What hearing aids actually do
Hearing aids do not restore normal hearing or make deaf people hear the way hearing people do. What they do is amplify sound — make it louder — so that some people with hearing loss can detect sounds they otherwise could not. Whether that helps depends entirely on what type of hearing loss someone has, how much hearing remains, and which ear structures still work.
A person who is completely deaf — meaning there is no usable hearing in either ear — will not benefit from a hearing aid, because there is no sound signal for the device to amplify. A person with severe hearing loss in both ears might hear some loud sounds with a hearing aid, but not speech. A person with moderate hearing loss might understand conversation with a hearing aid in a quiet room but struggle in noise. The outcome is not the same for everyone.
Key Takeaways
- Hearing aids amplify sound but cannot restore normal hearing or create hearing where none exists.
- Whether a hearing aid helps depends on the type of hearing loss, how much hearing remains, and which inner ear structures are working.
- An audiologist tests your hearing with a formal test called an audiogram to determine whether amplification will work for you.
- Some deaf people use hearing aids; many do not, and that is a personal choice based on their own needs and preferences.
- Cochlear implants work differently than hearing aids and may be an option for some people with profound deafness.
The difference between types of hearing loss
Sensorineural hearing loss — damage to the inner ear or the nerve that carries sound to the brain — is the most common type. If some hair cells in the inner ear still work, a hearing aid can amplify sound enough for those cells to pick it up. If all the hair cells are dead, amplification alone will not help, because there is nothing to detect the sound.
Conductive hearing loss — a blockage or problem in the outer or middle ear — often responds well to hearing aids because the inner ear itself is intact. Sound just needs to be made louder to get through the blockage.
A person can have both types at once. An audiologist performs a formal hearing test called an audiogram to measure how much hearing loss you have and what type it is. The audiogram shows whether amplification is likely to help you.
How much sound a hearing aid can amplify
Modern hearing aids can amplify sound by 20 to 70 decibels, depending on the device and how it is programmed. That sounds like a lot, but it depends on how much hearing loss someone has. If you have a 60-decibel hearing loss and the aid amplifies by 60 decibels, you might hear at a normal level. If you have a 90-decibel hearing loss and the aid amplifies by 60 decibels, you still will not hear normal conversation.
The louder a hearing aid makes sound, the more distortion and feedback it can create. Turning up the volume too high can also damage whatever hearing remains. An audiologist programs the device to find the balance between amplification and safety for your specific hearing loss.
What deaf people report about hearing aids
Some deaf people use hearing aids and report that they help them detect certain sounds — a doorbell, a car horn, a raised voice — even if they cannot understand speech. Others tried hearing aids and found them unhelpful or uncomfortable and chose not to use them. Both experiences are common and valid.
Many deaf people identify as part of Deaf culture and do not view deafness as something to fix. They communicate fluently in sign language and may not want or need a hearing aid. Others have progressive hearing loss and use hearing aids at some stages but not others. The choice to use a hearing aid is personal and depends on your own goals, comfort, and communication needs.
Cochlear implants as a different option
A cochlear implant is not a hearing aid. It is a surgically implanted device that bypasses damaged hair cells and sends electrical signals directly to the hearing nerve. Cochlear implants can help some people with profound deafness hear sound and understand speech in ways that hearing aids cannot.
Cochlear implants require surgery, ongoing programming by an audiologist, and rehabilitation to learn to interpret the signals. They are not right for everyone, and the decision to get one is complex. An audiologist and a cochlear implant team can discuss whether you might be a candidate and what the realistic outcomes are for your situation.
Getting a hearing test to find out what works for you
The first step is a hearing test with an audiologist. You can find an audiologist through your primary care doctor, your state's department of health, or a local hospital audiology department. Some audiologists work in private practices; others work in hearing aid retail chains.
During the test, the audiologist will measure your hearing in each ear, determine the type of hearing loss, and discuss whether a hearing aid, a cochlear implant, or another option might help. If a hearing aid is recommended, the audiologist will fit one and program it for your specific loss. Many audiologists offer a trial period so you can test the device in real life before committing to it.
Cost and insurance coverage
Hearing aids range from a few hundred dollars to several thousand dollars per ear, depending on the technology and features. Medicare covers some of the cost for people over 65 in certain circumstances, though coverage varies. Many private insurance plans do not cover hearing aids, or cover only a portion. Some states have programs that help low-income people get hearing aids at reduced cost.
Ask your audiologist about payment plans, manufacturer discounts, and whether your state has a hearing aid information program. The Hearing Loss Association of America maintains a state-by-state directory of programs that may help with cost.
Frequently Asked Questions
Can a hearing aid make me hear normally?
No. A hearing aid amplifies sound, but it does not restore normal hearing. How much it helps depends on how much hearing you have left and what type of hearing loss you have. Some people understand conversation with a hearing aid; others hear only loud sounds.
Will a hearing aid work if I am completely deaf?
Not if you have no usable hearing in either ear. A hearing aid amplifies sound, but there has to be some hearing left to amplify. An audiologist can test whether you have any remaining hearing and whether amplification would help.
Do I have to use a hearing aid if I am deaf?
No. Using a hearing aid is a personal choice. Many deaf people communicate fluently in sign language and do not use hearing aids. Others use them in certain situations. The decision is yours based on your own needs and preferences.
What is the difference between a hearing aid and a cochlear implant?
A hearing aid amplifies sound. A cochlear implant is surgically implanted and sends electrical signals directly to the hearing nerve, bypassing damaged inner ear structures. Cochlear implants can help some people with profound deafness, but they require surgery and ongoing care.
How do I know if a hearing aid will help me?
An audiologist performs a hearing test called an audiogram to measure your hearing loss and determine whether amplification is likely to help. If a hearing aid is recommended, most audiologists offer a trial period so you can test it in real life before you decide.