A lot of people with a hearing impairment express their frustration with family and friends who think that just because they now have hearing aid or even an implantable hearing solution such as a cochlear implant or baha, they are expected to hear perfectly again. Tolerance for their hearing loss is gone and frustration is often experienced (on both sides).

Where and how does this misconception about hearing technologies come about?
Many people, in fact (dare I say) most people wear or have vision correction of some kind, albeit glasses, contact lenses, laser surgery or implanted lenses. If you have blurry vision and you put on a pair of glasses made to your prescription most people get close to perfect sight again. Other people have knee, hip or other joint replacements and once the healing is over most people swear they can walk as good as ever and perhaps even better than before.
I think it’s these physical corrective devices from which people get their benchmark. The corrective examples I have used above, generally give the individual back close to normal vision or mobility. So there is an expectation that if you get a hearing device, you’ll get the same result.

So why doesn’t a hearing aid help in the same way as, say, glasses do?
Hearing loss should be likened to going blind rather than having blurry vision. Vision corrective prescription lenses make up for the difference in clarity, but if a person is blind it wouldn’t matter how strong the lenses they still wouldn’t see.

A mild hearing loss can be helped with the amplification a hearing aid can give. The added volume stimulates some of the damaged hearing cells in the cochlea and so helps with understanding. But even then there is a limitation because hearing aids notoriously do not cut out background noise in the same way a normal ear can. So all sound tends to be heard at the same sound level – the person talking to you is at the same volume as the motor bike going past the front of the house.

As hearing loss progresses and more cells die then stronger hearing aids do help, but some frequencies are missed because there are no longer enough cells to stimulate the hearing nerve for that frequency. And once again the background noise is even more difficult to overcome.

With the advent of digital hearing aids better programming has enabled a hearing aid to recognise background noise and cut it out to a certain degree, but still not as well as a normal human ear.

The most common hearing loss is age related and the condition is called sensorineural hearing loss. This means the hair cells in the cochlea degenerate. Usually the high frequencies die first so after a certain point in a typical hearing loss progression, sounds which form consonants (t, sh, ch, p, k, etc) can no longer be heard so speech seems mumbled. At this point in hearing loss a hearing aid cannot replace the missing sounds. Some modern hearing aids recode these sounds making them lower in frequency where the person can hear them…but it takes a bit of getting used to hearing speech at a lower frequency than before.

Once hearing loss becomes severe or profound a hearing aid cannot give much benefit at all. The few frequencies they still hear will be overloud and so many frequencies will be missed. So using the same example, despite the difference in distance, the person talking to you won’t be heard at all and the motor bike going past the house will be the only thing heard.
The next step is an implantable solution. The advantage of an implantable solution compared to a hearing aid is that implantable devices actually by-pass the damaged areas and stimulate the hearing nerve directly and often a profoundly deaf person (me included) will hear again. But it takes time to hear and understand the new stimulation. If someone hasn’t heard sound or not for a very long time, they won’t know what each sound is and will have to, like a baby, start learning to hear.

Understanding hearing loss is hard and understanding about hearing technologies can be even more difficult. To someone who is fully hearing this sound strange. There is a huge difference between hearing and understanding. Sometimes we hear everything and understand nothing. Think about it as being in (say) Germany and listening to them speak. You can hear it but you can’t understand it. Naturally in time, you will start to understand what is being said and so too will many people who wear hearing technology.

If you have someone with a hearing loss among your friends, colleagues, family or acquaintances, remember that hearing technologies are not perfect. They do not return absolutely normal hearing and in many cases hinder hearing in certain circumstances and even the best technologies may mean relearning to hear.