More than 21 million Americans suffer from some degree of hearing impairment. If your elder is one of them you know the frustration, anxiety and even dangerous errors that can stem from not hearing well. Hearing aids often make a big, positive difference in the lives of people who don't hear well. While they won't resolve all hearing problems, and they aren't appropriate for everyone, they do improve the quality of life for millions of users.


Most Common Causes of Hearing Loss

Medically, there are two major types of hearing loss:

Conductive hearing loss involves the outer and middle ear. It usually results from a wax blockage, a punctured eardrum, birth defects, ear infections, or it may be genetic. Conductive hearing loss generally can be corrected surgically.

Sensorineural--or "nerve"--hearing loss involves damage to the inner ear. It can be caused by aging, prenatal and birth-related problems, viral and bacterial infections, genetics, trauma (such as a severe blow to the head), exposure to loud noises, the use of certain drugs, or fluid buildup or a benign tumor in the inner ear. Sensorineural hearing loss usually can't be repaired surgically; it's usually corrected with a hearing aid.

Will a Hearing Aid Help?

Before you make the assumption that a hearing aid will be helpful, get an ear examination from a licensed physician. An examination will insure that there are no underlying illnesses or medical problems associated with the hearing loss: sometimes a hearing loss can be a symptom of a medical condition. Your plysician can give you information on the causes of any hearing loss and the kind of device that woud probably be most helpful.

Where To Buy a Hearig Aid

"Dispensers"--merchants or audiologists--sell hearing aids. First ask the doctor for a referral to an audiologist he or she has worked well with in the past. You will want to look for an audiologist who fits hearing aids made by several manufacturers. We've all heard the story about the workman whose only tool is a hammer - everything looks like a nail. If your audiologist represents only one brand of hearing aid you will have no confidence that you're being offered the best device for your particular needs. An audiologist who is not "married" to one brand is much more likely to be objective.

You also can check out prospective dispensers with your local Better Business Bureau, consumer protection agency, or state Attorney General. Your state or local consumer protection office may have records of complaints against dispensers or physicians, and can tell you how they responded to the complaints. Consumer protection officials also can tell you whether dispensers or audiologists must be licensed or certified in your state.

Trial Periods

Many states recommend or require that consumers get at least a free 30-day trial period. There usually is a service fee--five to 20 percent of the purchase price--if you return the hearing aid during that time. In fact, many manufacturers will make adjustments during the trial period, and allow returns within 60 to 90 days of purchase at no charge to the dispenser.

Never buy a hearing aid from a door-to-door salesperson or through the mail. Period.

The Hearing Aid Purchase Agreement

The hearing aid purchase agreement--or contract--should include all terms of the transaction, including a clear explanation of all verbal promises. In reviewing your agreement, consider the following:

Is the warranty honored by the manufacturer or by the dispenser? In some cases, a manufacturer may not honor its warranty unless the hearing aid is purchased from a seller authorized by the manufacturer.

What services--if any--will be provided free of charge, and how long will they be provided?

Will I get a "loaner" if my hearing aid needs repair?

Federal Hearing Aid Sale Regulations

The Federal Trade Commission (FTC) is responsible for monitoring the business practices of hearing aid dispensers and vendors. The FTC can take action against companies that mislead or deceive consumers. Such companies may use misleading sales and advertising practices--giving inaccurate information about hearing loss, hearing aid performance, refund policies, or warranty coverage. The law further requires companies offering warranties to fully disclose all terms and conditions of their warranties.

The Food and Drug Administration (FDA) enforces regulations that deal specifically with the manufacture and sale of hearing aids. The FDA requires that the following conditions be met by all hearing aid dispensers:

Dispensers must obtain a written statement from the patient, signed by a licensed physician. The statement must be dated within the previous six months, state that the patient's ears have been medically evaluated, and that the patient is cleared for fitting with a hearing aid.

A patient age 18 years or older can sign a waiver for a medical examination, but dispensers must avoid encouraging the patient to waive the medical evaluation requirement. Dispensers also must advise the patient that waiving the examination is not in his best health interest.

Dispensers must advise patients who appear to have a hearing problem to consult promptly with a physician.

The FDA regulations also require that an instruction brochure be provided with the hearing aid that illustrates and describes its operation, use, and care. The brochure must list sources for repair and maintenance, and include a statement that the use of a hearing aid may be only part of a rehabilitative program.

State Standards for Hearing Aid Sales

Many states have laws governing hearing aid sales. Most states license hearing aid dispensers. You also may be protected by implied warranties created by state law. Your state Attorney General's office can tell you what laws apply to hearing aid sales in your state.