Few people relish the idea of getting hearing aids. Some are too embarrassed to wear them, while others are put off by the high cost. Whatever the reason, about three-quarters of the roughly 30 million American adults who could benefit from these remarkable little devices don’t get them…and most who do get them postpone the decision for close to 10 years.

So you might assume that the battle is won when a holdout takes the plunge and does get hearing aids. But that’s not always true. Nearly 13% of new hearing-aid users wind up tossing the devices in a drawer. And up to 25% of new users wear them for less than two hours a day, depriving themselves of their full benefit.

Why do so many new hearing-aid users falter? One underappreciated trap is that it can take weeks or even months to get accustomed to the sounds (and the feel) of new hearing aids. So it’s crucial to not let the initial discomforts put you off.

Proper use of hearing aids can enrich your relationships and social life…possibly guard against accidents that can occur if you don’t hear warning signals…and prevent falls that can be precipitated by walking while struggling to understand what someone is saying. Improved hearing may even help protect your brain health because you can better communicate with family and friends and remain engaged.

For the latest advice on getting the most from hearing aids, Bottom Line Health spoke with Barbara E. Weinstein, PhD, a leading authority on hearing loss. Whether you’re a new hearing-aid owner or your hearing aids are collecting dust in a drawer, here’s what can help…

HEARING AND THE BRAIN

People cite a number of reasons for not wearing their hearing aids. Some complain that they hurt their ears. Others notice that the sounds they hear don’t seem natural…or that they’re bothered by sounds they hadn’t noticed before.

While new hearing aids do take some getting used to, they are definitely worth the effort. For one thing, emerging evidence suggests that the part of the brain that processes spoken language (the temporal lobe) may be subject to atrophy and volume declines when not stimulated. This means that people with an impaired hearing mechanism who wait too long to correct their hearing may not benefit as much from hearing interventions.

Even scarier risk: In a study by a group of researchers at Johns Hopkins who tracked 639 adults (ages 36 to 90), mild hearing loss was linked to twice the risk for dementia…and moderate-to-severe hearing loss increased the risk between three- and fivefold.

ADJUSTING TO CHANGE

It’s easier to get used to hearing aids in your younger years, so don’t wait until you’re adjusting the TV volume to wall-shaking levels. The most important part of successful aging is staying socially engaged—and you can’t do that when you can’t hear or communicate with others. Secrets to adjusting to your hearing aids… 

SECRET #1: Wear them all day. Depending on the degree/duration of your hearing loss, it might have been years since you’ve heard the sound of your own footsteps…water running in the sink…or the clatter of dishes. The “new” sounds can be distracting—even disturbing—until you get used to them.

My advice: Wear your new hearing aids all day, even when you first get them. We used to advise patients to use them for just a few hours a day at first, but we’ve found that people often do better with full-on exposure. Just know that it may take days, weeks or even months before background sounds truly fade into the background.

SECRET #2: When it’s too loud, make adjustments. You’ll probably find that most sounds—even the ones you want to hear—are uncomfortably loud at first. Some hearing aids have volume controls, which you can adjust, but it will take your brain time to adjust even to the lower settings. If sounds are too loud, be sure to return to your hearing-aid provider to make the necessary adjustments, as hearing aids have many features that can be adjusted.

My advice: As mentioned above, it’s important to wear your hearing aids all day. You might want to make an exception, however, for unusually noisy environments—for example, in the subway, at a concert or at the airport. High-volume venues won’t always be an impediment, but they can be a turnoff during the adjustment period.

If the sound of your own voice is disturbing, ask your audiologist if the devices need adjusting. Turning down the volume might not do it. An audiologist can make adjustments—to the sound frequencies, for example, or the shape of the earpiece (known as the mold)—that will often help.

Important: To become comfortable with their hearing aids, most people require one or two additional visits for adjustments, which are typically included in the price of the hearing aids.

SECRET #3: Cut through the clutter. People with normal hearing may struggle to hear conversations when there’s a lot of background noise, but it is worse for those with hearing loss. Even inexpensive hearing aids typically have a noise-cancellation feature that enhances higher frequencies (typical of speech) while suppressing lower frequencies (from background noise). The setting is often adjustable—learn how to use it.

My advice: If adjusting noise cancellation doesn’t help, ask an audiologist to make changes in the “output” and/or “gain.” Gain is the power of the signal that affects amplification, and output is the level of “sound pressure” that’s produced by the combination of incoming sounds and the gain added by the hearing aid.

SECRET #4: Master the controls. Hearing aids keep getting smaller, which means that the controls also are getting smaller—too small, in many cases, for people (especially those with big fingers or limited hand mobility) to easily adjust.

My advice: Don’t buy a hearing aid just because it has a zillion adjustable features. They won’t do you any good unless you have the finger dexterity (and the technical savvy) to master them. An audiologist can help you decide which features you absolutely need—and those you can do without.

Helpful: Many hearing aids use Bluetooth wireless technology, which allows them to be adjusted by an app that appears on the screen of your smartphone. This is a great feature if you have one of these phones and you’re willing to use it as a remote control. An audiologist talked my 93-year-old cousin into getting this feature…but in order to use it, she had to buy her first smartphone, which she didn’t know how to use and actually found annoying.

SECRET #5: Learn how to fix whistling sounds. The squealing/whistling sounds that you’ll sometimes hear are a type of feedback. It doesn’t mean that there’s a problem with the electronics. Most hearing aids have “feedback interceptors” that suppress whistles, but they don’t eliminate them entirely.

My advice: Ask your audiologist if you need a tighter-fitting ear mold. Squeals and whistles occur when amplified sound from the hearing aid leaks out of the ear…gets picked up by the microphone…and then returns to the ear as a whistling noise.

SECRET #6: Don’t put up with ear discomfort. Many people complain that their hearing aids are uncomfortable. They may find themselves constantly pulling/adjusting the ear mold to reduce discomfort, but the frequent back-and-forth adjustments only make the irritation worse.

My advice: You can get a hearing-aid lubricant/cream from an audiologist, online or at pharmacies. Brands include Westone Oto-Ease and Audiologist’s Choice anti-itch cream. They’re particularly helpful if you happen to have dryness in the ear canal.

Worth a try: If you continue to have problems, your audiologist might need to fashion an ear mold/tip that fits more comfortably. This is one advantage of buying locally. I don’t discourage patients from buying hearing aids online, but this type of adjustment can be done only by a local professional.