Despite a clunky image, modern hearing aids have gotten impressively high-tech. Richard Raiff showed up at his Mt. Lebanon audiologist's office on a recent sunny afternoon to trade his tiny behind-the-ear models for even smaller ones that work directly with his iPhone.
The new model is called the ReSound LiNX, and it's one of the first hearing aids made to work with Apple's popular smartphone. Two others have also launched this year: the Beltone First and the Starkey Halo. The phone sends audio to the hearing aids in much the same way as it does to a standard Bluetooth earpiece. It also can act as a remote control for the hearing aids via a specialized app.
Mr. Raiff's audiologist, Deborah Albaugh, hopes that the iPhone association will attract tech-savvy clients, especially young people who are more comfortable swapping apps than fiddling with the kind of remote control that, until recently, Mr. Raiff wore around his neck.
The remotes, which are available for most hearing aids on the market, send audio signals from a phone in the wearer's pocket directly into the hearing aids. This meant that when Mr. Raiff was bicycling along the North Shore and needed to stop to take a phone call, the hearing aids played the caller's voice directly into both ears, minus background noise.
Apple and its hearing aid partners seem to be hoping that hearing aids are an easier sell when they are positioned as merely a high-tech phone accessory. Less than 25 percent of people who need a hearing aid are using one, according to the American Speech-Language-Hearing Association. And when people realize they need a hearing aid, they typically wait most of a decade before seeking help.
The key to being happy with your hearing aid is to find a provider who can match technology to your needs, says Catherine Palmer, director of the Center for Audiology and Hearing Aids at UPMC's Eye and Ear Institute. For some, that might mean a simple device that can amplify the television or telephone; for others, it's something fancier.
Patients often visit a primary care physician first. If the hearing problem is the result of something wrong in the outer or middle ear, such as an infection, an ear, nose and throat specialist may be able to treat it. But if the problem is with the inner ear, where sound is detected and sent to the brain, the damage is permanent.
Hearing aids have come a long way since the first bulky electric ones that merely amplified sound. Today's aids have directional microphones that can listen to what's in front of wearers rather than sounds from all sides. They can automatically adjust parameters such as volume and can fine-tune the sound they produce to compensate for the wearer's particular pattern of hearing loss. "There's tons of good news in hearing aid signal processing," says Ms. Palmer.
In the end, though, only the brain can truly understand sound. Wearing hearing aids in both ears helps the brain process the sound better; so does wearing them all day long. People who use their hearing aids only occasionally aren't training their brain to process the new sound, says Ms. Albaugh, which leads them to put the devices back into a drawer as soon as possible. Ms. Palmer agrees: The best way to wear hearing aids, she says, is to put them on as soon as you wake up and keep them on until bedtime.
Ms. Palmer notes that no hearing aid can eliminate the most problematic kind of background noise: other people's speech. The best strategy for a busy restaurant is to use a small microphone placed near the person who is talking to you. For many hearing aids, that's a separate accessory; for the iPhone-enabled aids, the iPhone itself can be the microphone.
In addition to eliminating the neck-worn remote (which, Ms. Albaugh says, reminds some clients of boxy 1940s-era hearing aids), the iPhone-enabled models can use the phone to record information about when and where the user adjusted the hearing aid; they can also track how often it's used. An audiologist can then use this information to tweak the hearing aid's settings.
Another promising feature is the ability to locate a lost hearing aid. Based on the strength of the Bluetooth signal, the phone can tell you if the hearing aid is nearby. If the hearing aid's battery is dead, the phone can remember the GPS coordinates of where you were when you last had it.
While the new smartphone-enabled hearing aids offer some promising features, they also come with several drawbacks. A major one is price: the ReSound LiNX costs about $7,500 for a pair, compared with $4,400 for an otherwise comparable model that doesn't integrate with the iPhone. It also draws more power, requiring the pea-sized battery to be changed every three days instead of once a week.
Today's hearing aids are smaller, more comfortable and less visible than ever. Mr. Raiff's new hearing aids consist of a small silver-colored plastic box, barely bigger than a kidney bean, that sits behind his ear. It connects via an almost-invisible wire to a tiny earbud.
In the end, Mr. Raiff found he preferred his previous hearing aid, a Phonak that used a remote. He preferred having the controls around his neck instead of pulling the phone out of his pocket to adjust the hearing aid or even to answer a phone call.
"I had gotten used to walking around without worrying about where the phone was, as long as it was within 10 feet."
Freelance writer Beth Skwarecki: firstname.lastname@example.org.