I recently went with my son to the cinema to watch a movie when I started thinking that for some of my patients with hearing aids, this simple yet enjoyable activity can be a quite a struggle for them.
So why is hearing or rather following speech within a movie such a problem for some people who wear hearing aids and what can be done about? In a nutshell, most cinemas nowadays have what we call a room loop, infrared assistive technology or personal captioning devices available for hard of hearing patrons to make it easier for them. We will discuss the latter two options later in this post, but a room loop essentially is a metal rod with coiled wire around it which is located around the perimeter of a cinema. When current travels along the coiled wired, a magnetic signal is induced which can be picked up by a hearing aid that has a telecoil. A telecoil is a much smaller rod which also contains coiled wire found strategically placed inside a hearing aid. This allows the sound from the movie to be delivered directly to the hearing aid and is usually a much clearer and richer sound experience. Let us take a look at what a telecoil is in more detail and how to tell if your hearing aid has one.
What is a telecoil and does my hearing aid have one?
A telecoil also known as a t-coil (or T switch) is just a small component inside some hearing aids that is actually just a metal rod with a coil of wire around it. Its job is to pick up magnetic signals and convert them into an electrical signal that can be processed by the digital signal processing unit of the hearing aid. Unfortunately, not all hearing aids have this component due to space limitations or other technology such as bluetooth or wireless transceivers being prioritised.
With hearing aids getting smaller, the ability to physically house a t-coil is not always possible. The only way to know if your hearing aid has a telecoil is to ask your Audiologist. There are no identifiable marks on the hearing aid itself that can tell you if it has one or not. Your Audiologist should always give you the option of whether you would like a telecoil with your hearing aid as it has many more uses than just at the cinema.
A telecoil can make it easier to hear at the airport, bus terminal, train, art gallery, on the phone and can be used with some remote microphone devices. So I would argue that a telecoil is a feature that one should not simply disregard. Some of my experienced hearing aid patients who relocate over to our clinic having been seen elsewhere know nothing about telecoils and whether their hearing aid has one or not. They are surprised when I tell them about this feature and how they could have been benefiting from it for a while. What a shame.
I have a telecoil. How do I use it in the cinema?
A telecoil can be accessed by changing settings on your hearing aids. This can usually be done by physically pushing a button (either a rocker switch or a single switch) on your hearing aid or selecting the telecoil setting on your hearing aid remote control or smartphone app. Your hearing aids can be programmed to have different settings for different listening environments or situations. A telecoil setting can easily be programmed into you hearing aid by your Audiologist. If pushing the on-board hearing aid switch, you normally only need to do so on the one hearing aid as this will usually change the setting in both hearing aids simultaneously. You should hear 2 beeps to signify that you are now in the telecoil setting. If you are not sure, contact you Audiologist for specific instructions.
The telecoil can be programmed with either the microphones of the hearing aid switched off completely, dimmed or left on. You will get the best quality telecoil signal if you use it with the hearing aid microphones switched off. However, remember this will mean you may not be able to hear those sitting next to you which may or may not be a good thing 😊.
The next thing you need to consider is where the best place to sit at the cinema is. Although every effort is made by the sound engineers to ensure the room loop signal remains uniform in strength across the cinema, this is not actually possibly. What this means is that there will some seats where the signal will not be picked up as well by your hearing aid and hence the sound will be softer than it should. One way to get around this is to experiment yourself and sit in different positions around the cinema to find out which is giving you the best sound quality. Event Cinema (a Perth cinema chain) says that the best seats to access the room loop in their cinemas is in the middle section up the back. If you are not sure, it is always best to ask the staff at your cinema for help.
What if I don’t have a telecoil? What else can be done with my hearing aid?
Although most people with a hearing loss who wear hearing aids do just fine hearing at a cinema, this is not true for everyone. Cinemas are acoustically designed to enable the sound to be distributed evenly across the space with minimal reverberation to ensure a good quality sound regardless of where you sit. However, a good quality sound is not helpful for someone with a hearing loss if their hearing aids are amplifying it too much or not enough. If you are struggling at the cinema or have stopped going because you no longer enjoy yourself due to poor hearing, there are adjustments that can be made to your hearing aid even if you don’t have a telecoil.
One of the most important things to ensure when setting up a hearing aid for someone is to make sure that the MPO or maximum power output is set appropriately. The MPO is the maximum sound level a hearing aid can amplify too. As an Audiologist, this needs to be set high enough so that loud sounds don’t get clipped when they are amplified to reduce distortion. But we also want to make sure the MPO is set to a point that minimised loud sounds to getting painfully loud once amplified. This is always a balancing act. Chances are that if you are struggling at the cinema, the MPO of your hearing aid is set too low.
There are other tricks up our sleeve as Audiologists but this is a good place to start. Also, some hearing aids have a better dynamic range than others meaning they can amplify a greater range of sound levels without reduced sound quality. This is a feature that is being pushed now by some hearing aid manufacturers such as Signia (Motion P nx) and Phonak (Marvel platform) as they understand the importance of being able to maintain a good sound quality of amplified loud sound such as those experienced at a cinema or musical performance.
Other Cinema Assistive Listening Devices.
If you would like to know if your hearing aid has a telecoil or would simply like us to have a closer look at your hearing aids to optimise them for you, please give us a call on 08 6336 7170 today. You will speak to an Audiologist who can advise you on your next step. If you can’t come to us or are happy where you are, please ask your Audiologist to show you all that your hearing aids can do. You may be missing out on very helpful features to make your day to day communication easier and improve your quality of life.
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Battery technology in hearing aids have undergone interesting changes and development over the years. In fact, this can be generalised to all devices and technologies. If we just take a look at our mobile phones, this fact is blatantly obvious.
The size of the batteries have needed to keep pace with the miniaturisation of mobile phones while at the same time, improve on capacity and discharge time. We all know that mobile phones or smartphones rather, do more than they have ever done before and yet battery life continues to amaze.
One aspect to smartphones that has necessitated the improvement to battery life is the concept of wireless connectivity and more specifically Bluetooth technology. This wireless protocol has typically been renowned for sucking the life out of phone batteries. However, with smart changes to this universal communication protocol coupled with improvements to battery technology, staying connected to other devices wirelessly with your phone can be done for longer without requiring your phone battery to be recharged.
Of course, we would all still like for the battery life of our phones to last longer but this has definitely come a long way over the years -- even last 5 years.
When the first electronic/analogue hearing aids first came out from 1920-1950, they were big bulky devices that were body worn with the ear piece attached to a wire. The necessity for body worn aids was due to the large battery requirements and was also seen in the first cochlear implants.
The next step was to make the battery and hearing aid small enough so that the hearing aid could be worn on the ear. This was important for not only cosmetics by audiological reasons. Having the hearing aid on the ears instead of on the body ensures that the microphones pick up the sound where our ears would naturally do so. This helps with localisation cues as well as assists with hearing in noise.
This step towards miniaturisation occurred when the transistor was invented at Bell's Telephone Laboratories in 1948 with a hearing aid version developed in 1952. Essentially a transistor controls the flow and magnitude of electric current.Transistor technology was a blast and 200,000 of these hearing aids were sold in 1953 alone.
When transistors were able to be made with silicon towards the late 20th century, miniaturisation of hearing aids continued further and digital hearing aids became prolific.
Besides enabling intelligent processing of sounds and improving sound audibility and comfort in general, digital technology has enabled the reduction of battery consumption and as such, the hearing aid battery size could be reduced.
Nowadays the batteries size of hearing aids is contingent on the power output requirements of the hearing aid. This is in turn dependent on the degree of hearing loss of a patient. In general, the greater the hearing loss, the larger the battery you will need and hence size of hearing aid to accommodate the power requirements of the sound that needs to be delivered.
Disposable zinc air hearing aid batteries that are used today (from largest to smallest) include 675, 13, 312 and p10. These have served patients well over the decades but if you are a hearing aid wearer, you may have experienced some frustration with them.
They tend to have great variability in terms of how long each one lasts for. Size 13 batteries typically will last 10-14 days although some of our patients will get only 3-4 days out of them. Sometimes this is because there is current leakage within the hearing aid and suggests they would benefit from a hearing aid service or repair. Often, however, the battery itself is to blame.
Zinc air batteries like most disposable batteries work by creating energy from a chemical reaction that occurs when oxygen enters small vents. To improve the life of these batteries, we tend to recommends our patients not insert the new battery straight away but to leave them exposed to the air (or oxygen) for 5 minutes first. This allows the chemical reactions within the battery to become fully realised.
Disposable batteries also pose a problem for hearing aid user ill-equipped to handle small objects. This could be due to dexterity problems arising from arthritis or other inhibiting factor. As such, maintaining one's own sense of independence can be very difficult if hearing aids are required but you cannot change the batteries yourself. This scenario and others necessitated the advent of hearing aids that could use rechargeable batteries.
Hearing aid manufacturers brought out hearing aids that could have rechargeable batteries in size 13 or 312 to make it easier AND more convenient for hearing aid users. These hearing aids came out around 6-8 years ago and were very successful at addressing these issues.
Unfortunately with the improvements to other technologies since and the changes to how we use our smartphones has meant that the original rechargeable hearing aid battery solution wouldn't cut the mustard in the year 2019. The need to be able stream music, phone calls and other audio while being connected to your phone or other devices wirelessly using Bluetooth meant that rechargeable batteries in hearing aids would lose their charge too quickly (e.g. within 6 hours). Having to recharge your hearing aid (batteries) every 6 hours is and was not ideal.
The goal for rechargeable batteries for use within hearing aids is to provide full day use/charge while using the hearing aids for activities such as streaming with Bluetooth. This has only been made possible within the last 18 months (mid 2017) with the release of fully integrated lithion-ion battery technology. This is exactly the same technology used with our smartphones and is not wonder it has been adopted within the hearing aid fraternity.
All hearing aid manufacturers have brought out rechargeable hearing aid solutions using fully integrated lithium-ion technology. This means that there is no longer any battery compartment on the hearing aid itself. This can improve the the longevity of the hearing aid as there are less entry points for dust and moisture to damage delicate electronic components.
Most manufacturers claim their rechargeable hearing aid solutions are the best but lets look more closely. Signia (Siemen's) Charge&Go options claim that their hearing aids have a daily run time of 19 hours without streaming and 17 hours with streaming after a full charge. They also say these hearing take 3-4 hours to fully charge which is quite quick. There predecessors would take around 6 hours to fully charge. Charge&Go options come in the traditional behind-the-ear and receiver-in-the ear style of hearing aid.
Signia also brought out a new stylish receiver-in-the-canal hearing aid (or mini RIC) that is rechargeable but where the recharger does not need to be plugged into the mains power supply (see top image to this post). You can use the recharger for up to 3 days without needing to plug it in to be recharged itself. This is great for people who go camping or who don't necessarily have access to a power point say on a trip.
see also: Different hearing aid styles.
Phonak similarly has rechargeable options. Their Audeo M R receiver in the canal hearing aids are their pride and joy. It was just released late 2018 and is the only hearing aid on the market, at this stage, that is compatible with Android and iphone smartphones.
They claim that it can take up to 3 hours to fully charge their hearing aids which seems comparable to Signia. They also say that the hearing aids are 50% charged in just one hour which is very convenient. They have similar discharging times to the Signia aids too.
Their chargers come in 2 sizes with one being quite small that can even be plugged into your computer/laptop for charging. They also have lithium-ion rechargeable options in their super-power hearing aid range which is great news for people with a severe-profound hearing loss who also want the convenience of rechargeable batteries.
Other manufacturers have similar solutions. No doubt hearing aid technology and battery options will continue to astound. We are living in exciting times and hearing aids of the future will do much more than just improve audibility of sound.
If you are excited and would like to trial the latest hearing aids technologies available, we welcome you. Please call 08 6336 7170 to arrange a suitable time with one of our Audiologists.
Michael is a very thorough and experienced Audiologist who takes pride in ensuring his patients are listened to, valued, respected and achieve the best results possible. He has worked as a Senior Audiologist seeing a broad case load from young infants right up to complex adults who require more specialised audiological care and management. Apart from Audiology, Michael has a Bachelor in Electrical Engineering and Applied Mathematics from The University of Melbourne. When you see Michael for a consultation, you will wonder why you never saw him sooner.