If you’ve been considering hearing aids for yourself or a loved one, you may be wondering just how much they’ll improve your hearing. Will you be able to hear everything clearly again? Will you be able to confidently engage in conversations, no matter the environment? Will hearing aids restore your hearing to a “normal” level?
The short answer is, unfortunately, no. Hearing aids will certainly make your life easier and more enriching. But they cannot fully compensate for your loss of hearing, nor can they completely overcome very challenging situations—such as a noisy, crowded restaurant with poor acoustics. A hearing aid is indeed an aid—like how a walking stick helps with mobility but doesn't restore full function.
Hearing is a complex sense that differs significantly from vision. Unlike eyeglasses, which often restore sight to near-normal levels, hearing aids cannot fully restore lost hearing. When we hear a sound, it travels into the ear canals, causing the eardrum and tiny bones in the middle portion of the ear to vibrate. These vibrations transmit sound onward to an organ in the inner ear called the cochlea. The cochlea converts the sound into electrical signals that are then sent to the hearing nerve and on to the brain for processing.
Most hearing aid candidates have sensorineural hearing loss, which is due to damage in the inner ear, specifically in the cochlea, and possibly the hearing nerve itself. This damage can cause sound to seem distorted—even when it is loud enough to hear. This means that even when wearing hearing aids that have been fully adjusted and optimised for your prescription, you may still struggle to some extent with the clarity of what you are hearing.
A person’s difficulty with clarity affects what audiologists refer to as “speech understanding” or “speech recognition.” For example, if a word or phrase is spoken at a volume that is loud enough for someone to hear, are they able to make sense of what they are hearing? They may be aware that something was said, but it might sound garbled and unclear, making it difficult to understand. Speech understanding abilities can vary widely among individuals. Two people of the same age, with the same degree of hearing loss, may have vastly different speech recognition abilities. This, in turn, greatly affects how well an individual can understand words and sentences.
If there is significant background noise during a conversation, this can add another layer of difficulty. Hearing aids have sophisticated technology that helps focus on conversational speech rather than distracting background noise. However, hearing aids will not eliminate background noise entirely. The brain must still process both the speech and the noise, filtering out distractions. This is something everyone struggles with, whether they have a hearing impairment or not, but it is particularly challenging for those with hearing loss, even when using hearing aids.
Cognitive processing abilities also play a significant role in what we can hear and understand. Our ability to retain and recall information influences how easily we can comprehend and participate in a conversation. Suppose you’re speaking to someone and miss a word or two in a sentence. Your brain uses the information it already has—such as the rest of the sentence—to piece together the missing words. However, this requires the brain to recall and retain information quickly. As we age, our cognitive processing speed slows, making this more difficult. This is a normal part of the ageing process, affecting our ability to react to and process surrounding information.
How Much Will Hearing Aids Actually Help?
The benefit you receive from hearing aids depends on several factors. The hearing aids themselves play a role—particularly the type or “style” of hearing aid and the sophistication of its built-in technology. More advanced technology can provide better support in difficult environments, like pubs or coffee shops. Additionally, the type and degree of hearing loss you have—what part of the ear is affected and by how much—also impact how much benefit you perceive. Someone with a more severe inner ear hearing loss may not experience as much improvement as someone with moderate hearing loss.
Perhaps most importantly, speech recognition and cognitive processing abilities influence hearing aid benefit. A thorough hearing assessment often includes a test to measure speech understanding. For example, you may be asked to listen to a set of words and repeat them back. These words will be presented at a volume you can hear based on your level of hearing loss. The audiologist then measures how many words you were able to repeat correctly. If you correctly repeat 90% of the words, you will likely perceive significant benefit from your hearing aids. However, if you can only repeat 50%, you may still struggle to some extent, even with hearing aids.
This is not to discourage those with poorer speech recognition abilities from pursuing hearing aids. In fact, if your hearing loss has progressed over time without treatment, your brain may have been deprived of important auditory stimuli. When finally exposed to sound again through hearing aids, the brain may struggle to process it. This is why wearing hearing aids is crucial—it helps stimulate the brain and may even slow cognitive decline.
What Can Improve the Benefit of Hearing Aids?
I discuss this topic in more detail in another blog article, How to Get the Most Benefit from Your Hearing Aids. However, the most important recommendation is consistent use. Ideally, you should wear your hearing aids all day, from morning until night. This keeps the brain active and stimulated with sound, allowing it to adapt more easily to hearing through a hearing aid. Many people fall into the habit of wearing hearing aids only when they “need” them—such as during group conversations or in crowded places. But if the brain is not used to hearing with hearing aids, it will struggle to filter out distracting background noise. The more you wear your hearing aids, the better your brain becomes at responding to challenging listening environments, ultimately increasing your overall benefit.
Good communication tactics also play a significant role. Speaking from separate rooms, having backs turned, or talking over background noise (e.g., running water or a loud TV) makes conversations difficult for everyone, not just those with hearing loss. However, hearing aids cannot fully compensate for these challenges. It is helpful if people get your attention before speaking, reduce background noise, and face you directly. Lipreading also plays a natural role in understanding speech, as visual cues from facial expressions and mouth movements provide additional context. Looking into local lipreading or “speechreading” classes—often offered free by charities—can further enhance communication.
You may also consider auditory training, which consists of exercises designed to improve speech awareness and understanding. Often guided by an audiologist, these exercises help train your brain to process sounds more effectively. Auditory training is sometimes referred to as “physical therapy for the brain” and, when paired with hearing aids, can improve speech recognition and overall cognitive function.
Final Thoughts
Hearing aid benefit depends on several key factors, including hearing aid technology, the degree of hearing loss, and speech recognition abilities. Understanding this relationship helps set realistic expectations for what hearing aids can achieve. Your audiologist can guide you in setting and meeting these expectations. It is best to think of hearing aids as reducing the effort required to hear and listen, rather than as a complete fix for hearing loss. However, by wearing your hearing aids consistently and using effective communication strategies, you can significantly improve your ability to hear and understand others.
If you'd like to learn more about the kind of hearing care we provide for our patients at Finchley Hearing, please explore our website and feel free to get in touch with any questions. We're a private, independent audiology practice in London committed to ethical, evidence-based practices and would love to help you on your journey to better hearing.
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