Hearing Loss and Aides

Technological advances in hearing aids and HATS have expanded the range of options available to improve the success of a device use. Today's hearing aids differ significantly from their analog predecessors because the application of digital signal processing has permitted many adaptive and/or automatic features. In the past decade, hearing instrument technology has developed to the point that digital hearing aids now constitute nearly 90% of all hearing aid sales in the U.S.[21] This growth has permitted decreases in the cost of digital technology so that digital hearing aids now span the range from entry-level prices to high-end pricing, thus allowing all users the option of digital technology. Included in the benefits of digital hearing aids are improved sound quality; multiple listening programs for different listening environments; advanced noise reduction strategies; acoustic feedback reduction; compatibility with remote control options; and flexibility in manipulation of the frequency, compression, and gain ( Table 1 ). These developments allow the audiologist considerable flexibility in choosing appropriate technology for the varied needs of older adults. Such features as automatic function of the telecoil (a hearing aid component for use with the telephone or for coupling to HATS) and multiple programs ensure that even those with limited manual dexterity or cognitive impairments can wear a device that optimizes performance across a broad range of listening environments. It is no longer necessary to find the switch or remember to return to a listening program when the conversation has ended for effective telephone use. Difficulty understanding speech amid noise is a common complaint for hearing aid users. Directional microphone technology has advanced to optimize the directional responsiveness of the hearing aid microphone in order to reduce the level of noise when the noise source is from an angle that is behind or beside the hearing aid user. Automatic directional systems are intended to accurately switch between directional and omnidirectional modes, and this option is available even in the lower-priced entry-level digital devices.