I’ve discussed the importance of hearing health and hearing loss prevention in previous articles, and my genuine hope is that at least a few readers were inspired enough to take my recommended preventative measures to heart. Who knows, maybe a handful of elder millennial audiophiles are now on the path to long-term hearing health and preservation. I hope so, as that was the stated goal of the articles…
But what about the core demographic of our hobby, the “OG” audiophile – who is likely a little past middle-aged and worried about (or possibly even starting) to experience hearing loss in the present day? We all know it’s coming – disabling hearing loss affects five percent of adults aged 45-54, 10 percent for those aged 55-64, 22 percent among ages 65-74, and 55 percent for individuals aged 75 and older (source: National Institute on Deafness and other Communication Disorders). Those statistics don’t bode well for our mostly male, mostly older adult audiophile demographic.
The thought of disrupting the process of purely pursuing music listening perfection without obstruction or assistance can be a terrifying prospect – but I’m here to ask you to rethink what you know about hearing aids, and why they may be the reason our hobby survives long-term. I say this as a fellow audiophile, as well as a medical professional.
How Hearing Aids Work and Why They’re Actually Cool…
Let’s first discuss what hearing aids actually are and how they work. When you break them down, hearing aids are really just small, integrated audio systems designed to amplify specific frequency bands and make hearing more enjoyable. Sound familiar?
Microphone: I know that microphones (outside of room correction or noise cancellation applications) generally don’t have a seat at the audiophile table, but they are the first and most integral component of a hearing aid. The microphone picks up sound from the surrounding environment and converts it into electrical signals, which contain information about the amplitude (loudness) and frequency (pitch) of the stimuli. This is then passed on for processing and amplification.
Amplifier: Now we’re entering true HiFi territory. Tiny amps just centimeters from your brain – this is an audiophile’s dream, right? The electrical signals produced by the microphone are then sent to the amp, which boosts the strength of these signals, accentuating the frequencies needed to suit the user’s specific needs. The amount of amplification can be adjusted based on the individual’s hearing loss profile and comfort level.
Processor: Wait… hearing aids contain chips? Damn right, just like the one in your DAC. Maybe that’s a bit of a stretch, but many modern hearing aids contain impressive processors, as well as digital signal processing (DSP), which processes the electrical signals using algorithms designed to enhance speech intelligibility and suppress background noise. This allows for more customized and adaptive amplification, improving the wearer’s ability to understand speech in various listening environments. Some hearing aids are even designed with music players and listeners in mind. More on that later…
Receiver: After processing, the amplified electrical signals are sent to a receiver. The receiver converts the electrical signals back into sound waves and delivers them into the ear canal.
Battery: Older hearing aids relied on tiny, disposable batteries. Most modern models use rechargeable batteries for convenience and longer battery life. Just place them back in the case at bedtime and you’re ready to rock and roll the next day. Just like a pair of Apple AirPods Pros.
User-Specific Controls: Many hearing aids come with user controls or settings that allow the wearer to adjust volume and switch between different listening programs (e.g., for different environments like quiet, noisy, or music). Most modern models also have Bluetooth 5.0 or higher, allowing the user to connect to his or her smartphone or digital device for listening to music or streaming.
Customized Fit and Finish: First, an audiologist or hearing professional conducts a hearing test, commonly known as an audiogram, to assess the individual’s frequency profile. This test is crucial for fine-tuning the settings of the hearing aids. Following this, a fit test is carried out to ensure the user achieves a snug and comfortable fit, achieving a near-perfect seal. This is very similar to the process used by high-end In Ear Monitor (IEM) manufacturers catering to musicians and sound engineers. Throughout this process, the hearing aid settings are personalized according to the individual’s unique hearing loss characteristics and preferences. Any necessary adjustments are made to guarantee maximum comfort and effectiveness.
Could Hearing Aids Be the Next Big Audiophile Product Category?
Hearing aids have historically been designed to focus on “functional” aspects of sound, meaning they are intended to improve your ability to function within your normal environment. Speech and conversation are typically first, with other environmental sounds, such as a cellphone ringing or a car horn, next in line. Audiophiles will want to return to high-frequency hearing at very high levels, which could radically change how we perceive sound. Bright speakers don’t sound all that bright to people with very rolled-off high-frequency hearing. Do you need new speakers if you could hear to, say, 17 kHz? Perhaps you would? Would that be a good thing? If a blue Viagra pill makes you like a 21-year-old in bed, is that a good thing?
Hearing aid manufacturers are increasingly developing products that not only include dedicated modes for music listening, but also excel in enhancing the musical experience, striving for the most natural sound reproduction possible. While they may never be able to achieve pre-hearing loss quality, these products might be worth looking into:
- The Phonak Lumity Bluetooth Hearing Aids were ranked by HearAdvisor as the best overall prescription hearing aids for music streaming. They are fully customizable and feature StereoZoom software dedicated to fine-tuning both speech and music listening. They also feature a handsome, discreet design and come in a variety of attractive colors.
- The Oticon Intent is a brand-new model, brandishing a proprietary chip that utilizes AI-based Deep Neural Network (“DNN 2.0”) technology to improve listening in all environments and contexts. They also utilize Auracast Audio and Bluetooth 5.2 to maximize connectivity and streaming quality.
- The ReSound LiNX Quattro features a music listening mode that enhances bass, while also accentuating higher frequencies to achieve a more natural representation of most music selections.
I’m still waiting for a major speaker or headphone manufacturer to design and produce a pair of hearing aids made specifically for audiophiles. Would you wear a pair made by Bowers & Wilkins, KEF or Mark Levinson, featuring some of the amazing tech listed above, but wrapped in leather and featuring custom drivers and a sexy charging case? I know I would.
Why is There a Stigma Associated with Wearing Hearing Aids and What Can We Do About It?
In the United States, approximately 28.8 million adults could benefit from hearing aids, yet less than a third of those aged 70 and older, and only about 16 percent of adults aged 20-69 with hearing loss, have used them. I see this stat daily as a medical speech pathologist specializing in geriatrics and dementia care. Almost all of my senior patients have some form of hearing loss, yet roughly only half actually own a pair (and many who do prefer not to wear them for both vanity and comfort-related reasons). The stigma associated with wearing hearing aids has been a longstanding issue for many who rely on these devices to navigate their daily lives. which can manifest in various ways, including socially, emotionally, and psychologically. An aging audiophile who acquires hearing loss later in life would undoubtedly consider this stigma when deciding whether to purchase a pair.
Addressing the stigma associated with hearing aids requires a multifaceted approach that involves challenging stereotypes and promoting inclusivity and acceptance. Just because you can no longer consistently hear beyond 6000 Hz does not make you less of an audiophile, nor does it limit your ability to participate as a critical listener of high-quality music.
Education about hearing loss and assistive devices can help debunk myths and misconceptions, fostering a more supportive and understanding environment for individuals who wear hearing aids. Additionally, advancements in hearing aid technology are helping to reduce the visibility of hearing aids and normalize their use in everyday life. After all, given the ubiquitousness of AirPods and other in-ear monitor-style earbuds, aren’t we used to seeing things in and around peoples’ ears?
Ultimately, creating a culture of acceptance and empathy is crucial in combatting the stigma associated with hearing loss and hearing aids, empowering individuals to embrace their unique listening experiences and musical identities, even if this means redefining what it means to be an aficionado of sound later in life. After all – we must remind ourselves that music listening is almost entirely subjective, and one listener’s experience will never be the same as that of the person seated next to them. Audiophiles need to recognize that, while the listening experience may differ for those wearing hearing aids, it remains valid and valuable. This concept of inclusivity and celebrating what makes us different is nothing new for the youngest generation of audiophiles – who are known for being more accepting of new technologies than generations before them. Perhaps we should follow their lead?
What is your take on audiophile hearing aids? Is the stigma too much to handle or if you could revert back to your hearing before you went to that Blue Cheer concert – would you do it? Or would you stick with what hearing you have and enjoy what you can hear now and accept things as they are? We want to hear from you below in the moderated comments?
Hearing tests should be recommended for all, especially 50+. Audiophile hearing aids for speech and music/movie listening is a great idea. How does Medicare support hearing aid?
Unfortunately Medicare does not cover services related to hearing aids, despite the growing knowledge that hearing loss significantly decreases health outcomes (dementia, depression etc). There has been some legislative chatter (seems like a bipartisan slam-dunk to me) but nothing has solidified yet.
The hearing in my left ear is non-existant & my right ear is compromised too. I have the best Oticon aid for the right ear but don’t use it. Why? (1) I’m fine with single sound sources but as soon as there are multiple sources (voices) the hearing aid is no help. (2) The hearing aid causes irritation in the ear that suddenly produces wax & clogs the aid. I don’t know if my situation is unique. As a precaution against further damage I have my ears professionally cleaned at least three times a year & definitely before flying. I lost hearing in my left ear after a multi-hop flight. I’ve had temporary deafness in my right ear too after a multi-hop flight. Also, I’ve had temporary deafness after taking strong NSAIDs, so be careful about medications, alway consult with your doctors. HTH.
P.S. last summer I decided to reorientate my speakers favoring my right ear, the best thing I’ve done in a long time. It took a lot of repositionings to minimize bass room modes but now I’m happy!
It sounds like you have Eustachian tube issues. Have your doctors discussed this?
I have intermittent tinnitus. Everyone says tinnitus is related to hearing loss and no doubt my hearing loss is partially to blame (I am 70). But the ringing is also definitely related to barometric pressure changes. I have an appliance for clearing Eustachian tubes. It creates pulses of pressure, and you have to learn to swallow while holding it in your mouth. But it definitely helps me sometimes, and clears my hearing.
I use ear drops to clear wax occasionally, which seem to work about as well as a doctor’s cleaning. If you have hard impacted wax they may tell you to do that anyway, then come back.
There are treatments for Eustachian tube blockage, though they typically are temporary. Since yours is, unfortunately, severe enough to have caused nerve damage, you should definitely look into it.
I was originally diagnosed with Menieres disease, that with immediate treatment could have been aleviated, unfortunately I waited a month. Hearing in my left ear came & went over a two year period. With Menieres there’s a loss at bass frequencies but the brain adapts. Of course, I have tinnitus too in both ears. Funny thing is I can ‘hear thru’ both problems & still very much enjoy music. I’ve had many ENT doctors verify the problems. My health insurance covers the cleanings.
I am 74 and have little ability to hear above 7khz. Wish I had read this a month ago, because I just was fitted with hearing aids. I would have appreciated knowing about the brands mentioned in this essay.
I originally bought OTC Lexie/Bose aids on Black Friday. They were adequate for my needs, but they simply would not stay in my ears. I tried every combination of tube and cushion and nothing remained in place after an hour or two. After a couple of sessions with Lexie customer care, the company said, “We give up” and told me to return the units to the retailer, which I did.
I then decided to bite the bullet and get prescription aids, which I assumed were more customizable. My audiologist is very disposed towards Widex products and suggested that company’s most recent model when I said specifically that I enjoy listening to both live and recorded music. There is an available “music” preset in the Widex phone app. I would have been better prepared to ask that other products be considered if this article were available then.
The Widexes generally are fine and they include a little plastic “tail” that keeps them in place. Sonically, they are not significantly more useful than the Lexies, at four times the price, although they are rechargeable and my Lexies were not. For hifi listening, they help a bit, but I have had to remove them for live music, where they are just too much.
I also have some pretty screaming tinnitus. Neither hearing aid helped much with that. If anything, that issue seems subjectively worse since I started wearing hearing aids, whether they are in my ears or not. I assume that’s a correlation, not causation, issue, but hearing aid literature is damned silent about whether aids affect tinnitus for better or worse.
As a consumer, I have two observations about hearing aid purchases.
First, in all my years of being a smart consumer, I never have shopped for a product that was more difficult to evaluate. Googling taught me one thing right out of the box: there is no information from disinterested parties on the internet. None. Even sites that aren’t direct sellers of anything have links to Amazon and other pages that pay them referral commissions. The audiologists and prescription manufacturers all say you never should buy OTC. The OTC manufacturers and resellers all say you don’t need audiologists and that their own XYZ OTC product is fifty times better for moderate hearing loss than any prescription product is. It was my inability to parse the self-interest in everything I found on the internet that paralyzed me for a year from the time my neurologist first recommended that I get hearing aids to save what is left of my cognitive skill.
Second, the unspoken reason that most older people don’t consider hearing aids is their astronomical cost. You can get low-end OTC products of dubious pedigree for a few hundred bucks, but some of those aren’t even hearing aids (they are just amplifiers) and the rest don’t have advocates. Name brand OTC starts at many hundreds of dollars and high end now goes into the two thousands. Prescription hearing aids have the audiologist infrastructure built into the pricing and start at several thousand. Most or all of the purchase price is uninsured: even with an allowance in my Medicare Advantage plan, I paid $2800 for a midline model and the audiologist wanted me to buy a higher end model that cost almost four grand after the allowance. Audiophiles already are used to insane prices for mainstream products, but the rest of the world either finds these prices staggeringly insane or simply won’t spend the money this way instead of paying the rent.
I haven’t found stigma, by the way. My few surviving friends are open to hearing aids themselves. The struggle is real.
My Oticon hearing aids were $7000/pair retail $6000 with discount. After a few weeks I returned the left aid because my perception of sound was distorted & distracting. I did get a full half refund. I also get free batteries, whoopee!
I appreciate your much needed article, but I cannot understand why Widex hearing aids were not mentioned. I am confident Widex is generally considered the most music capable of all hearing aids by a wide margin. Widex leads in processing speed, frequency range and their new units set the standard for microphone capability. Again, I appreciate the article. I believe most of the arguments we have in audio are the result of people with good hearing and people with poor hearing talking over each other. I encourage you to investigate Widex and update your article.
Superb article, Eric. Have any best bets for wearing only ONE aid for interaural unmatched sensitivity?
My right ear could use some lift. As well, to compensate for age-related FR droop, best recommendation for fixing spectral tilt above 4k, let’s say? Thanks.
$8,000 hearings aids. REALLY????