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.

  [0]: https://upsun.com/blog/tech-accessibility-hard-of-hearing/
  [1]: https://captify.glass/

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.

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-...

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...

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.

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!

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.

The one thing that I find absolutely essential is using ear molds instead of domes. My cousin hated ear molds and gave up on them, but I definitely prefer them.

Incidentally, I would recommend the HA/hearing loss subreddits (r/HearingAids and r/hardofhearing) over HN for this discussion. The HA group can get a little rigid, but I really like the community at HoH.

Oticon just announced/released their 'Zeal' product - a non-custom CIC, with seemingly all the bells and whistles, including bluetooth. Planning to try them soon.

I have tried a few aids before (Starkey and some older Phonak) and I do really like the Oticon 'sound'. They work for me, but of course YMMV. I think many aid manufacturers (many of them the same company - WDH!) do 60 day trials. Worth a shot.

My only dislike is the new fad, particularly of Oticon, of stopping disposable batteries and only going rechargeable. Disposable zinc-air cells have great life (I'd get a week on the Opns at least, with a few hours streaming per day). I travel for work a lot, so carrying a couple of tiny 312's in my wallet or keychain was perfect. The Zeal look to have what Oticon think is a 'compact' charger - but it ain't small. My kingdom for a charger the size of the AirPods Pro case...

I finally got (very expensive) hearing aids, and made several trips back to the audiologist to have them tuned. Then I wound up not wearing them, because most people think they're speaking English, but it's some kind of mumbly slobbergobble with incorrect, missing, or mispronounced words. The aids just turned "mufuh dogga baytaaa" into "MUFUH DOGGA BAYTAAA."

Yeah, I heard that just fine without electronic assistance.

Paying attention to how often people with "normal" hearing said "what?" to each other was a revelation. Yes, I have a problem. But it's a small problem; the big problem is that a large number of people may as well be trying to communicate by interpretive farting and tap-dancing, because "the words what are coming out of their mouth" are mostly gibberish.

What is the best thing for people with no hearing loss but need help in noisy environments?

My partner and I both have difficulty listening to conversations in crowds.

Logic tells me that there must be some noise cancelling devices with directional mics that let you hear just what is in front of you, but querying staff in stores gets me the same bemused look as when I asked about Arm laptops before Apple did one.

One of the engineers I had lunch with actually used their own product and he seemed to like it. I get the impression it's a more premium tier kind of thing that may not be covered by insurance, though.

For one, unless you use Med-El's Rondo processeor, you're going to have a thin cable connecting your processor to the coil. Taking off your CIs and putting them back on (as one does every day) is going to put stress on the cable. Sometimes the cable frays and you find that out with sound cutting in and out. There's nothing you can do until the manufacturer sends you a replacement cable in exchange for your frayed one. If you want a backup, be ready to shell out $250 for each cable.

Another UX issue is that processors depend on gravity to stay on your ears. Since there's no earmold to anchor to, processors can easily be jostled off and left hanging precariously. Wearing hearing aids, I never had to worry that my hearing devices would fall off if I rode my bike on a bumpy road. Also with cochlear implants, high-intensity interval training requires some kind of hat or bandana to make sure that the processors don't fly out.

Battery life is another disappointment. Rechargeable batteries don't last a full day. If I put them in at 6:30a, they'll last until about 4:30p. With disposable zinc air batteries, I can squeeze out about a day and a half, but then I'm having to dispose batteries. And while I can track processor battery levels with the rechargeable batteries on my phone, disposable batteries are opaque to the app.

One new thing that would be useful in terms of UX would be an configurable indicator, e.g., a blinking LED, signaling that audio streaming is occurring. It's awkward to find oneself in a conversation that already started and having to excuse oneself to turn off the stream.

Don't get me wrong, I'm glad I have my cochlear implants, but they're way behind hearing aids in terms of UX.

In terms of hearing quality, for me, it's been solid, with the caveat that it took a while to get the fitting right. I think my audiologist was a bit old school, and was sticking to settings he'd known to be good in the past rather than fitting for what the aid is capable of. I've recently had its prescription type updated to the native Oticon one, and it's been a revelation in terms of clarity.

My hearing loss is relatively recent (About four years now) so I will caveat this that I've only used Oticons, so can't really compare to anything else.

I've tried some OTC hearing aids (Sony & Sennheiser) but its been hit or miss. I'm going to try whatever the hearing aid tech at my ENT proscribes.

IMHO rechargeable models are not worth the extra cost. With a typical 5 year replacement cycle the batteries will no longer hold the early levels of charge. 312 batteries are cheap and easy to carry spares.

I tried the Starkey ITC ones a couple of weeks ago, but found the performance in noisy environments to be sub-par.

The Oticon Zeals seem good so far, but it has only been a few days. One thing they seem very strong at is the Bluetooth connectivity.

Thanks to recent iOS changes, I can use the mic in the Oticons or the iPhone for calls - and I’m tempted to try a DJI mic on my lapel as the mic. Although, so far during testing it seems that the Oticon mic might actually be good for phone calls.

https://www.costco.com/f/-/jabra-brand-showcase

Backup:

Airpods Pro 3 with hearing test through iPhone.

Mother uses hearing aids since end of 90s and most of the time it was in-the-ear but recently due to increased hearing loss she had to pick a new behind-the-ear device - still with button battery tho.

HN is a great place to get genuine thoughtful discussions compared to a big portion of the rest of the internet. Reddit used to be the place for finding genuine experiences for products with subreddits like buyitforlife (or more specific) but now these and other subreddits are filled with bots and marketeers promoting what they sell and hammering their competition in the same thread.

Some bots are already here but I fear when the marketeers come.

Currently using rechargeable Phonak Audeo with an air fly for connecting to any device other than my phone to avoid Bluetooth switching chaos.

I wish iOS had better control controls over microphone routing but with iOS 26 you can change the microphone during a call to be the phone microphone, even though the hearing aids have their own microphone.

I have some hearing loss (suppose moderate) only in my left ear. As this is only on single one I think I am coping enough with the right for now. With regular "ha , sorry, what?" moments.

In your experience should I be investing in one immediately or trying my best with current coping situation for now?

adjective 1. having a high degree of heat or a high temperature.

Hope that helps!

- The car washing scene in Cool Hand Luke

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