Roughly 20% of all people who need hearing aids actually get them. Most people don't realize that most hearing losses can be treated with hearing aids. Most people also don't realize that untreated hearing loss causes embarrassment, social stress, tension, and fatigue not only for the person with the hearing loss but also for family members, friends and work associates.

Successful hearing aid users are those who are motivated to improve their communication by improving their listening and hearing. They have worked with their audiologist to learn what they can expect from hearing aids - that is, understanding what a hearing aid can and cannot do. They also have family support.

How can family, friends, and co-workers be affected by MY hearing loss?
Family, friends, and people at work are just as bothered by your hearing loss as you are.

Talking take extra effort. They may be impatient because they have to repeat what they say to you so often. Conversations with you become time consuming.

They can't communicate with you by phone the way they used to.

You miss out on whispered affections. They feel at a loss to help, and they often wish for the "old relationship" they remember.

This is where you can take the lead and consult an audiologist to see what can be done to improve your hearing and to improve communication at home, at work, and in your social and leisure time activity.

Find an audiologist near you who is certified by the American Speech-Language-Hearing Association.

What are the first steps in considering hearing aids?
First you should have a good understanding of your hearing loss. What kind of hearing loss do you have? Is it permanent? What does your audiogram say about what sounds you can and cannot hear? Once you understand your audiogram, you can begin to understand why it is you have trouble hearing in different situations.

What can I expect the audiologist to do in selecting a hearing aid for me?
Assuming that the audiologic evaluation has been completed and you have had an opportunity to ask questions about your hearing loss, the audiologist will talk with you about your ability to use hearing aids.

Your audiologist will want to find out about your typical communication activities: at home with family, at work, in your social activities, and in your leisure time activities. You are a very important partner in this discussion. Your answers will help to decide the type and style of hearing aid that is best for you. Your answers will also help in deciding what hearing aid features you need.

In thinking about communication at home, the audiologist may ask:

• Do you live alone? With another person? With children?
• What is your current living situation? A dormitory? An apartment? A house? A facility such as a group home, assisted living, or nursing home?
• Do you watch television?
• Do you spend a lot of time on the phone?
• Are there certain people that are more difficult to hear than others?
• Do you have to communicate from upstairs to downstairs, or across many rooms?
• Do you have difficulty detecting the doorbell? The phone ringing? The microwave buzzer? The baby crying?
• Do you have conditions such as reduced vision? Arthritis? Other conditions that might affect your ability to manipulate hearing aid controls and batteries?

In thinking about communication at work, in career training, or in school or college environments the audiologist may ask:

• Where do you work? Construction? Sales? Office? School?
• What is your work environment like? Outside? Noisy? Large office? Quiet, small office? In a vehicle?
• What level of interaction with people does your job require?
• What level of telephone use does your job require? What kind of telephone? Cell phone? Wired phone? Speakerphone?
• Do you deal with voice messages? Taking dictation via phone or recorder?
• Do you have to attend meetings? Lectures? Seminars?
• Do you give presentations or run meetings?
• Are there situations or communication with certain people that are particularly difficult?
• Does your employer know about the Americans with Disabilities Act responsibilities for reasonable accommodations? (For example, phone amplifiers or assistive devices for meetings).

In thinking about your social and leisure activities:

• Are your social activities more one-to-one or larger group activities?
• Do you attend lectures, concerts, theater?
• Have you ever used an assistive listening device in a public setting?
• Do you go to movies? Dinner parties? Restaurants?
• Do your leisure activities involve sporting events? Machinery? Fishing? Bird-watching?
• Are there activities you now avoid because you can' t hear well?

Once you and your audiologist have talked about your listening needs, the audiologist will have a better idea of what hearing aid will best accommodate your  hearing loss in your personal situation. The audiologist will take into account your hearing loss, your communication needs, and your budget in selecting your hearing aids.

Once I get my hearing aid(s) what happens?
The audiologist will explain how your hearing aid(s) works. Information that should be covered includes:

• inserting and removing your hearing aids
• operating the switches (on/off, telephone switch)
• using audio-input (if part of your hearing aid)
• replacing batteries
• caring for your hearing aid
• cleaning any earmold
• using your aid with assistive listenng devices
• expectations for hearing in different listening situations
• troubleshooting problems.

Again, it is important that you attend and participate in this hearing aid orientation.

Examples of common questions that you should be sure to have answered are:

• How tight should my earmold be?
• How do I put my hearing aid in my ear?
• How do I remove my hearing aid? Should I turn it off before I remove it?
• What if I drop my hearing aid?
• Where should I store my hearing aid? Should I take the battery out?
• Where do I get batteries?
• How often should batteries be replaced? How long do they last?
• What do I do with old batteries? Are batteries harmful if swallowed?
• What are signs that I need to contact my audiologist?
• Should I wash my hearing aid? How do I clean it? What do I do when earwax plugs up the hearing aid?
• How do I clean my earmold?
• What is the whistling sound I sometimes hear? What do I do about it?
• How often should the earmold or tubing be replaced?
• What if I lose my hearing aid? What if it goes through the laundry? Or is chewed by a pet dog or cat?
• Should I get insurance for my hearing aids?
• What is an assistive listening device? Isn' t my hearing aid enough?

Many audiologists offer group classes on adjusting to your new hearing aid. This is an opportunity for you to meet in a group with new hearing aid users and learn how to make optimum use of your hearing aids. Sometimes experienced hearing aid users participate in classes and share useful hints about managing hearing aids.

Other Assistive Technology
Hearing aids are very helpful in one-on-one situations, but sometimes they are not enough. In fact, many hearing aid users ask, "Why do I need additional assistive technology devices? I thought that was what the hearing aid was for."

There are three situations that are difficult for all listeners, but especially difficult for people with hearing loss and people using hearing aids:

1. Distance between the listener and the sound source
   The farther away you are from a speaker, the harder it is to hear the speaker! This is pretty self-evident! The intensity, or loudness, of a sound fades repidly as it travels over distance. In fact, for every doubling of distance, the sound's intensity decreases by 6 dB. For example, an 80dB speaking voice three inches away will be reduced to 50 dB 8 feet away. This fact explains why you may have no difficulty hearing someone in close range, but considerable difficulty hearing the same person across the room.
2. Competing noise in the environment
   Most rooms have significant levels of background noise that compete with the spoken message or sound we want to hear. Examples of background noise are ventilation systems, others talking, paper shuffling, computers, radios, TVs operating, food preparation going on, outside traffic or construction, activities going on in adjacent rooms, etc. These sounds, combined with the lower volume of speech reaching your ear due to the distance factors described above, make hearing in noisy backgrounds very challenging. For optimum hearing, speech should be at least 20-25 dB louder than the competing noise.
3. Poor room acoustics.
   Room acoustics is another factor that plays a role in your ability to hear. Sound waves bouncing off hard surfaces like windows, walls, and hard floors create sound reflections and echoes (reverberation) that "smear" and distort speech. For example, large gyms, cathedrals, marble lobbies, etc. quickly come to mind when we think about reverberation. (Reverberation occurs, too, in classrooms, indoor sports courts, etc.). We' ve all experienced how much easier it is to hear in rooms that are carpeted than in rooms with tile or cement floors.

Any one of these three conditions (distance, noise, and reverberation) is problematic, but more often than not, they occur together and have a debilitating effect on your ability to hear and process speech.