This is the 10th (and so far last) part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

Most hearing aids are not waterproof. That leads to a lot of situations which are perfectly normal for hearing people but exclude hearing-impaired ones. For example: social water sports, pool parties, sauna with friends, a trip to the beach with friends, watching a movie with wet hair after you just had a shower, open air concerts in the rain, muddy festivals, listening to audiobooks or watching TV while lying the bathtub. I could go on and on. Also simply sweat is a problem for many people, especially those who perform a lot of sports.

There are a few hearing aids on the market that claim water resistance, I hope it will be standard and affordable soon.

See also the previous point on my wishlist: Legal certainty for situation related to broken hearing aids.

This is the 9th part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

When my hearing aids break, I am not able to go to work. I mean I could go there, but I would not be able to communicate with my coworkers properly. Also, I have to spend time at the audiologist, to hand in my hearing aids and get the spare hearing aids (roughly) tuned. Wearing poorly tuned hearing aids cause me headaches, which also reduce my work performance. The audiologist visit takes time, but I have no idea if I can officially call in sick for that. I am wondering if my employer can actually fire me if that happens too often. I asked this question several audiologists and none of them could give me a definitive answer.

Same applies to when my hearing aids break when I was doing something that might be considered “risky” with respect to the hearing aids. For example, am I allowed to attend a martial arts class with my hearing aids? Can my insurance refuse to pay the reparation if they break during that class? What about when I accidentally have a shower with my hearing aids on? (It happens because when you wear them every day, you forget that you are wearing them.) What about when I attend an open air concert, it starts raining and I did not seek cover, because I did not want to miss the awesome performance? Those situations might sound constructed, but actually they happen if you are are not an old grandpa, but a young person with an active life.

There are a lot of situations related to hearing aids where there is no legal certainty for the patient. Sick leave and reparation costs are only examples here.

See also the next point on my wishlist: Waterproof Hearing Aids. Or the previous one: Offer tuning in realistic circumstances, legalize and support self-tuning.

This is the 8th part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

In order for hearing aids to improve a patient’s life, they have to be tuned correctly. The tuning is done in many meetings with an audiologist. The process of tuning hearing aids takes months and still after that most patients are not entirely happy with the result.

From my own experience I guess that one reason for this is that the tuning never takes place in a realistic hearing setting, but in the audiologist’s soundproof cabin. The only information he has is what I describe about that situation where I was not able to understand my friend at that party last week. In comparison, if you bring your car to a car repair shop and describe in what situations it makes problems, they for sure will try to reproduce the situation in order to examine it and fix the problem. The only thing audiologists do sometimes is taking you out on the street for a minute or two [1].

So getting your hearing aids tuned is a frustrating and time-consuming experience. As a patient you are totally dependent on your audiologist and spend a lot of your valuable time in his office without being happy about the result afterwards. It is no surprise that there are quite a number of people who started to tune their hearing aids themselves.

The problem with self-tuning is: you need special hard- and software and you need the knowledge. The knowledge is out there, although it might not be too easy, it is possible to teach yourself the required audiology.

The hardware and software on the other hand is hard to get. Officially it is only sold to audiologists and doctors [2]. There is no way to buy it on the free market like on ebay etc., because those hardware is classified as medical devices and as such not obtainable by patients.But for every market, there is a black market and when people are frustrated, they find a way. So, there are quite some people out there which tune their hearing aids, because they can do that wherever and whenever they want and not just when their audiologist is willing to give them an appointment and willing to do the tuning outside his office. So the situation is that there are people self-tuning, but because they have to do it inofficially, they don’t get any support for that. Support means software updates, manuals, maintenance material for the hardware, trainings for the software, warranty for the tuning hardware and their hearing aids etc.

What I want here is that interested and skilled patients are allowed to get a “hearing aid tuning license”. Similar to a driving license, I imagine that you take some classes and maybe have to do a test and in the end you are allowed to tune your own hearing aids. Most hearing conditions are permanent, which means as a young person, you are facing several decades of having to wear hearing aids. In that situation you might as well spend some weeks on learning how to tune your hearing aids yourself in order to be more independent.

Also, it would great, if the software would comply to common standards, meaning that it has open APIs which everyone can use to extend its functionality. The hardware should comply to open standards and be legally purchasable by patients. It would be even better if you don’t need special hardware at all but can use consumer hardware. Why do you need a special device when you hearing aids can talk bluetooth in the near future? So, why can’t I just tune my hearing aids using my smart phone or my tablet PC while I am sitting in the subway?

[1] I heart rumors, that some audiologists come home to people and adjust the hearing aids there. Of the four audiologists that I have seen so far, none of them offered that.

[2]  There is one exception in the U.S: americahears.com

See also the next point on my wishlist: Legal certainty for situation related to broken hearing aids. Or the previous one: Open hardware and software standards.

This is the 7th part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

This goes along with the 2nd point of my wishlist. Hearing aids and peripheral hardware should be compatible independent of the vendors. For this, standards for hardware and software have to be established. Those standards should be public. This would make the hearing aid market more open and lively since it would open doors for new companies and open source projects to develop hardware and software that is compatible to the established vendor’s devices and as such attractive for the customers.

It would make the market more competitive, (hopefully) leading to more customer-friendliness, maybe even cost-reduction and especially to a market that reacts faster to developments in the general consumer electronics market than it currently does. The market would be open for small companies that cannot offer a full portfolio like the established ones, but might specialize in a niche that is desperately missed by the patients so far.

Open standards would also enable skilled patients to improve their hearing aids themselves. I am dreaming of the day that I can write my own signal processing algorithm against the application programming interface (API) of my hearing aid and thus regain power over (the electronic parts of) my body again.

See also the next point on my wishlist: Offer tuning in realistic circumstances, legalize and support self-tuning. Or the previous one: Affordable hearing aids and full insurance coverage for devices and peripheral hardware and maintenance costs. 

This is the 6th part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

Insurance companies barely cover the costs of hearing aids [1]. The only devices that are covered are the cheapest and oldest models, which lack a lot of features which are necessary for a person who has an active social and work life. Insurance companies provide their share to new hearing aids at most every five years. That means I basically need to save money every month since I got my last hearing aids in order to buy the new hearing aids. I could decide to not buy new hearing aids that soon and keep the old ones for 10 years. But for a person with an active life, this is not an option. If you consider the progress that the consumer electronics industry makes in 5 years, you can easily transfer that to the hearing aid industry imagine how many chances you miss to get a better signal processing and thus a better social life.

Peripheral hardware such as adapters for phones are not covered at all by the insurances. Insurance companies do not consider it a necessity to be able to talk on the phone. As much as I hate talking on the phone anyway, unfortunately in a business environment it is still communication medium number one.

Also, in order to maintain the functioning of hearing aids, one has to clean and try them frequently and provide them with new batteries every couple of days. Insurances do not cover any of the costs there.

[1] This might only apply to Germany, I cannot give an exhausting description for other markets. Feel free to add comments about that.

See also the next point on my wishlist: Open hardware and software standards. Or the previous one: Longer battery life and non-proprietary batteries in peripheral hardware.

This is the 5th part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

Peripheral hardware often needs their own batteries. Those are very often proprietary batteries and most often they don’t last very long. For example in order to use my bluetooth adapter a whole day, I need to buy an extra battery for it and often a charger station as well (if available at all). And situations where this is necessary are common for example when you travel have nothing else do to than listening to music while sitting in the air plane for 12 hours.

I would rather prefer peripheral hardware to use normal non-proprietary batteries which are available in every grocery store in the world and that I can use my charger for normal batteries for. And please don’t tell me those proprietary batteries are necessary for the design of the devices, most of them look dorky anyway, so I might at least have the benefit of using non-proprietary batteries.

See also the next point on my wishlist: Affordable hearing aids and full insurance coverage for devices and peripheral hardware and maintenance costs. Or the previous one: 24/7 Service and Availability of Replacement Devices.

This is the 4th part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

Audiologists and accousticians have opening hours which are not compatible with a schedule of a working person [1]. They usually open only between Monday and Friday 9 a.m. and 6 p.m. and most of them are closed on Saturday, with the exception of a very few shops in very big cities. This makes it nearly impossible for me to see an audiologist without spending valuable vacation days or risking trouble with my employer.

This is especially bad, when my hearing aids break. If they break on a Friday night, I have to wait until Monday morning to see my audiologist. Most likely, he will not be able to repair it right away, but will give me a spare hearing aid, which will mostly not be of the same model as my own hearing aid. Since the settings are not compatible between different hearing aid models, those will be poorly tuned and cause me a lot of distress.

What I want is a service similar to what you can buy for your car or your computer. If my car breaks down somewhere (not even necessarily in my home country), I can call that service and they come to me, repair my car right away or bring my car to the nearest repair shop and transfer me to wherever I was going. There is no service like that for hearing aids, although I am much more dependent on my hearing aids than on my car. I would even pay for it, but so far I have not heart of any offers like that [2].

I would even be willing to give my audiological data and hearing aid setting parameters to a third party provider if in case my hearing aids are broken, they guarantee to provide me with a set of hearing aids of the same model as I usually wear tuned with my parameters within 24 hours. It would be great if that was not only available in my home country, but everywhere in the world.

[1] This might only apply to Germany, I cannot give an exhausting description for other markets. Feel free to add comments about that.

[2] I heart rumors that some vendors offer service like that, but only for some of their hearing aid models. And so far, I haven’t seen those offers.

See also the next point on my wishlist: Longer battery life and non-proprietary batteries in peripheral hardware. Or the previous one: Seamless compatibility between hearing aids and peripheral hardware to consumer electronics.

This is the third part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

The compatibility between hearing aids and peripheral hardware and consumer  electronics like phones and mp3 players is often very bad. My bluetooth adapter often fails to pick up calls, so the first thing I do when someone calls is asking “Do you hear me? Wait, I don’t hear you, I’ll call you back.” And seriously, especially in a work environment, that is quite embarrassing and annoying.

Also, signal quality is often bad, especially with mobile and bluetooth-compatible phones of particular vendors. I cannot freely choose to buy a phone, I always have to borrow the same model from a friend first and check if it works. It often doesn’t, which restricts my freedom of choice significantly. If I have choice at all. My guess is, that there is not much testing going on to make a piece of peripheral hardware as compatible as possible to the consumer electronics market.

See also the next point on my wishlist: 24/7 Service and Availability of Replacement Devices. Or the previous one: Compatibility between vendors for hearing aids and peripheral hardware.

This is the second part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

Most modern hearing aids communicate with each other. If you switch the program on one side, the other hearing aid does so as well. Also, for the signal processing, they talk to each other and exchange information to analyze the acoustic setting more thoroughly. This does not work when two hearing aids come from different vendors, sometimes not even when they are different models from the same vendor.

The same applies for peripheral hardware. Hearing aids from one vendor most often are only compatible to peripheral hardware (such as bluetooth adapter or FM systems) of the same vendor. If you buy a hearing aid from that vendor and the compatible peripheral hardware, you are very likely to to choose your next hearing aid from the same vendor, because you don’t want to rebuy the peripheral hardware or the hearing aid for your other ear. You are stuck with one vendor and don’t have the freedom to choose the best product next time, just because there are no standards and/or no willingness of the vendors to coorporate with each other.

The same applies to compatibility between cochlear implants and peripheral hardware, other hearing aids or cochlear implants of other vendors.

Also the parameters and settings between hearing aids are not compatible, often not even between different models of the same vendor. When your hearing aids break and you temporarily get a spare hearing aid of a different model, the accoustician can only roughly tune it and you have to live with those crappy settings until you get back your own hearing aids from the reparation.

See also the next point on my wishlist: Seamless compatibility between hearing aids and peripheral hardware to consumer electronics. Or the previous one: Better Signal Processing.

This is the first part of my wishlist to audiologists and accousticians, hearing aid manufacturers, and the health care system. If you like to add something, share your experiences, or provide more information, I encourage you to submit a comment.

Nowadays hearing aids still don’t fully compensate a hearing loss. They fail particularly in difficult but frequently occurring acoustic situations. The reality is that the cocktail party problem still exists and that it makes life hard for the hard of hearing. Hearing-impaired people still avoid noisy situations like in restaurants, bars, at parties, or any kind of event where a lot of people are talking. Since those are exactly the situations where people socialize, hearing-impaired people have significant problems in connecting to other people – both in their personal life as well as in professional environments. That means if you are not able to make friends and business partners, you will get isolated and won’t make a career.

Also, many hearing-impaired people depend on lip-reading and ‘guessing from the context’, because hearing aids are just not good enough. It is not uncommon that hearing-impaired people still avoid situations where they have to rely on acoustic channels and switch to workarounds like subtitles for movies or text messaging instead of calling on the phone.

One specific problem of the signal processing of hearing aids are feedback loops. Feedback loops occur frequently when something is close to the hearing devices, for example if you put on a hat, if someone hugs you, or you lay down on the sofa to watch a movie. The only effective measure that today’s hearing aids have is to detect the feedback loop and then damp the affected frequencies. But those frequencies might be the ones that you need to understand speech. Thus, you have the choice between wearing a hat on a cold winter day or being able to understand the person in front of you.

See also the next point on my wishlist: Compatibility between vendors for hearing aids and peripheral hardware.