The Best Hearing Aids for Seniors

Hearing aids aren’t one-size-fits-all. Most seniors will gravitate to behind-the-ear (BTE) devices, as many are likely to find in-the-ear (ITE) aids difficult to work with. Here’s a look at both categories.

Behind-the-ear (BTE) aids have the traditional design you probably think of when you envision hearing aids. As the name implies, they sit behind the ear. Most of today’s BTE hearing aids are technically known as receiver-in-the-ear (RITE), due to a small component that sits in the ear canal instead of the case. Though smaller than predecessors from even a half-decade ago, they remain visible to observers. Still, what they lack in style they make up for in audio quality. Note that BTE devices can often be challenging to position just right in the ear canal—especially if you wear glasses.

In-the-ear (ITE) hearing aids, also called in-the-canal (ITC) aids, often look like wireless earbuds and can be even smaller, disappearing nearly entirely into the ear canal. If you don’t want a noticeable hearing aid, these are much more discreet than BTE devices, and they can be easier to work with too, since they lack the wire that wraps around your ear. If you pop your hearing aids in and out frequently during the day, ITE aids will save you a mountain of time. One drawback to these devices is that their small size usually means less battery power (and the need to charge more frequently). Due to their smaller size, they can be challenging to manipulate if you have dexterity issues.

If you’ve seen signs advertising hearing aid shops while driving around town, you might be lulled into thinking these specialized storefronts are the only way to buy them. Not so. In 2022, the US Food and Drug Administration paved the way for hearing aids to be sold over the counter, which means consumers now have a wide variety of outlets from which they can purchase these devices.

If you do choose to visit a retail audiology center—whether it’s a small storefront in a strip mall or a more official medical office—you’ll begin the process with a medical examination wherein the audiology will physically check your ears and then test your hearing in a specialized room. This hearing test takes about 15 minutes and involves listening to pings played at different frequencies and volumes. Once complete, the audiologist uses this to create a map of your hearing called an audiogram, which in turn is used to program the prescription hearing aids that, ostensibly, the audiologist will subsequently sell to you. The audiologist can later adjust the hearing aids’ settings over time if you need additional support.

If you choose to forgo this process and purchase high-end hearing aids from a retail channel, you’ll miss out on the physical exam, but you will likely still have access to a hearing test, delivered either online or through an app. With these tests, you first purchase your selected hearing aids. Once you have them fitted in your ears, you run through a similar kind of testing to program them, with the pings delivered through the aids you’ve just bought. The resulting audiogram is often surprisingly accurate in comparison to one created by an audiologist. And like prescription aids, hearing aid companies often have an audiologist on staff who can tweak settings over time remotely.

Many less expensive hearing aids—under the $300 price level—usually do not include hearing test technology like this, or if they do, it can exist in a more limited fashion. The user is left to their own devices to program them to their liking.

All hearing aids have a battery, but some can be recharged—like Bluetooth earbuds—while some require you to buy standalone batteries that are replaced as they expire.

Rechargeable hearing aids offer the user the convenience of being able to simply drop the aids into a special case which tops up the battery whenever the aids are not in use. A typical rechargeable aid will get anywhere from 8 to 30 hours of operational time from a single charge. The hearing aids’ case will also usually carry a charge of its own that will provide another 3 to 5 additional charges. With a fully charged case, most users should be able to go for up to a week before having to recharge the case, though it’s easier if the case is simply left plugged in and always topped up.

Hearing aids with a replaceable battery represent older technology, though it’s not a technology without some advantages. Foremost, replaceable hearing aid batteries last a lot longer than rechargeable batteries, up to eight times the lifespan in some cases. With a replaceable battery-powered hearing aid, a user may be able to use their aids for a full week without having to change the battery. That may be more convenient for some users who don’t want to have to carry a charging case with them. (Some recharging cases can be quite large.) The catch is that eventually the battery will die and it will need to be replaced. This isn’t always the easiest process, as these batteries are quite tiny and prone to being easily dropped and lost, particularly if you have dexterity challenges. Also, if you have pets or grandchildren around the house, swallowed batteries pose a huge health risk. While you won’t need to carry a case with you, you will need to carry spare batteries for when you run out of juice.

Which is best? Categorically, I no longer recommend any model hearing aids with replaceable batteries, but since the market is headed full-bore toward rechargeable hearing aids, you probably won’t have a choice for long anyway.