Your Hearing Matters

Why get a hearing test?

Everyone’s hearing loss is different and until you know the extent and nature of your loss you won’t be able to make the best decisions about how to deal with it. A proper audiological (hearing) assessment will produce a wealth of information you can act on. It will also provide a baseline, so subsequent testing can tell if your hearing has changed.

The test will indicate whether hearing aids could help you – they are the most common solution for permanent hearing loss, though it’s estimated that only about 40 per cent of people who could benefit use them.

You can have hearing tests on the NHS via your GP or go direct to a private audiologist (hearing specialist). It’s often a good idea to see the GP first even if you intend to have audiology privately – the GP might spot a treatable cause for your hearing loss, especially if it is a recent development e.g. a build-up of wax. You should always seek emergency medical advice if you get sudden hearing loss.

Using the NHS

The first step in getting NHS treatment is to see your GP and explain the difficulties your hearing loss is causing. The GP will check to see what health conditions may be causing hearing loss and might do a simple hearing test. You may be referred to an ENT (Ear, Nose and Throat) specialist for a treatable condition or the GP may refer you directly to an audiologist who provides NHS services.

How long you might wait for an appointment varies across the country and, according to Action on Hearing Loss, up to 45 per cent of people who visit the GP with hearing loss are not referred to an audiologist even though they should be. If your GP doesn’t offer to refer you, you can ask for a referral. If the GP refuses, you can ask for a second opinion or opt to be seen privately.

If, after seeing an NHS audiologist, hearing aids are recommended, these can be provided free by the NHS. Hearing aids provided by the NHS are all modern, digital aids suitable for all types of hearing loss. The Audiologist will discuss the various features that are available and will ensure the hearing aids are optimised to meet your needs. You may decide that you would like a different style of hearing aid to those offered in the NHS, for example an ‘in-the-ear’ hearing aid. These are available from numerous private providers and they can advise you on whether there are any other additional features you could benefit from.

Using private services

Numerous large pharmacies and opticians have audiologists who can conduct a hearing test for you. These ‘high street’ tests are often free, but you’ll usually have to pay for any hearing aids you decide to use. If you buy hearing aids, prices vary depending on how sophisticated the devices are. You can expect to pay around £500-£1,500 for a single hearing aid but can pay considerably more for top models.

You can find private audiology services through internet searches or through organisations such as the British Society of Hearing Aid Audiologists or the Association of Independent Hearing Healthcare Professionals.

It is possible to buy hearing aids online, though this is generally not a good idea as hearing aids need to be suitable for your precise needs and inappropriate devices can damage your hearing. Hearing aids should be fitted and set up for you in person by a qualified specialist.

Seeing an audiologist

Whether through the NHS or privately, the audiology test will be broadly the same. The aim is to establish what are the quietest sounds, measured in decibels (dB), that you can hear across a range of frequencies or pitches, measured in hertz (Hz).

Hearing loss is usually most apparent at certain frequencies. You can have normal or near-normal hearing at some frequencies and hearing loss at others, typically the higher frequencies in age-related or noise-induced hearing loss.

Before your audiology appointment

• Think about the situations in which you struggle to hear. Your audiologist will ask you about all the difficulties you may be having at home, at work and socially. Make a note of three ‘priorities’ – the situations you have most difficulty with, or the problems you would most like to solve. An example could be: ‘I want to hear better on the telephone’, ‘I want to hear the tv at a volume that is comfortable for my partner’ or ‘I want to feel more confident in meetings’. The Audiologist will discuss these priorities with you and talk about how a hearing aid might help.

The audiologist will also want to know about your overall health, any long-term conditions and medicines you take, as well as things like your activity level, employment, home life and leisure activities – all can be relevant to your hearing loss and the next steps.

• Download a checklist to help you prepare for the appointment.

The hearing test

The hearing test may have several parts. The audiologist will play a series of tones of different frequencies through headphones and you have to indicate when you hear a sound. This will be done separately for each ear, as hearing loss is often not the same in both.

You may also have a speech perception test in which you listen to words or phrases instead of tones. This sometimes includes listening to speech through background noise. You may also have tympanometry, a test to check for fluid behind your eardrum.

The results of your test are plotted on a graph called an audiogram which shows the lowest sound level you can hear in each ear across the range of frequencies that are relevant for hearing speech clearly. The resulting graph shows the ‘shape’ or configuration of your hearing loss. Watch the video below to understand how an audiogram is interpreted.

Questions to ask your audiologist

Read more about hearing tests at Hearing Link

Hearing aids

There’s a huge variety of hearing aids and if you need them your audiologist will be able to advise you on what would be most appropriate for your hearing loss. Depending on your type of hearing loss, some hearing aids may not be suitable.

Modern hearing aids can have many adjustable features for use in different situations and can connect directly to external sound sources, such as loop hearing systems (see Module 2 for more information) or smartphones.

It may be useful to bring a friend or family member to the hearing aid fitting appointment, so you have someone else who learns how to use the hearing aid technology.

Hearing aids make sounds louder and clearer, and can reduce some background noise, but they won't restore your hearing to its original level and you will almost certainly need to take some time to adjust to using them.

At first your own voice may sound strange or echoey, other sounds may seem 'tinny' and background sounds might be very loud because your brain is picking up things you may not have heard well for a long time and doesn't filter them out. If you wear the hearing aid regularly you will acclimatise to background sounds and pay less attention to them.

Many people start by wearing their hearing aids for an hour or two somewhere quiet, such as at home, then gradually increase how long they use them for and start using them in noisier situations. You will get most benefit from hearing aids when you are wearing them daily from when you get up until bedtime.

• Read about the different types of hearing aid at NHS.UK or download the Getting Hearing Aids booklet from Action on Hearing Loss.

If you do start to use hearing aids, you should get a check-up 6 to 12 weeks later.

This could be a telephone consultation but may be a face to face appointment or a group session. The audiologist will want to make sure you're happy with the hearing aids and any assistive listening devices (ALDs) you’re using. Having used the aids and devices for a while, you may have new questions about them, queries about ongoing care and maintenance, want more tips on getting the best from them or maybe want to find out about things like lip-reading and other communication aids.

Benefits of hearing aids

Many people are reluctant to wear hearing aids but there’s plenty of evidence that the earlier you start using them the easier it is to adjust and get the best results. Apart from being able to hear more clearly, there’s a whole range of other benefits to be had from hearing aids, including improved mood, reduced fatigue and increased self-esteem.

“I would not be able to function in a working environment without my hearing aids. I have moderate to severe hearing loss, but with my hearing aid and with some support from an amplified phone and listener for meetings, I am working in a level playing field with my colleagues. My hearing has not improved but hearing aid technology has greatly improved during the 15 years I have been wearing them, so the extent to which my hearing loss affects my life has lessened over the years.” - Frances

If hearing loss occurs in both ears, your audiologist may recommend you wear two hearing aids. Many first-time hearing aid wearers think starting with just one hearing aid may be easier to adjust to or save them some money; however, two hearing aids are truly better than one for a number of reasons, including:

• Greater ability to work out where sounds are coming from
• Better hearing in background noise
• Listening balance – you won't be turning your "good" ear to hear

Support and resources

If you are just coming to terms with your hearing loss, there’s a great deal to take in and a lot to learn. In the next module we’ll cover how to find help, support and information that will enable you to keep getting the best out of life