One of my Phonak Audeo 90’s (RIC) died the other day after 5 years and I’m shopping for new. What’s your go to hearing aid currently if you’ve upgraded recently or have been thinking of doing so?
Moderate loss, have worn them for many years, enjoy listening to music and nature, but also need help in meetings and noisy environments.
Not worried about cost and wanting to get one more good deal out of work insurance before I retire.
For a while now, like the last 15 to 20 years, since hearing aids went DSP, I had not been much impressed by each new generation. At the risk of sounding like a bit of an advertisement, that changed this year.
I have the new Oticon Intent. RIC style aid. They have some of the best spatial awareness I've experienced. They're capable of quite a lot of directionality - accelerometer and three microphones in each. I had to have the intensity of the directionality turned down a bit. It was startling me when I turned my head and I wasn't hearing things behind me enough. But that's at the expense of less signal due to more environmental noise.
The machine-learning based noise reduction is an improvement over the previous generations, too.
They have a music mode. It drops all the speech remapping and noise reduction and just makes it feel loud. It's some sort of perceptual algorithm: in my case as I turn up the volume it gets more and more treble, because only at the loudest volumes would I hear those high frequencies. All while being power limited at 95 dB SPL so I know I'm not blowing my ears. I used to wear over-the-ear headphones for that but I now prefer the hearing aids. It's nice to not worry about if it's too loud.
Perhaps this is just the limit of her hearing capacity. Or do you think she should not settle for this and push for something better?
This is where my normal hearing is now. My assumption is the "some I understand clearly" is base very much on what frequency their speech is in.
I'm meeting with a hearing aid doctor this week, actually.
Does she have primarily high frequency loss? High frequency loss is the most typical in the elderly and also from damage from noise exposure.
Different people have different voices. I usually find it easier to understand men because I hear the lower frequencies better, especially without my hearing aids but also with them. And it's always easier to understand people you know well compared to strangers.
I find small speakers to be awful. The high frequencies are distorted and tinny. Scratchy is a good way to put it. I have a very hard time understanding anything played through a smartphone or tablet speaker. The speaker is too small to reproduce the bass frequencies I can hear the best, and so it's just TSSST TSSSSSZZT sounds through my hearing aids.
I cannot wear my hearing aids at full volume at the dinner table or while working in the kitchen for this reason. Metal, plastic and paper are also common offenders. CLINK. CLINK. CRSZZST. It's almost painful and headache inducing if I'm tired.
Unfortunately those high frequencies are what carry speech sounds like sh, t, ch and so on. Without those it's like the adults talking in the Charlie Brown cartoons. "wah-womp-wah-wah-mhuh??"
Hearing aids can do two things for this: one is to take some of that high frequency information and remap it to lower frequencies. This is part of why they say you won't like wearing your hearing aids when you first get them. They're systematically distorting what you hear -- but in a way you might eventually learn to interpret.
The other is just to make it loud enough that it can be heard. And as you suggest that may be the limit of the hearing capacity if there's very little at the high frequencies the only way to make something high frequency to be perceived, is to hammer the ear with a 90 or 100 dB level of sound.
It's absolutely worth having them adjusted a bit. Also every manufacturer uses a different algorithm for speech frequency remapping. Some people have strong preferences by brand as to the hearing aid sound. (Phonak and Oticon certainly have different "feels" in my experience.)
Almost all hearing aids allow multiple "configuration profiles" where you can switch through them with the app or buttons. I have four: general, lecture, comfort, music. Comfort mode just nukes the high end and cranks up the noise reduction. That's what I use if I'm just reading alone in the living room, or when out at the grocery store, etc.
As to large groups, personally I've simply conceded I can't do large groups. If I try I will feel left out and get depressed over it. If people want to see me at a family reunion, for example, after I do a brief tour to say hi to everyone, they'll have to join me for a small group chat in the den or whatnot.
As a parent with a child with mild-to-moderate hearing loss it is heartening to know that the hearing aid technology is progressing, and progressing well!
He's been using a pair of Phonak Skys since infancy, and while they can be tuned by the audiologist I sometimes wonder what it'll be like if and when he gets his next pair.
The newer tech is definitely worth it but spendy. There are times though when I'm a bit jealous, too! He can turn them off when he doesn't want to hear and can listen to anything on his phone over bluetooth, as well as take calls. And he never wakes up at night because of noise :)
I'm using a pair of 8 yr old phonak BTEs, which have various levels of directionality focusing. (Actually, I'm down one HA; 8yr old on left; 13 yr old left one one on right ear... getting new ones in January) I too prefer a lower level of directionality as my default.
I assume your HAs are doing bluetooth for the music setup you describe? Or are you describing a setup with speakers at home?
But at home I often use telecoil. It's one of the killer features for hearing aids that no one seems to know about. Short-range (inches to a few feet) baseband analog radio.
I have a transmitter set up in the living room. If I come within a few feet of the couch I'll hear the television. Got another at my desktop computer in the office. I also have a loop I put around my neck when I play my electric guitar. Telecoil transmitters will plug into any standard line audio source.
Standard IEMs isolate you from the world, which is the opposite of what a hearing aid does. However, a specific category called "Active Ambient" IEMs bridges this gap. These are IEMs with embedded high-fidelity microphones on the outer shell. They pick up the sound of the room (bandmates, crowd, conductor), amplify it, and blend it with your monitor mix. The accompanying bodypack or app often includes a multi-band EQ and Limiter. You can boost specific frequencies where you have hearing loss (e.g., boosting highs to hear cymbals or speech clearly) and set a volume ceiling to protect your remaining hearing. I have no ownership/sponsorship in the product, but I personally LOVE the ASI Audio 3DME (powered by Sensaphonics), which is the industry standard for this. [1] It allows you to use an app to shape the ambient sound to your hearing needs.
The Pros: It provides hearing protection + monitoring + hearing enhancement in one device.
The Cons (Why they aren't daily hearing aids):
1) Form Factor: You are tethered to a belt pack. You likely won't wear a wired bodypack to a grocery store or dinner party.
2) Social Barrier: Wearing full-shell custom IEMs creates a "do not disturb" look that discourages conversation in social settings. This can be more socially alienating than a comparatively inconspicuous hearing aid.
3) Battery Life: IEM systems typically last 6–8 hours, whereas hearing aid batteries can last days or weeks.
[1] https://www.sensaphonics.com/products/3dme-custom-tour-gen2-...
Audio gear isn't made to last long on batteries, it's made to be reliable for the hours a show typically lasts. I worked part-time as a sound tech (paid hobby) for 15+ years, and I never started a show without fresh batteries, regardless of what the indicators on the transmitters/receivers told me.
Hearing aids run on tiny voltages (typically ~1.4 Volts). They are designed to amplify speech (a small frequency range) at moderate volumes. An IEM is designed to handle the massive energy of a live drum kit without distortion. To do this, the internal amplifier needs Headroom. It likely steps up the battery voltage significantly (internally converting to higher voltage rails) to ensure that when a snare drum hits 120dB, the amplifier has enough electrical height to reproduce that spike without clipping.
Hearing aids use microscopic balanced armature receivers that require almost zero power to move because they are only moving a tiny amount of air near your eardrum. IEMs use dual-driver miniature subwoofers and tweeters that are physically larger and heavier. It takes significantly more electrical current to push these drivers back and forth.
Hearing aids often use aggressive battery-saving tricks, such as lowering the sampling rate or "sleeping" processes when silence is detected. The processor of an IEM is running wide open 100% of the time. It is constantly digitizing the world at a high sampling rate to ensure zero latency. If it tried to save battery by "sleeping" between notes, you would hear a delay (latency), which would make it impossible to play in time.
Is there a little computer doing DAW work inside the earpiece?
As a workaround, some artists performing outside wear a thin, acoustically transparent beanie or headband over the ears effectively acting as a pop-filter/windscreen. This breaks the wind before it hits the mic while still letting mid-to-high frequency sound (speech/music) pass through. Not exactly a hearing aid alternative.
I [recently wrote an article][0] going over my journey, but the recent technology that significantly improved my life has been live captions in glasses. Specifically, the ones from [Captify][1]. Not a paid sponsor at all, just a very happy customer.
Between the glasses for IRL settings and bluetooth/live captions on meet/etc, I've felt much more empowered in my working life.
FWIW it is far from perfect but it is helpful - and better than any paid apps that we've encountered.
I was at a meeting earlier this month where the Zoom live captions were displayed on-screen. This is not something I ever use or had much need for but they were quite good. It handled different English speakers, with some distinctly different accents, very well. It got a couple of words wrong here and there, usually proper names or acronyms but it was generally quite impressive, and much better than the "text to speech" efforts last time I really tried them years ago.
Your recommendation has made me think I should finally take the leap on live-caption glasses, which I've been watching for a while now. It sounds like they've finally got to the point where they're effective.
A question: how do you find them in conversations with multiple people? Do the glasses help you distinguish speakers by breaking out text from different voices, or is it all just a stream of words? What if there are multiple conversations going on - do the glasses manage to "focus" captioning on the one you're closest to, or do other conversations creep in?
The captions on google meet have been useful for me as well, although I do wish they were more configurable, e.g. being able to give the captioning model a list of technical phrases, internal company terms, or acronyms that are likely to come up. There also seems to be a gap still between real time transcription, which is good, and after-the-fact transcription, which is excellent. (You can also use an LLM for the latter and prompt it yourself with extra context, although that may not be the best model.)
It's been great to see so much progress in this area in the past few years. I am hoping the current (over-)investment in AI at least has the side effect of improving the tech still further.
It really depends if people are talking at the same time or not. If in a close group (space matters, the mic only goes ~2-3m), one person talking at a time, then they're great. That's the setup I most often have at conferences, so it's been great there.
In evenings/parties, it's a bit more chaotic, and the glasses tend to fall off for sure.
Regarding distinguishing different speakers etc I haven't needed that, I use the glasses as a helper, they fill in the gaps. So it's "just a stream of words", but it has been enough to already help a ton.
The directional mic does work quite well, but sometimes you have just 2 conversations happening in front of you and it's not working at all. In other setups (especially professional ones), people usually speak one at a time and it works great.
Looks and seems great, always felt like a no-brainer use case for the smart glasses. But considering the kind of hardware they most likely are using, how is the captioning actually happening? I'm really scared of getting hardware that is 100% cloud dependent, as eventually the company gets bought or shut down, and then you end up having to repeat the process of figuring out what to buy next, and sometimes that just one or two years in the future.
They are not making it clear how the captioning is happening, but since they don't claim it'll continue working even if the company disappears/shuts down, one can be safe to assume it's a cloud product, meaning it won't actually be a good fit for most people out there with a limited amount of money to spend on things like these.
Edit: I realize now this product is not at all for people like me, "Boost caption accuracy up to 98%" and "More accurate translations" are locked behind a $15/month subscription, kind of disgusting how they hide making the product work as it should behind a subscription.
I just want some simple glasses that can caption what people are saying without ripping me off, I guess we're too late into capitalism for that to actually be made for consumer.
https://support.apple.com/en-us/123720
I'm rarely an apologist for subscription services vs outright purchase but those features sound like ones that are going to use cloud services instead of working on-device only. If it's associated with an ongoing cost it's perfectly justifiable to charge an ongoing fee, IMO. That said I’d much prefer an option tied to how much you actually use it.
That said, the paid subscription has some useful features, but I personally don't care about multi-languages translation. The rest of the conversational improvements seem to help but I don't think they're necessary... although I don't know what they mean with "Boost caption accuracy". Maybe using more expensive models?
I have Phonak Audeos paired over bluetooth with my iPhone. A few years prior, I used to have Oticon, also paired with my iPhone.
With the Oticon, if I made a cellphone call, the iPhone would use the default iPhone microphone while the audio would stream to my hearing aids. It was good that way because in a noisy environment I could hold the iphone right up to my mouth and the other party would be able to hear what I was saying.
With the newer Phonaks, I was very disappointed to find that the new hearing aids would only use the microphone input that is built into the hearing aids themselves, and not the iPhone mic input. I discovered this when I realised that talking directly into iPhone mic did not make it any easier for the other party to hear me.
I complained to my Audiologist who explained that yes, the new hearing aids were copying the behaviour of Apple AirPods, which also have the mic input on the earpod itself, and that there was no way at all to configure the Phonaks to use the iPhone mic input instead.
Why is this a problem you might ask? Because my hearing aids are Behind The Ear (BTE) and thus the mic input on the hearing aid is a good 4 inches away from my face and thus my voice cannot possibly sound as clear as when I could speak directly into an iPhone mic.
When I next replace my hearing aids, I shall look for aids that do not mimic this crappy AirPods behaviour...
During a call, swipe down for the control centre. You’ll see an option at the very top to adjust the audio options. Mic input is just there.
I don't think there's a way around it on the iphone, but I was able to cobble a fix for my macbook at least. It uses Shortery to run a Shortcut whenever my HA connects. The Shortcut runs a shell script that uses https://github.com/deweller/switchaudio-osx/ to determine the built-in mic and switch back to it immediately:
BUILTIN_MIC_ID=$(switch-audio --list-input | jq 'map(select(.name == "MacBook Pro Microphone")) | .[0].id') switch-audio --set-input="$BUILTIN_MIC_ID"
And AirPodsSanity (& SoundAnchor) offer polished options here. Maybe using that same script underneath!
They were Phonaks.
I guess I'm glad to hear that it's not intrinsically a hearing aid thing, and I may find a better experience with other brands.
Mine were exactly like this to start with and over time the effect goes away such that you don't notice. I'd recommend if you do actually have hearing problems, sticking with it for quality of life improvements.
We ended up with Phonaks rebranded as Sennheisers. The audio quality during calls may not be as clear as a separate mic (what i believe you refer to as oticon), but from a user experience its nice to not have to fish out your phone to answer a call or wonder why you can hear the other person but they cant hear you.
Note that my complaint here is specific to Android support.
I personally use iPhone and I do prefer to leave phone in pocket for my phone call. But it does seems like a massive oversight to not make this configurable.
Settings > Sound & Haptics > Input > change from "Automatic: ..." to "iPhone Microphone"
It’s a brain thing, my hearing itself is above average for my age (40), so I’m not sure what exactly can be done, but there was an article many years ago about someone (Bose?) working on aids for that issue, no idea what came of it. I guess all modern hearing aids have some focus mode.
[0]: https://en.wikipedia.org/wiki/Auditory_processing_disorder
edit: In case there’s an airpod suggestion, I’ll also need to know if that feature works on Android, it’s not crippling enough to make me use an iPhone.
The newest HAs have AI that helps in noisy environments. The ones I have are the Phonak Audéo Sphere Infinio I90s. I've worn HAs for 40 years. It's truly unbelievable in noisy environments. I know it's easy to think it's all marketing garbage, but some great demos on YT of the technology. I keep them in AI mode all the time when I have them on, and charging them for an hour at lunch is enough to get me the necessary runtime.
But it’s cool that this stuff is now integrated, hopefully those advancements will eventually trickle down further, from what I’ve now read, the AirPod Pro feature is a bit of that trickle.
The traditional solution is an FM system where you give the person speaking a microphone linked to your hearing aids. There are dedicated ones like Phonak Roger. You could probably also use your phone as a microphone if it's bluetooth connected to your headphones or hearing aids.
The tech for isolating a speaker at conversational distances exists. You use half a dozen microphone transducers (minimum; Crappy microphone transducers are cheap and quality is expensive, so just use a bunch of them), and through a combination of phase and intensity they decode relative location, and amplify that phase expectation while suppressing everything that isn't phased like that. Sound is slow, and readily susceptible to real-time triangulation. The math/processing is much easier if the parallaxes are fixed (eg the microphones are arranged in a line array on the top band of a rigid pair of smart glasses), but with a little latency it's not prohibitive for a deformable array to solve for its own relative position as well.
Often people who lose their hearing want to be able to hear in social situations such as restaurants and family gatherings. In this context, the signal and noise have similar properties and are coming from the same direction. Directionality helps but can only do so much. Noise reduction can make hearing aids more comfortable to wear but don't necessarily improve comprehension in challenging situations. Progress here is fantastic -- at the same time it helps to have realistic expectations.
Putting the mic on the person speaking sidesteps the problem -- it's like the rest of the room isn't there.
People rely on the (usually very large) dynamic range of hearing to be able to understand in those situations. In people with typical hearing the brain filters out the sounds too loud or too quiet to be what they are trying to listen to. But hearing aids act as compressors reducing the dynamic range.
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1. https://github.com/kavishdevar/librepods
https://support.bose.com/s/product/hearphones-conversationen...
I absolute loved them, but unfortunately lost them, and they are irreplaceable.
I also liked that there was a neckband - easy to take the buds out when not needed and leave them hanging, and of course more power in a larger battery.
They sure seem to be marketing in your direction. No idea how well they work though.
But thanks, and I'll say loops are amazing for the price for concerts.
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I also very much appreciate that they can natively connect to iPhones (this is also essentially the main reason I have an iPhone). This makes phone calls and music and podcasts very easy. (Whereas up until 2017, I used to dread phone calls.)
I actually tried Phonaks briefly in 2022 and hated them. Lots of controls to fiddle with (some with oddly unintuitive names), but that meant I was constantly trying to adjust it and was rarely able to just exist in the moment. I found them markedly worse in noisy environments - I basically couldn’t have a conversation in a restaurant.
As for technology, they use bluetooth low energy to connect to the smart phone, which works really well, with the caveat that the range is quite low and if it is in the pocket and you are moving around, media sound will often disrupt or desync intermittently. On the plus side, they last well over a day even with media use (WIdex says they last 37 hours without bluetooth use and that checks out). The case provides charge for about a week, and has wireless and usb-c charging.
They are quite pricey, but there are several options (110, 220, 330, 440), and the 220 were more than enough for me. The app has several modes, including directional focus mode, and you can define your own. I sometimes use a different mode for listening to concert music, that disables most filters such as volume protection.
I am wearing them for 9 months now, and there was no situation (concerts, traveling, work, sports, etc) were they gave me any issues whatsoever.
With that said, my recommendation are the new Phonak Infinio Sphere devices with with their "Spheric speech in noise" feature. It's a complete game changer in terms of speech perception in loud noise. Activating this program in a noisy situation feels like turning off the background noise, leaving only (nearby) voices.
The caveat is that to achieve this they use a separate, power-hungry processor and compensate by increasing the battery size (making the whole hearing aid bigger than other, similar hearing aids). The upside to this is that if you're _not_ using the spherical program, you'll have really good battery life. I use mine for exactly 16 hours a day and if I'm careful I can make them last almost three full days. The charger is much better than the previous ones; they use magnets to keep the devices in place instead of relying on plastic friction.
The Oticon Intent and new Starkey AI aids are also great. You should always try more than one model before you make a decision.
Happy to answer any questions!