How Do Hearing Aids Work?

25 September 2019 Assisted Living

People all around us wear hearing aids all the time, yet most of us don’t really know exactly how they work. You know that they are electronic devices that fit in or behind a person’s ear to help them hear better. Although the idea has remained the same, technology has advanced to make these essential devices more convenient and effective than ever.

What Is a Hearing Aid?

If you have a close family member who wears a hearing aid, you already know the difference when they don’t have it in. The device makes some sounds louder so that the person who has hearing loss can still hear what others have to say. They might remove the device when they sleep, shower, or when they are home alone. It’s easier to understand the full effect of the hearing aid when you compare their ability to hear and understand you without it.

Why a Hearing Aid Is So Important to a Senior’s Quality of Life

Imagine that everyone around you was speaking a different language. You can hear them speaking, but you don’t understand what they’re saying. Hearing loss can be a lot like that. It isn’t only that sounds aren’t loud enough; they also have problems comprehending them when they do hear them. That’s why your grandparents or parents mistake the words you say for something similar but persistently miss the mark.

You might laugh at an elderly loved one when they say something funny in response to your questions. But it isn’t any fun for someone who can’t hear. People often avoid them because it is a struggle to understand them. When they need something from someone, they have problems explaining what it is because they can’t hear the other person’s response. When there is noise around them, it might make matters even worse.

Hearing loss can impact a person’s quality of life in every way. They might withdraw from social settings, experience stress, depression, or a decline in their ability to work. Even more frightening, research has shown that individuals with moderate to severe hearing loss are as much as 5 times more likely to develop Alzheimer’s or other forms of dementia.

The research showed that anyone with a greater than 25dB hearing loss had twice the risk of developing dementia in comparison to those with no hearing loss. The risk of dementia increases as the severity of hearing loss increases. Those with severe hearing loss are five times more likely to develop dementia. The research also showed that the risk is highest for men.

Hearing aids can help some people with hearing loss, but not all. They are most effective at improving the hearing and comprehension of those with hearing loss which results from damage to the small sensory cells inside the inner ear. These cells are commonly called “hair cells” because of their fine, hairlike appearance.

This type of hearing loss is “sensorineural”, meaning the damage comes from disease or a lesion of the inner ear or the auditory nerve. Sometimes the damage occurs from exposure to loud noise or from using certain medications. In some cases, it is a symptom of aging.

The Structure and Operation of a Hearing Aid

A hearing aid contains a microphone, speaker, and amplifier. It either fits inside the ear canal or over the ear. Sounds enter the device through the microphone before getting converted to electrical signals. The hearing aid then sends the electrical signals through an amplifier which increases or amplifies their power. It then sends them through the speaker and into the wearer’s ear. For some people, hearing aids help the person hear better in both quiet and noisy settings.

Inside the ear, the signals vibrate the remaining undamaged hair cells and convert them to neural signals before sending them to the brain. People with greater damage to the hair cells have more severe hearing loss, preventing them from hearing as well, even with hearing aids. Without adequate hair cells remaining, there is nothing to detect the signals and convert them into neural signals.

Do You or a Loved One Need a Hearing Aid?

Seniors aren’t the only ones who suffer from hearing loss. Even babies are born with hearing loss in one or both ears. Adults of all ages suffer from different types of hearing loss. However, age-related hearing loss is the most common, with 1 in 3 people in this country between the ages of 65 and 74 having hearing loss. At the age of 75, nearly 50% have difficulty hearing.

Hearing loss from aging usually occurs gradually in both ears. You might not notice the changes at first. Once you do, talk with your primary care doctor about seeing an ENT doctor who specializes in ear, nose, and throat disorders. The specialist will examine you and perform tests to measure the degree of hearing loss and find the cause. They will advise you on whether using one or two hearing aids will benefit you or if you should consider other options.

Types of Hearing Aids


Hearing aids that fit behind the ear are usually made of hard plastic and are connected to a plastic earmold which fits inside the outer ear. They work for people with all levels of hearing loss. Some people don’t like wearing the BTE styles because they feel too conspicuous.

A new style of BTE called an open-fit hearing aid is smaller, allowing it to fit behind the ear completely. Other than a narrow tube you insert into the ear canal, the hearing aid is out of sight. They are also less prone to earwax buildup and any damage it might cause. Some people also prefer this open style because it doesn’t cause their own voice to sound plugged up.


ITEs are hard plastic hearing aids that fit entirely inside the ear. They effectively treat mild to severe hearing loss. Some styles of ITEs come with additional features installed. One example is a small, magnetic telecoil which allows the user to receive sound through the hearing aid’s circuitry instead of the microphone. This feature facilitates easier hearing over the telephone. The telecoil also aids with hearing sound through special sound systems called “induction loop systems.” Some places that frequently use induction loop systems include airports, churches, and auditoriums.

Canal Canal hearing aids come in two styles, both of which fit into the ear canal. The in-the-canal style is made to fit the individual’s ear canal. A completely-in-canal hearing aid is almost invisible. It is fitted securely in the ear canal. This minimal style isn’t good for people with profound hearing loss due to their small size and power and volume limits.

Do They All Work the Same?

It isn’t the hearing aid type that determines how it works. It’s the electronics contained in the hard plastic case. Basically, the difference comes down to analog vs digital.

Digital – In the age of digital, we have computers, phones, and all types of electronic devices that rely on digital technology. Some hearing aids also use it to convert sound waves into numerical codes and then amplifying them. One advantage of digital aids is that the code also has information regarding a sound’s pitch or loudness. The aid might be specially programmed to amplify some frequencies more than others. The ENT or audiologist (hearing doctor) can adjust digital hearing aids specifically to a person’s listening environment. The digital circuity works in all of the types of hearing aids listed above.

Analog – These aids work by converting sound waves into electrical signals which are then amplified. These hearing aids are custom built for every individual. The manufacturer programs them according to your specialist’s request. This type of hearing aid has more than one program or setting. The specialist uses a computer to change the hearing aid to accommodate your environment. Like digital circuitry, analog works in all types of hearing aids. They also tend to be more affordable than digital ones.

Your specialist will help you determine the best type that is right for you. The best choice depends on the severity of your hearing loss, whether it’s in one or two ears, and its cause. Most specialists recommend getting hearing aids for both ears to mimic a normal signal to the brain. Two devices also make it easier to understand speech and determine which location a sound is coming from.

One of the biggest deterrents that prevent people from getting hearing aids when they need them is the expense. The average hearing aid price ranges from $1,000 to $4,000 per device. For seniors who rely on Medicare for their healthcare, the cost of hearing aids isn’t usually covered. Some types of Medicare supplements help pay for the testing and exams, but not for the devices needed to correct hearing loss.

Everyone should still get tested if they suspect they have hearing loss. There might be a more affordable option that works for you. Hearing aids aren’t effective at treating every type of hearing loss. If you require a cochlear implant, Medicare will probably pay for the procedure. There are other procedures and solutions that can help. There is also new research underway to develop new drug and gene therapies that help reduce or prevent noise-induced and age-related hearing loss. A new solution for your hearing loss might be right around the corner.

What to Expect from Your New Hearing Aid(s)

It takes time to adjust to a new hearing aid, but it’s worth the time you take to get used to wearing it. It might feel somewhat uncomfortable at first. Your specialist might recommend wearing it for shorter periods of time until you get used to it.

Something called the “occlusion effect” is common for new users. The hearing aid causes a plugged-up sensation that makes the user’s voice sound louder inside their head. Your specialist might be able to make a correction, but you will probably get used to it over time.

If you hear whistling from your hearing aid, it might be due to a poor fit, not working right, or it is clogged by fluid or earwax. See your specialist about having it cleaned, repaired, or adjusted.

In addition to feedback, you might hear other noises around you. If background noise is a problem, your specialist might be able to adjust it to filter the extra sound out.

If you use a cell phone like most people these days, take yours with you to the hearing aid fitting. Although the problem of radio frequency causing interference is less than it used to be, it could still result in your hearing a buzzing noise from your hearing aid. Taking your phone with you will allow you to make sure it works with it before you bring the new device home.

At the doctor’s office, familiarize yourself with the hearing aid’s features. Learn to replace batteries, how often, and how to clean it. Some hearing aids come with rechargeable batteries that you don’t change. You drop the entire hearing aid into the charger overnight and it’s fully charged when you get up the next morning. These styles are pricier, and you still have to replace the batteries once a year or so.

Caring for Your New Hearing Aids

Taking care of your hearing aids will help extend their life and keep them working efficiently.

  • Keep them away from heat and moisture
  • Follow your specialist's instruction for cleaning your devices and keep them free of earwax and drainage. If your hearing aids come with a wax filter to prevent ear wax from getting inside, change it regularly
  • Schedule regular cleanings with your specialist and ask about any adjustments that might make your hearing aid work better
  • Avoid using hair care products while your hearing aids are in use
  • Keep new batteries available and replace old ones as soon as needed
  • Don’t leave dead batteries or replacements where children or pets can get to them

Get the Assisted Living Services You Need at Bethany Homes

At Bethany Homes, we understand how important it is to retain your freedom and enjoy the highest quality of life possible during your senior years. We provide the level of care each resident needs, including reliable transportation to doctor’s appointments and personal care assistance for those things you find difficult to do on your own. Contact us today to schedule a tour and get the best possible care for you or your loved one.