Digital Hearing Aids

This article, slightly edited, will appear in the next issue of Talking Sense in about September 2005 : In recent years digital hearing aids have become the norm replacing analogue hearing aids which have been around since the 1970s. In April 2003 the government announced an allocation of £94 million to provide, over the next 2 years, digital hearing aids for all those in England who could make use of them. This was to be "rolled out" in three stages. When this arrived in your own area depended on whether you were in stage 1, 2, or 3 of the "roll out". Digital aids have been available privately for some years but at a typical cost of £2000. The NHS is such a large bulk purchaser that the actual cost of each digital aid to it is about £70. Essentially, the word digital implies that information is supplied in discrete electrical charges as opposed to infinitely variable electrical signals representing changes in air pressure which is what sounds are. In practice, we can expect much clearer sound and the ability to modify or control sounds to suit the aid wearer. In my own case, over a decade ago, I applied to my local audiology department (here in Brighton) for a pair of digital hearing aids as, at the time, priority was given to those who also had a sight problem. It may seem strange to younger people but until fairly recently it was the practice to provide hearing impaired people with just one hearing aid (although it has been known for many years that most people have two ears) even if their hearing loss in each ear was similar! This has always seemed to be indefensable. People with lung cancer have never been offered treatment on just one lung. After a long delay involving going to a NHS hospital in Birmingham and having my local NHS body set up a special budget for me, I finally obtained a pair of digital hearing aids. I mention this episode to illustrate how much things have improved in the last decade. Nobody should have to go through the nonsense I did then. It has to be said I am more determined than most and it must be that many people who could have benefited from a pair of hearing aids ( digital or analogue) previously did not get them. There is no doubt that digital aids do produce better sound. Digital hearing aids offer a possibility of fine-tuning the processor inside to meet the particular needs of the wearer. They can also cope better with the endemic problem of background noise. The fundamental problem with the NHS dispensing of digital hearing aids is that there is shortage of staff in the audiology departments of our hospitals. Many of them have not recieved enough training and lack experience. This is not a criticism of the staff but reflects the fact that for so many years audiology has been the Cinderella of the NHS. We need to press for yet more improvement in this area. Having said that, I want to state clearly that in my own local audiology department there has been a great improvement in the attitude of the staff to deaf people. Quite often in the past, staff have been brusque. I should point out that many of us with hearing problems are very 'cheap to run' as there is no possibilty of surgical operations to improve our hearing and apart from hearing aids, batteries and periodic examinations we do not cost very much. Now a few words about the aids themselves. They are rather flimsy. I have pressed for them to be made more robust. I am very careful with mine but I am aware that they could easily be broken as they are nearly all plastic. In the past, my aids have sometimes broken at a crticial place namely where the behind-the-ear plastic moulding meets the tubing that leads to the ear mould. When this has happened there has been an inordinate delay in getting them repaired. Another problem is that the plastic tubing gets hard quite quickly. This means that it is quite difficult to fit that tubing onto the 'tail' of the hearing aid. The end of that tail (the "spigot") is quite soft and easily distorts. One often has to disengage the tubing from that tail in order to blow through the mould to remove any blockage in the ear mould. I realise this sounds a bit disgusting but the bald fact is that if one has a foreign body, namely a mould, in one's ears 20 hours a day then the ear reacts against this by secretions which tend to block the mould. I was discussing this very recently with someone who has experience of the Danish NHS. She told me that hearing aid users are provided with a little tool that widens the plastic tubing. As far as I know English NHS patients are not provided with this. This might seem trivial but those dependent on hearing aids will recognise the mini-panic that can ensue when they can't get the tubing back onto the "spigot"! The digital hearing aids that I have are made by Oticon. There are several makes that your local audiology department can dispense. A big problem is that there is a huge waiting list for digital hearing aids in the UK. It seems there are about 1.8 million users of hearing aids in England and it was hoped that by April 2005 all of those who could make use of digital hearing aids will have been supplied with them. I do not know if this target has been achieved. I realise this is a subjective account of digital hearing aids and I would welcome other views especially if I have made errors.