Ask your audiologist...

My wife has been having trouble hearing for a number of years. She just purchased new hearing aids and she is still saying, "Huh? and "What?" I went with her to the audiologist and we were told that she has poor word discrimination. Can you please explain what that means.

Poor word discrimination (WDS) is the fancy way to say she has trouble understanding speech, even if the volume of the voice is loud enough. We test WDS by placing the patient in a soundproof booth and giving them a list of words at a volume level that the patient says is loud and clear to them. If the patient gets less than 72 percent of the words correct, they are considered to have "poor" word discrimination. A "good" word discrimination score would be 80 percent or better.

A quality hearing aid will help her hear louder and clearer, and give her a better chance of understanding what is being said. A hearing aid cannot restore or repair a poor ability to understand. You may ask, "What good is the hearing aid if it can't help her understand me?" For her to be able to try and understand your speech, she first has to be able to hear it. The hearing aid is necessary to amplify your voice so that her ears with her hearing loss can hear you which, in turn, gives her brain a better chance of understanding you.

Be assured that the brain can only try to understand what the ear hears if it hears it in the first place. The hearing aids are necessary and worth the cost to make voices audible to her. It will take her brain a good six weeks to six months to learn to hear as well as it can through the new hearing aids. This adaptation process takes time.

Hopefully, you will notice that she may start understanding you better once she adapts to the new aids. Some people with hearing loss can get into a bad habit of saying, "Huh?" or "What?" even though they heard what was said. Some people need a moment to process what was just said, so slowing down your speech and speaking to them in a quiet room will help. You may also try getting her attention, like saying her name or tapping her on the shoulder, before you start speaking.

If the patient exhibits a poor WDS score, counseling about realistic expectations of hearing aids is important. If the patient's WDS is poor in a controlled environment like a sound proof booth with a voice amplified, they will have even more difficulty trying to hear and understand in a noisy environment out in the real world. People with hearing loss most likely aren't going to catch every word. There are no miracle hearing aid(s) that can overcome a poor understanding problem. Speech understanding can also deteriorate with cognitive slowing of the brain due to the normal aging process.

I have met many patients that have bought many different sets of hearing aids from many different offices, searching for better WDS. Some will spend a lot of money with basically the same results each purchase. Some people can hear and understand in background noise better than others. There are speech in noise tests that can tell us who needs the most help with directional microphones in background noise.

Some folks think because they spent money on a hearing aid, their hearing should be restored to normal. This is not the case. A hearing aid is an AID. It is an electronic device that helps the hearing you have left do the best it can. The best advice I can give someone with poor understanding is to find a hearing aid that works for you, wear it, and give yourself time to get used to it. Hearing aids are so much better than they used to be, and the technology keeps improving. Buy the best you can afford.

Another word of advice is to get hearing aids when your hearing loss is mild to moderate, instead of waiting until the loss is severe. Patients have more trouble adapting to the sound of the hearing aid the longer they wait. Our dexterity (ability to handle small objects) also tends to deteriorate the older we get. Typically, the older a person is when they get hearing aids, the harder it is for them to learn how to insert the aid in their ears and change the batteries.

I fondly remember the former SHHH (Self Help for Hard of Hearing) president John Centra telling members that, "The best hearing aid is the one that your wallet can afford, and that you will wear and keep in your ear."

Dr. Tia Flynn is a certified audiologist and has been in business for more than 14 years. Every Tuesday morning from 9 a.m. to noon, Dr. Flynn provides free hearing screenings at 1601 Third St. in Coeur d'Alene. (208) 664-2767. Visit www.affordablehearinginc.com for a free copy of the consumers guide to hearing aids and to watch helpful videos.