Making phone calls with a hearing aid

Making phone calls with a hearing aid can be a challenge, but it doesn’t have to be. Modern technologies now enable a direct connection between the phone and the hearing aid, making conversations much easier to understand. From Bluetooth streaming and telecoils to special phones designed for older people, there are various solutions available to make everyday phone calls easier. The key is choosing the right technology and ensuring it is optimally tailored to individual needs.

Basics and challenges of using a telephone with a hearing aid

Telephoning presents a particular challenge for people with hearing loss. Unlike face-to-face conversations, visual cues such as lip movements or facial expressions are missing. At the same time, background noise can further impair speech intelligibility. The quality of the telephone transmission plays a key role here, as compressed audio signals are often more difficult for hearing aids to process than natural speech.

Modern hearing aid technology now offers numerous ways to overcome these challenges. Direct transmission of the telephone signal to the hearing aid can significantly improve intelligibility. This minimises background noise and transmits speech clearly and distinctly directly into the ear. Clear communication in everyday and professional life is essential for many people with hearing loss, which is why there is a great need for practical solutions.

Understanding compatibility labels

Special classifications exist to determine the suitability of telephones for hearing aid users. For mobile phones, the so-called M and T ratings are used. The M rating assesses acoustic coupling and indicates how well the phone reduces feedback and background noise. The scale ranges from M1 to M4, with M4 representing the best compatibility and enabling virtually interference-free use.

The T-rating, on the other hand, measures compatibility with inductive transmission via the hearing aid’s telecoil. Here too, T4 represents the highest level and ensures optimal signal transmission. Landline telephones are labelled HAC (Hearing Aid Compatible). All public telephones, workplace telephones and emergency telephones must meet these compatibility requirements to ensure barrier-free communication.

Direct digital transmission via streaming

The most advanced method for making calls with a hearing aid is direct digital transmission via wireless technology. Many modern hearing aids are equipped with Bluetooth and can be connected directly to smartphones or other devices. This technology transmits the sound of the conversation directly to both hearing aids, resulting in crystal-clear speech transmission whilst minimising background noise.

With this solution, the hearing aids function as a wireless headset. The phone no longer needs to be held to the ear, enabling hands-free calling and a high level of comfort. The caller’s voice is played directly into the ear, whilst the user’s own voice is picked up by the microphones in the hearing aids or the smartphone. With some systems, calls can be answered and ended directly by briefly pressing or tapping the hearing aid.

Bluetooth protocols and standards

It is important to note that not all Bluetooth connections work in the same way. Various protocols govern communication between the hearing aid and the phone. Made for iPhone (MFI) is a special protocol for Apple devices, whilst Audio Streaming for Hearing Aids (ASHA) was developed for Android smartphones. The newer Bluetooth LE Audio standard promises even better sound quality with lower energy consumption and could unify both systems in the future.

Compatibility between the hearing aid and smartphone should be checked before purchase. Not all Bluetooth standards are compatible with one another, which can lead to connection problems or limited functionality. Hearing care professionals can advise on selecting compatible devices and assist with setting up the connection. Professional advice on assistive devices and technology helps to find the optimal solution.

Accessories for wireless pairing

If the hearing aid or telephone does not support a direct Bluetooth connection, special accessories are often required. These additional devices, known as streamers, transmitters or telephone adapters, serve as a wireless interface between the telephone and the hearing aid. They receive the audio signal from the telephone and transmit it directly to the hearing aids, thereby achieving sound quality similar to that of a direct Bluetooth connection.

For landline telephones, such devices can be connected between the home line and the handset. They usually require their own power supply and need to be paired with the hearing aids once. Specific accessories such as the ConnectClip or Easy LE Adapter transform hearing aids into wireless headsets and enable hands-free calling even with older devices. For behind-the-ear hearing aids, audio shoes can also be used to connect to additional systems.

Inductive transmission and telecoil

The induction coil, also known as a T-coil or telephone coil, is a tried-and-tested feature in many hearing aids. It enables a wireless connection to compatible telephones via electromagnetic signal transmission. When the coil is activated, the electromagnetic speech signals are picked up from the telephone receiver and transmitted directly to the hearing aid, bypassing the telephone’s loudspeaker.

This method significantly improves speech transmission and sound quality, as background noise is effectively reduced. The sound reaches the hearing aid directly and without any detours, which can be particularly beneficial in noisy environments. However, special telephones capable of generating the necessary electromagnetic field are required to use the T-coil. Many landline telephones and public telephones have this function, whilst it is rarely found on smartphones.

Neck loops as an alternative

Neck loops offer another option for inductive transmission. These are worn around the neck and generate an electromagnetic field that can be received by the hearing aid’s T-coil. The neck loop is connected to the telephone or another audio device and transmits the signal inductively. This solution is particularly practical for people who wish to use different audio sources, as the neck loop is universally applicable.

Special telephones for hearing aid users

Special telephones are available for people with hearing impairments, often referred to as senior citizens’ telephones or telephones for the hard of hearing. These devices are either directly compatible with hearing aids or feature functions that assist even without direct pairing. A key feature is an adjustable handset volume, which can be set up to 40 dB higher than the standard telephone volume. On many models, the ringtone volume can be increased to up to 95 dB, ensuring that incoming calls can be reliably heard even with severe hearing loss.

Furthermore, these telephones are characterised by simplified operation. Large, tactile buttons make operation easier, even for people with limited fine motor skills. High-contrast displays with large text improve readability. Speed dial buttons allow you to call frequently contacted people quickly with just one press of a button. Some models also offer an emergency call function, which can be used to call for help quickly if necessary.

Additional signalling functions

Modern specialist phones and some smartphones offer additional features that make telephoning easier. Visual call signalling via flashing LEDs or lights makes incoming calls visually noticeable. Vibrating wristbands or vibrating alarms can provide an additional signal for incoming calls. Some models feature voice prompts for the dialled keys or the caller’s name, which further simplifies operation.

Security features such as call protection with whitelists and blacklists help to block unwanted calls. This can be particularly important for older people with hearing loss to protect them from telephone scams. The combination of increased volume, simplified operation and additional signalling functions makes these telephones valuable aids in everyday life for people with hearing loss.

Optimised hearing programmes and sound settings

Many modern hearing aids offer special hearing programmes specifically optimised for telephone conversations. These programmes individually adjust the amplification and filter settings of the hearing aid to the conditions of a telephone conversation. This improves speech intelligibility by, for example, minimising feedback and regulating the processing of background noise.

The hearing programmes can be activated automatically as soon as the hearing aid detects a nearby telephone, or switched manually via a button on the device or a smartphone app. Some systems also allow sound profiles to be adjusted to emphasise specific frequency ranges. High frequencies, for example, can be amplified to make sibilant sounds easier to understand, whilst low frequencies can be adjusted to support the user’s natural hearing ability.

Artificial intelligence and transcription

Modern technologies go beyond mere sound enhancement. Artificial intelligence can analyse listening situations in real time and automatically optimise sound quality. Voice assistants such as Siri or Google Assistant enable hands-free operation of the phone, which can be particularly helpful for those with limited mobility.

A particularly valuable feature is the real-time transcription of phone calls, also known as speech-to-text. The spoken text is displayed as live subtitles on the smartphone screen and can be read along with the conversation. This makes communication much easier, particularly in noisy environments or when the other person’s speech is unclear. Some apps offer this feature free of charge and can be a valuable addition to audio transmission.

Correct handling depending on the type of hearing aid

The correct position of the telephone receiver is crucial when using acoustic coupling to achieve optimal sound quality and avoid feedback. With in-the-ear devices, which sit entirely within the ear canal, the microphone is located directly in the ear. Therefore, the telephone receiver can usually be held to the ear as normal without any special adjustments being necessary.

The situation is different with behind-the-ear devices. The microphone is located on the upper part of the hearing aid, behind the ear. To ensure clear sound transmission, the telephone receiver should be positioned higher up or slightly behind the ear. This ensures that the telephone’s speaker is aligned directly with the hearing aid’s microphone. This positioning may feel unfamiliar at first, but it results in significantly better speech clarity.

Avoiding feedback

Feedback occurs when the amplified sound from the hearing aid is picked up again by the microphone. This results in unpleasant whistling noises that can make conversation impossible. Correct positioning of the receiver is the first step in avoiding such interference. In addition, modern hearing aids feature feedback suppression, which automatically detects and eliminates such interference.

When using streaming technologies via Bluetooth, this problem is completely eliminated, as the sound is transmitted digitally and no acoustic coupling takes place. This is one of the major advantages of wireless transmission and makes hands-free calling particularly comfortable and interference-free.

Optimising the calling environment

Even the best technology can only be effective if the conditions are right. For important phone calls, it is advisable to choose a quiet environment. Background noise such as a running television or loud TV speakers should be minimised or switched off. Conversations between other people in the room can also impair intelligibility.

Choosing a quiet place not only helps with better understanding but also reduces the effort required to listen. People with hearing loss often have to concentrate harder to understand speech. In a quiet environment, this is much easier, and conversations become less tiring.

Communicating with the person you are speaking to

It can be helpful to inform the person you are speaking to about your hearing situation at the start of the call. People are usually happy to comply with a request to speak slowly and clearly. Pauses between sentences give you time to process what has been said. Important information such as names, addresses or numbers can also be sent in writing via text message or email if necessary.

For longer or more complex conversations, it may be a good idea to arrange an appointment so that you can prepare for the call in peace. Using video calls can also be an alternative, as this provides additional visual information such as lip movements, which makes understanding easier.

Expert advice and personalised solutions

As there are no legally binding standards regarding compatibility between all phones and hearing aids, it is often necessary to try out different solutions in practice. Hearing care professionals are the right people to contact for any questions regarding the connection between hearing aids and phones. They assist with configuring the devices, setting up hearing programmes and selecting the appropriate accessories.

Various solutions can be tested in the hearing aid clinic to find the best option for each individual. This takes into account both the technical capabilities of the existing hearing aid and the user’s personal needs and habits. Some people prefer a direct Bluetooth connection, whilst others find the telecoil more suitable.

Ongoing adjustment and optimisation

After the initial setup, further fine-tuning may be necessary. The volume during telephone calls may be perceived differently from that during normal conversations. The balance between the other person’s voice and one’s own voice can often be optimised further. Modern hearing aid apps often allow users to adjust these settings themselves.

Regular check-ups with your hearing care professional help to adjust the settings as needed and familiarise you with new features. Technology is constantly evolving, and many hearing aids can be equipped with new features via software updates. Good support ensures that the full potential of the technology is realised.

Practical tips for everyday life

In addition to the technical features, there are some practical tips that make using the phone with a hearing aid easier. It should be possible to adjust the volume during a call as required. With many systems, this can be done directly via the hearing aid or an accompanying app. A volume that is too high can be just as problematic as one that is too low, as it can lead to distortion.

During longer phone calls, you should keep an eye on the battery level of your hearing aids. Bluetooth streaming uses more power than normal hearing aid use. It is advisable to check whether the batteries are sufficiently charged before important or longer calls. For rechargeable hearing aids, a charging station at your phone station may be useful.

Using multiple devices

Many modern hearing aids can be paired with several devices simultaneously. This allows for seamless switching between a smartphone, a landline phone with an adapter, and other audio sources. The management of multiple connections is usually automatic, so that incoming calls can be received regardless of the device.

For people who make a lot of calls both professionally and privately, it can be useful to create different hearing programmes for various situations. One programme for quiet office conversations, one for calls in noisy environments and possibly another for video conferences. You can switch quickly between these programmes via the hearing aid app or directly on the device.

Future prospects and developments

Technology for making phone calls with hearing aids is constantly evolving. Bluetooth LE Audio promises even better sound quality with lower energy consumption and could standardise the various protocols in the future. This would further improve compatibility between different devices and simplify setup.

Artificial intelligence is increasingly being integrated into hearing aids, enabling ever-better automatic adjustments to different listening situations. AI can also help during phone calls by separating speech from background noise and further improving intelligibility. Some manufacturers are already working on systems that can recognise different voices and process them differently.

The integration of hearing aids into smart home systems offers further possibilities. Incoming calls could be indicated throughout the house via light signals. Connecting to doorbells or smoke alarms enhances safety. The use of voice assistants is also becoming increasingly convenient and natural thanks to direct integration into hearing aids.