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What Options Are There for Patients Who Won’t Wear Hearing Aids?

Anna Karlsson Lejon

September 23, 2013



I have a patient who I know needs hearing help, but they are reluctant to even schedule further visits because they are not ready to commit to hearing aids.  For this segment of the population, does it always have to be hearing aids that I recommend?


Hearing loss is a common disability, perhaps more common than you think. Around 10% of the total population suffers from hearing loss. The percentage changes with age. In the group of 60 year olds and over, 30% have a hearing loss (Gates, Cooper, Kannel, & Miller, 1990); according to the figures of Cruickshanks et al. (1998), 50% of the over-70 population has a hearing loss. The prevalence of hearing loss is predicted to rise since the population is getting older.

How many persons with a hearing loss are using a hearing aid? The use of hearing aids is growing, but it is still a very low number.  Only 25% of the persons with a hearing loss are actually using a hearing aid (Kochkin, 2007). This may be a surprising number, since hearing aids are a good and simple solution for hearing loss.

Why do People not Wear Hearing Aids?

The reasons for not wearing hearing aids are probably as many as there are individuals with hearing loss. Kochkin (2002) reports that 44% of the persons who got a hearing aid are unsatisfied with their hearing aid in larger meetings. Around 30% are not satisfied with their hearing aid when using the telephone.

Another reason could be due to the handling of the hearing aid. Hearing aids require general maintenance like changing of batteries and cleaning, and they have to be placed correctly on the ear. These procedures can be tricky if dexterity has declined and vision has become weaker.

Is There an Alternative to Hearing Aids?

The alternative for a hearing aid could be a simple hearing amplifier, a device which can be used specifically in those situations when persons with hearing loss find it most difficult to hear. Since 2005, Comfort Audio has distributed the Comfort Duett, an amplifier for difficult hearing situations. The Comfort Duett can be connected to the TV for a better sound experience for not only the person with hearing impairment, but for everyone in the room. Furthermore, the Comfort Duett can be connected to a landline telephone, amplifying sound to the right level for users. Comfort Duett has been redesigned with bigger buttons and a lighter color make it easy to use.

Focus on Ease of Use

The new Comfort Duett is designed to be easy to use. To make sure that the design meets the demands, it was tested by a group of 21 people between 75 and 90 years. The test subjects were asked to describe how it was to use the Comfort Duett. The general opinion was that it was easy to handle, both when manipulating the volume control and the on/off function.

A hearing amplifier should be designed in a way so that it is actually used. Comfort Duett is equipped with a charger and AAA rechargeable batteries. Eighteen of the 21 test persons thought it a big advantage that it can work with both rechargeable and standard batteries. Furthermore, charging the new Comfort Duett caused no problems. It was compared to charging a mobile phone. A light-indication feature made it easy to place the Comfort Duett into the charger when necessary.

Designed for the User

When the design work of Comfort Duett started, its designer interviewed a group of possible users. They were asked to describe a good size for the device, as well as color and size and form for the buttons. The result of their answers was the starting point for the new design of Comfort Duett.

The test persons were asked to adjust the volume to a comfortable level. All 21 users considered the volume buttons as easy to handle. The minus button is concave and the plus button is convex, making it very easy to differ between the two of them.

Furthermore, the color contrast of the buttons was an important feature, too. One third of the population older than 70 years has an eye cataract, meaning they need very distinct color contrasts. Three test persons had an eye cataract, having not much sight left. They considered the big black buttons with white text to be read easily.  The buttons also contrasted well with the white Comfort Duett housing.

What Did the Users Think About the Design?

As a part of the evaluation of the Comfort Duett, 14 test subjects had the possibility to choose between the new and the old design of Comfort Duett. Fourteen out of 14 test persons chose the new design (A) for the following reasons:

  • It is easier to handle.
  • The design is nicer.
  • The design appears to be newer and better.
  • The buttons are well defined.
  • The old design is a little smaller, but I would still rather have the new device.

Does it Have to be Hearing Aids?

No, it does not have to be hearing aids. There are good alternatives for having a decent hearing situation that can be combined with using the telephone and watching TV. That answer is Comfort Duett, designed and made in Sweden by Comfort Audio.

For more information about Comfort Audio, please visit or the Comfort Audio Expo Page on AudiologyOnline.


Cruickshanks, K. J., Wiley, T. L., Tweed, T. S., Klein, B. E., Klein, R., Mares-Perlman, J. A., & Nondahl, D. M. (1998). Prevalence of hearing loss in older adults in Beaver Dam, Wisconsin: The Epidemiology of Hearing Loss Study. American Journal of Epidemiology 148(9), 1075-1078.

Gates, G. A., Cooper, J. C., Kannel, W. B., Miller, N. J. (1990). Hearing in the elderly. The Framingham cohort, 1983-1985. Part I. Basic audiometric test results. Ear and Hearing, 11(4), 247-256.

Kochkin, S. (2002). MarkeTrak VI: 10-year customer satisfaction trends in the US hearing instrument market. Hearing Review, 9(10), 14–25, 46.

Kochkin S. (2007). MarkeTrak VII: Obstacles to adult non-user adoption of hearing aids. Hearing Journal, 60(4), 27-43.

anna karlsson lejon

Anna Karlsson Lejon

Audiologic Product Specialist

Anna Karlsson Lejon has a master's degree in Audiology from Lund University, Sweden. She has clinical experience in hospitals and private clinics in Sweden. Anna currently works as an audiological product specialist at Comfort Audio AB, Sweden.


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