listening experience exhausting. Better hearing aids use directional microphones to focus on sound coming from in front of the wearer while reducing sound from the sides and back. Advanced models learn the wearer's preferences and adjust automatically when the user moves between environments. Premium models connect wirelessly to smartphones and other devices.

Many modern hearing aids use rechargeable batteries. Your parent charges them like phone earbuds instead of messing with tiny disposable batteries. This is genuinely life-changing for people with arthritis or vision problems. Some still use disposable batteries because they're reliable and people are used to them.

Bluetooth connectivity is increasingly standard. Your parent can stream phone calls directly to their hearing aids. They can use a remote control from their phone to adjust volume and settings. They can pair their hearing aids with their television or other audio devices. This technology is powerful when your parent is comfortable using it.

The Reality of Cost

Hearing aids are expensive. A pair of quality hearing aids can easily cost three to six thousand dollars or more. Basic models might be a thousand to two thousand dollars. This is a real financial barrier for many families.

Medicare doesn't cover hearing aids, though some Medicare Advantage plans offer limited benefits. Medicaid coverage varies by state. Many private insurance plans don't cover them either. Some employers offer hearing aid coverage through their retiree benefits. Military veterans might have access through the VA. Otherwise, your parent is paying out of pocket.

Some hearing aid manufacturers offer assistance programs for people who qualify financially. Some nonprofits help cover costs. Some audiology practices offer payment plans. Over-the-counter hearing aids are significantly cheaper, starting at a few hundred dollars, but they're not appropriate for everyone.

The cost is especially frustrating because hearing aids genuinely help people stay connected and independent. Untreated hearing loss increases risk of cognitive decline, falls, and depression. In the long run, the cost of not addressing hearing loss might exceed the cost of hearing aids. But in the short run, your parent still needs to figure out how to afford them.

Getting Your Parent to Accept Hearing Aids

The hardest part of hearing aids isn't always the technology. It's getting your parent to actually use them.

Many people resist for emotional reasons. Hearing aids feel like admitting they're old or declining. There's some complicated identity stuff tied up in hearing, which relates to connection and capability and who you've always been. This is real and worth naming.

Some people resist because the adjustment period is uncomfortable. Hearing aids feel foreign in the ear. They amplify every sound, including annoying background noise and your parent's own breathing or chewing. Everything sounds louder and different. This is overwhelming for several weeks until the brain adapts.

Some people have real physical problems. Ear wax buildup, ear infections, or anatomical issues make hearing aids uncomfortable. Hearing aids can sometimes cause feedback or whistling. These are solvable problems, but they require working with the audiologist and sometimes getting medical treatment.

What helps: managing expectations about the adjustment period. Your parent should know they'll feel weird initially. Spending time with hearing aids at home before trying them in noisy environments helps. Starting with lower amplification and gradually increasing it helps the brain adjust. Your parent should wear them consistently because wearing them part-time actually makes adjustment harder.

A good audiologist is invaluable. Your parent should see someone who listens to concerns, tries different settings, and doesn't just sell the most expensive option. The relationship with the audiologist matters because your parent will need follow-up adjustments.

Beyond Traditional Hearing Aids

For some situations, other approaches help. Assistive listening devices for specific environments matter. Your parent might not want to wear hearing aids all day but would really benefit from a system that amplifies the television or a personal amplifier for one-on-one conversations.

Captioning is increasingly available on television and at movies. It helps people with hearing loss stay engaged with content. Smartphone apps can provide real-time captions for conversations, though results vary in quality.

Addressing the environment helps too. Hard surfaces bounce sound around and create noise. Adding soft furnishings like carpets and curtains helps. Reducing background noise, turning off fans or air conditioning during conversations, and sitting closer together all improve hearing for everyone.

When Your Parent Refuses

Some older adults never warm up to hearing aids. They tolerate them but don't like them. They use them inconsistently or abandon them altogether.

This is frustrating. You know they'd hear better and connect more effectively if they wore them. But you can't force someone to use hearing aids if they're resistant.

What you can do is keep conversations open. Ask what specifically isn't working. Is it physical discomfort? Vanity? Frustration with settings? Some of these have solutions. If it's fundamentally that your parent is resistant to using technology, that might be unchangeable.

You can also work around it by making sure you're speaking clearly when you interact with them. Face them directly so they can see your lips. Speak at a normal volume, not shouting. Reduce background noise when possible. These accommodations don't replace hearing aids but they do help.

The Long View

Hearing loss is permanent. Your parent's hearing likely won't improve. Hearing aids are a tool to manage that loss, not a cure. That's an adjustment everyone needs to make.

Well-fitted, appropriately programmed hearing aids can make a real difference in quality of life. Your parent can participate in conversations. They can enjoy television and movies without the volume being set to a level that disturbs others. They can stay engaged socially and mentally. That matters.

The investment in good hearing aids and a good audiologist pays dividends in independence, connection, and overall well-being. It's worth exploring options and pushing gently on your parent's resistance, while also respecting that ultimately they have to be willing to wear them.

Hearing evaluation and hearing aid selection should be done by a qualified audiologist or otolaryngologist. Over-the-counter hearing aids may work for mild hearing loss but aren't appropriate for everyone. Medicare does not cover hearing aids, though some Medicare Advantage plans offer limited benefits. Insurance coverage varies widely, so check your parent's specific plan. If your parent experiences pain, infection, or significant discomfort with hearing aids, report this to their healthcare provider.