What is the best course of action for a 79-year-old male patient with difficulty hearing, currently using a hearing aid in one ear?

From the Guidelines

I strongly recommend referring this 79-year-old male patient to audiology for evaluation for a left ear hearing aid, as bilateral hearing aids can significantly improve sound localization, speech understanding, and overall hearing clarity, ultimately enhancing his quality of life. The patient currently has a Motion 13 1 NX hearing aid in his right ear that was provided on January 13,2025, but is experiencing continued hearing difficulties and has repeatedly requested a second hearing aid for his left ear. According to the clinical practice guideline on age-related hearing loss 1, the use of questionnaires such as the Abbreviated Profile of Hearing Aid Benefit, Hearing Handicap Inventory for the Elderly, and Health Utilities Index Mark 3 can help assess hearing-related quality of life.

The patient's experience with amplification and/or speech-to-text in the clinical interaction may motivate them to use these communication solutions in their daily lives, as noted in the guideline 1. Additionally, the use of a remote microphone paired with their personal hearing aids can improve the signal-to-noise ratio, thereby improving signal quality, especially in noisy and complex listening situations 1.

It is essential to address the patient's ongoing concerns and potentially improve his quality of life through enhanced hearing capability. The audiologist will conduct a comprehensive hearing assessment to determine if a left ear hearing aid is medically indicated and, if so, recommend an appropriate device that would complement his existing right ear hearing aid. This referral should be made promptly, considering the importance of audiometric follow-up in patients with hearing loss, as highlighted in the clinical practice guideline on sudden hearing loss 1.

Key considerations in the evaluation and management of this patient's hearing loss include:

• Assessing hearing-related quality of life using standardized questionnaires
• Evaluating the potential benefits of bilateral hearing aids
• Considering the use of remote microphones and other assistive listening devices
• Ensuring prompt referral to audiology for comprehensive hearing assessment and management
• Prioritizing the patient's quality of life and independence in daily activities, as emphasized in the guideline 1.

From the Research

Patient Complaints and Hearing Aid Use

• The patient is experiencing difficulties with hearing and has a hearing aid in his right ear, which was provided on 01/13/2025.
• The patient's right ear is equipped with a Motion 13 1 NX hearing aid.
• The patient is requesting a second hearing aid for his left ear, prompting a referral to audiology for further evaluation.

Relevant Studies on Hearing Loss and Hearing Aids

• A study published in 2019 2 found that hearing loss is underrecognized and hearing aids are underused, with age-related sensorineural hearing loss being the most common type in adults.
• The study recommends that patients with suspected hearing loss undergo in-office hearing tests and examination for cerumen impaction, exostoses, and other abnormalities of the external canal and tympanic membrane.
• Another study published in 2017 3 reviewed the effect of audiological rehabilitation programs on hearing aid outcomes and found that educational approaches seem to be useful in enhancing the use of communication strategies, but more research is needed.

Audiological Rehabilitation and Hearing Aid Use

• A study published in 2016 4 found that assistive listening devices, such as remote microphones, can improve speech recognition in background noise for students with hearing impairment in mainstream schools.
• The study suggests that the use of assistive listening devices can provide functional hearing advantages in the classroom.
• A systematic review and meta-analysis published in 2018 5 found that alternative listening devices can improve behavioral measures of speech intelligibility relative to unaided and/or aided conditions, but the evidence for self-reported outcomes is inconsistent.

Audiologists' Language and Hearing Aid Uptake

• A study published in 2017 6 found that audiologists' use of complex language can present a barrier for patients to understand hearing rehabilitation recommendations, and clear, concise language is recommended to facilitate shared decision making.
• The study suggests that patients are less likely to obtain hearing aids when audiologists' language is at a higher reading grade level.