Many patients we've met who were reluctant to invest in hearing devices knew someone who said their hearing aids didn't help. There can be many reasons why hearing aids aren't working correctly, and that's why we work closely with patients to keep devices clean and well maintained. But beyond the devices themselves, there can be another problem caused when the brain doesn't get an opportunity to be retrained because of infrequent hearing aid use.
The brain needs to be retrained because hearing doesn't happen in the ear. That can be a difficult concept to understand because common sense says hearing is something the ear does. The reality is much more complicated. Sound waves are detected by the ear's complex mechanisms and converted into signals that travel through the nervous system to the brain. The brain decodes the neurological impulses into what we recognize as sounds and speech.
If you've ever watched a British TV show and experienced difficulty following the dialogue, you have a good idea of what impaired sound decoding can be like. Even when every word is heard it may still be hard to understand what's being said. You may infer the meaning from the context of the scene, or from the dialogue that came before or occurred after, but it can take a lot of work and attention.
Many patients treated for hearing loss have been living with impaired detection or decoding for a long time. Like a speaker of American English watching a show from Britain, the brain has learned new ways to determine meaning by using the environment, movements of the speaker's mouth, and the bits and pieces of the words that are understood.
Most people assume that hearing will improve immediately when properly programmed hearing aids are worn, but it takes time to retrain what our brains once it has learned to compensate for hearing impairment. With hearing devices, there is an immediate increase in the strength and clarity of sound signals. Still, it can take time for the brain to become re-familiarized with the new signals so it can decode the information accurately.
It's not uncommon for people with new hearing aids to avoid wearing them every day all day. Some may be conserving battery use by not wearing their hearing aids, which is one a reason we provide free batteries for the life of the devices. Others may only wear them at "special times," like going to social events or being around family and friends. Because it can take a month or more of constant hearing aid use for the brain to relearn to accurately decode the signals it receives, hearing aids worn infrequently prevents the necessary retraining from happening. Patients who don't wear their devices all the time are the ones most likely to say their hearing hasn't improved.
Fortunately, there are some excellent tools and strategies for speeding up the process of retraining the brain.
Audible.com - Audible is a great site for audiobooks and content that is both entertainment and brain-training wrapped into one easy-to-use package.
LACE Auditory Training – LACE (lacelistening.com) is a daily training program for improving the ability to listen and communicate in challenging hearing situations. The program runs on PC's Macs, iPads, and Android devices.
Your Local Library – Don't forget the free resources from your local library. We're located in Cedar Rapids, Iowa, and are thankful for all the audio resources available for free through the Cedar Rapids Public Library. Your public library can help you locate audiobooks, music, and a wide variety of recorded content to help your brain improve skills for listening and understanding speech.
While you're at it, don't neglect some simple, non-tech ways to improve your ability to hear more clearly. Some recommendations that can improve hearing include:
Avoid smoking – the many ways smoking damages hearing are almost too many to list, but a shortlist includes reduced blood flow to the ears, interference with auditory nerves, along with irritation of the Eustachian tube and middle ear.
Avoid alcohol – alcohol changes the amount of fluid in your ears and can damage the fine hairs inside the ear that detect sound waves.
Practice sound focus – turn up the volume on two devices and ask someone to read short passages aloud as they move around the room. Try to repeat what they've said.
Get exercise – exercise increases blood flow in the ears and the brain while removing toxins.