About this leaflet

You should read this leaflet if you have been to your GP and been told you need further hearing tests. It will also help you if you think you may need a hearing aid or have just got your first hearing aid.

You should read this leaflet if you want to know about:

You can download a portable document format (PDF) version of this leaflet or request a printed copy from the RNID Information Line.

What will happen at the hearing test

When you go to the hospital or clinic, you will be seen by an audiologist and sometimes by an ear, nose and throat (ENT) doctor. Before they test your hearing, you will be asked some questions about your hearing and they will look in your ears using an instrument called an otoscope.

The hearing tests - also called audiometry - last about 20 minutes. The audiologist will ask you to put on headphones and listen to sounds of differing frequencies (pitch) and levels of loudness. These are low, middle and high pitched musical notes. One ear is tested and then the other. You have to press a button each time you hear a sound. The audiologist will make them gradually quieter to find out the softest sounds you can hear. The results are drawn on a chart called an audiogram.

Then they may ask you to put on a headband with a vibrating pad. This pad transmits sound through the bones of your skull to the cochlea in your inner ear, on both sides of your head. Again you have to press a button each time you hear a sound. When the results are compared with the headphone test, it shows up any problems you might have with your eardrum or middle ear. This helps to decide what can be done about your hearing loss.

At some point during the test, the audiologist might play a rushing noise into one ear to cover up the sounds on that side while your other ear is tested.
You may be given another test where you listen to sentences or words and repeat what you hear. This shows how much your ears are distorting sounds.

The audiologist will explain your test results and discuss whether hearing aids are likely to help you, or if you could have some other treatment. Occasionally, you will be offered further tests.

What happens next?

If the audiologist says you need hearing aids, it is a good idea to try them. You may find that you get on better with two - one for each ear. It takes time to get used to using them because you have to become familiar with the sounds you hear and with operating the controls, so the sooner you start the better. You can get free hearing aids on the NHS.

What a hearing aid does

A hearing aid makes sounds louder and clearer so that you hear them comfortably. It is battery-operated and you put it in or around your ear. Hearing aids are available in different shapes, sizes and types. However, all hearing aids work in a similar way. The type of hearing aid you get will depend on your hearing loss and what you find comfortable.

Read more about different types of hearing aid.

How a hearing aid works

Very simply, all hearing aids have a built-in microphone that picks up sound and converts it into an electrical signal. The signal is processed electronically and amplified. Most modern hearing aids do this using digital technology.

The resulting signals are then passed to a receiver, or earphone, in the hearing aid, where they are converted back into sounds for you to hear, made louder and tailored to suit your own hearing needs.

A hearing aid won't give you perfect hearing, but it should make sounds loud enough for you to hear them at a comfortable level. This may help you to hear on the telephone and make conversations easier. This should increase your confidence when talking to other people. However, it won't necessarily make sounds perfectly clear.

Hearing aids and tinnitus

If you have tinnitus (hissing, buzzing or other noises in your ears or head), you may hear it less when you use a hearing aid.

Read more about tinnitus.

Adjusting to wearing hearing aids

After you first get a hearing aid, you will need to gradually build up the amount of time you wear it so you can get used to the new sounds and the feeling of wearing it in your ear. Eventually you should be able to wear it for most of the day comfortably. This may take up to three months, so you will need to be patient.

When you get your hearing aid, you should be given advice on how to get the best from it. You should also be shown how to use it and look after it. You can always ask for more help.

Waiting to get a hearing aid

If you want an NHS hearing aid you may have to wait several weeks or even months for a first appointment. After that you may have to wait again, for a few weeks, before you have your aid fitted.

For more information read our factsheet The NHS Hearing Aid Service.

Choosing a hearing aid

In the NHS, you cannot always choose the style of hearing aid you want. However, the NHS does have a range of hearing aids, and you should be able to get one that suits your particular hearing loss.

Hospitals should offer you a hearing aid for each ear if you would benefit, although policy about this varies. If you are offered two, it is a good idea to try them, as many people find two aids more helpful than one. Some people prefer to buy a hearing aid privately so that they can choose the style they want. Some types of hearing aid - such as aids that fit entirely in the ear - are not available on the NHS. 

How a hearing aid is fitted

The NHS generally fits behind-the-ear (BTE) hearing aids. These have an earmould connected to the main part of the hearing aid. There are also some other, smaller types of earpiece, which can be used instead of an earmould. We will explain this when we describe different types of hearing aid.

If you need an earmould, the audiologist will take an impression of your ear (pictured below) so that it can be made to fit your ear snugly. You will be asked to return to the hospital to get your new hearing aid a few weeks later when the earmould is ready.

At your fitting appointment the audiologist will adjust your hearing aid using a computer to suit your hearing loss. They will make sure it sits comfortably in your ear and show you how to use and look after it. They will also make sure you can put the hearing aid in and remove it.

You should also be offered a follow-up interview to check that your hearing aid is helping as it should and that you are not finding any problems in using it. This may be either in person or over the phone. Sometimes the hearing aid needs fine-tuning to get the best result.

If you have problems with your aid(s) in between appointments, contact your audiology department as you may be able to attend a repair session.

How long hearing aids last

Hearing aids last on average about five years. If you need a more powerful hearing aid or a new one, you will not have to pay for it. NHS hearing aids are free. So are new earmoulds, tubing, batteries and, normally, repairs. However, if you lose or damage your hearing aid, you may be asked to pay something towards the repair or replacement.

Buying a hearing aid

Ask your GP or a friend if they can recommend a private hearing aid dispenser. By law, all hearing aid dispensers must be qualified - or in supervised training - and registered with the Hearing Aid Council (external link, opens new browser window). This regulates dispensers' training and conduct, and handles complaints. Our Information Line can give you a list of hearing aid dispensers in your area, but cannot recommend one.

In some ways, getting your hearing aid privately is similar to getting one from the NHS. You will have your hearing tested and your hearing aid dispenser will show you how to use and look after your aid. But you also have to sign a contract agreeing to buy your hearing aid. Make sure you read the terms and conditions of this contract and find out about any money-back guarantee before you sign anything. Ideally, you should get at least 28 days to try out the hearing aid and be able to return it during this time if you are not satisfied with it, and get a refund.

How long will I have to wait if I buy privately?

Your hearing aid dispenser will probably see you within a week and you will be able to get your hearing aid within about two weeks.

How much do hearing aids cost?

To have them fitted privately, hearing aids cost between £300 and £3,000 each. Medical insurance may cover part of the cost of a hearing aid, but check with your insurer first. When the guarantee runs out, you will also have to pay for repairs and the costs of these can mount up. You will also have to buy your own batteries. Hearing aids last about five years on average so remember that you will have to pay for new ones in the future.
You should also insure your hearing aid against loss, theft or damage if you buy it privately.

What 'analogue' and 'digital' means

Hearing aids are described as either analogue or digital, depending on the technology they use to process sound. Digital hearing aids are the newest kind and are now available as standard on the NHS.

Digital hearing aids take the signal from their microphone and convert it into 'bits' of data - numbers that can be manipulated by a tiny computer in the hearing aid. This makes it possible for the hearing aid to process sounds in ways that are impossible with analogue aids. It also means that the hearing aid can be tailored to suit you.

The more advanced digital aids can be very finely adjusted to suit your individual needs. You may also be able to switch between different settings suitable for different listening conditions. Many digital aids even adjust themselves automatically to suit different sound environments.

Most digital hearing aids are also designed to whistle or squeak less than analogue aids. Read more about problems with hearing aids.

Hearing in noisy places

One of the biggest problems for people with hearing aids is following what people are saying in noisy places. Many digital hearing aids are designed to reduce steady kinds of background noise such as the rumble of traffic or the whirr of a fan. This can make listening more comfortable, though it does not necessarily help you pick out one voice when many people are talking.

To help with this problem, many digital hearing aids use directional microphones to help you hear sounds best when they are directly in front of you so that you can focus on what you want to listen to.

Different types of hearing aid

The following types of aid are available as digital or analogue - except for body-worn aids and some types of bone conduction aid which are analogue only. Your audiologist or hearing aid dispenser will advise you on the most suitable type for you.

Body-worn hearing aids have a small box that you can clip to your clothes
or put in your pocket. This is connected by a lead to an earphone and earmould. Body-worn hearing aids may be suitable if you have sight problems, or problems using very small switches or buttons. Some models are very powerful.

Bone conduction hearing aids are for people who cannot wear a conventional hearing aid or people with a 'conductive' hearing loss. They deliver sound through the skull by vibrations. One type involves an operation behind the ear.

CROS/BiCROS hearing aids are for people with hearing in one ear only. CROS hearing aids pick up sound from the side with no hearing and feed it to the hearing ear. BiCROS aids amplify sound from both sides and feed it into the ear that has some hearing.

Hearing aid accessories

These include:

Get the best from a hearing aid

Once you get your hearing aid, it is important to practise using it and its various controls. This will help you get used to it and get the most from it. Make sure that the earmould fits snugly but comfortably.

It may take several months to get used to your hearing aid.

Start by wearing it once or twice a day for about an hour in quiet situations.

Listen to everyday noises such as the kettle boiling or doors opening and shutting to get used to how they sound. Then try conversations with one person, again in a quiet room. Make sure the other person sits facing the light as it will make it easier to lipread them.

Next, try conversations with two people or in small groups. Don't expect to hear everything that is said, but try to follow the conversation.

When you have practised using your hearing aid indoors, try using it outside. To start with, be careful not to have the volume too high when you go out because sounds, such as traffic, can be loud.

Finally, try using your hearing aid somewhere where it is noisy such as a restaurant or pub. This is likely to be the most difficult situation. You will probably not be able to hear everything that people say to you, but with time this should get easier.

If you still can't get used to your hearing aid, talk to your audiologist or hearing aid dispenser. They will be happy to give you some tips on how to get the best out of your hearing aid.

The controls on a hearing aid

Some hearing aids have a switch with different positions, often marked 'O' for 'off', 'M' for 'microphone' (the usual setting) and sometimes one marked 'T'. You switch other hearing aids on and off by using the battery door. Practise switching the hearing aid on and off and remember to switch the aid off when you are not using it.

Some hearing aids have a volume control wheel and others adjust their own volume automatically.

If there is a volume control, practise adjusting the loudness to a comfortable level.

Digital hearing aids often have a switch or button to change to different settings (programmes) suitable for different listening situations.

The 'T' setting

Most hearing aids either have a switch position marked 'T' or, if they are digital, a 'T' listening programme that you can switch to. On the 'T' setting, your hearing aid will be able to pick up sound from listening equipment, such as a loop system (we talk about this later). This equipment transfers sound directly to your hearing aid, cutting out background noise.

When you get your hearing aid, ask if it has a 'T' setting. If it is a very small aid, there may be no room for one. This means that you won't be able to use listening equipment with it.

Batteries

You will have to change the batteries in your hearing aid regularly. If you have an NHS hearing aid, you can get free batteries from any hospital audiology or ENT department that has a battery service. Sometimes you can get them from your local health centre. You can also buy batteries from any pharmacy.

Looking after a hearing aid

When your hearing aid is fitted you should be given written instructions about how to look after it. If you are not sure about any of the information, ask your audiologist or hearing aid dispenser for advice.

How to look after behind-the-ear (BTE) hearing aids

Wipe the hearing aid and earmould with a dry tissue every time you take your hearing aid off. Ideally, you should wash the earmould and tubing every night. If you can't do this, wash them at least once a week. Only wash the earmould and tubing. Do not wash the hearing aid - the part that contains the battery.

Don't unscrew the hooked part (or 'elbow') from the hearing aid. Instead, gently pull the plastic tubing off the hooked 'elbow' but don't pull it out of the earmould. Wash the earmould and tubing together in warm soapy water, and rinse them.

Blow down the tubing to get the water out, and let it dry overnight. Once it is dry, push the end of the tubing back onto the hearing aid. The tubing will need changing every three to six months before it hardens or splits and causes problems.

How to look after in-the-ear (ITE) hearing aids

There are two types of ITE hearing aids:

How to look after in-the-canal (ITC) and completely-in-the-canal (CIC) hearing aids

You must not wash these hearing aids. Wipe them with a dry tissue and use a soft brush to clean wax from the opening. ITC hearing aids often come with special instructions and cleaning tools.

How to look after body-worn hearing aids

If you have this type of hearing aid, wipe it all over with a dry cloth every time you take it out. Wash the earmould at least once a week.

First, gently pull the receiver, the metal piece at the end of the cord, off the earmould. Put the hearing aid (the part with the battery in), lead and receiver in a safe, dry place. Don't ever get these wet.

Wash the earmould with warm soapy water, using a soft brush to remove any wax blocking the opening in the earmould. Rinse and dry the earmould carefully.

Leave it to dry overnight before you clip it back on to the receiver.

Earmoulds

Ask your audiologist or hearing aid dispenser to make a new earmould if it wears out or becomes loose or uncomfortable.

Problems with hearing aids

If you are having problems with your hearing aid, your audiologist
or hearing aid dispenser will be able to help you. However, there are some common problems that you may be able to sort out yourself.

If your hearing aid doesn't seem to be working:

Buzzing noises may mean that you have switched your hearing aid to the 'T' setting by accident. However, if this is not the problem, buzzing generally means your hearing aid has developed a fault and needs to be repaired.

Whistling or squeaking is caused by 'feedback', when sound amplified by your hearing aid is fed back into it. It may happen if:

Other ways to improve hearing

You can get a range of equipment to help you hear conversation, your television or stereo. Some of it is specially designed to be used with hearing aids on their 'T' setting.

Loop and infrared systems are often fitted in places such as theatres, public halls, post offices and banks. You can also fit them at home.

Telephones described as 'hearing aid compatible' have a kind of built-in loop. When you use this kind of telephone with your hearing aid on the 'T' setting, the sound you hear will be clearer and have less background noise.

You can also use conversation aids, radio microphone systems and listening equipment with your hearing aids by plugging in a neckloop or earloop, and switching your hearing aid to 'T'.

For more information, read our leaflet Everyday solutions.