Hearing aid for father, in-ear electronics

[Audioguru]

front and rear microphones?[/quotew]
Normally all 4 microphone produce sounds from all around but is someone talks at the front then the rear mics are muted a little and the same for the sides.

Are you talking about a hearing aid you bought, or one you sell/fit? Could you provide a bit more info?

I tried the latest Widex hearing aids but I did not like the sound. Then I tried the latest Phonak hearing aids and they sound wonderful so I bought them with a pretty good discount.

Some "direct to consumer" hearing aids sold in the US are listed here..
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755807/table/T1/

What do you think about their critiques?I think they are trying to say that US consumers should be able to get a wider choice given the falling prices of electronics generally.

Bangood also sells a cheap hearing aid that is good for almost nothing. You need to have a free 3 months demo Like I did. During the demo the equalization and a few other features were adjusted to my taste.

As far as tuning, some of that could likely be performed by a "wizard" (part of the software) Some but perhaps not all. Since some hearing loss is likely caused by Rx drugs, a patients doctor should be in the loop - maybe a prescription some older person is taking might be aggravating their hearing loss?

Drugs? I had a heart attack before getting hearing aids and took and still take asprin, a blood pressure reducer and a cholesterol reducer like most old people do. I need the drugs to stay healthy and since my hearing failed so slowly and not suddenly then I doubt they caused my "normal" hearing loss.   

.... hearing aid affordability ....

My hearing aids were expensive but I wanted them and I could pay for them so I did pay for them. My government payed 25% because I have low income and am old.

I forgot to say that my hearing aids pickup a magnetic telephone signal from one of them and plays the equalized sounds in both hearing aids. They can also receive Bluetooth audio from a TV, stereo or remote microphone.
Poor people need and want many things I have but why should taxpayers give them these things for free?

[cdev]

Despite great advances in miniaturization and cost reduction, a great many Americans still can't afford them.

[b_force]

OK, but I found in USA, Cosco has pair(2) of highly customer rated aids for $1800 with super liberal return period. I have decided when the time comes (soon)  that is who I will use. Forget the 4,6,8 thousand brands.

A friend of mine works for a company that produces hearing aid transceivers (oddly enough they just call them receivers).
He is actually R&D engineer there.
Guess what the cost when they leave the factory including profit..............................?


1 USD dollar

yes ONE!!!!! 
And than you have actually a very decent model.
He said that 2-3 bucks is absolute tops.

So a middle man in between is filling his pockets very well. 

I have been working as an acoustic engineer pretty much my whole career, and I can also tell that everything more than $100-200 is absolute nuts.

[cdev]

A while back there was a discussion about contests..

This would be a good project for a design contest..

people could design a small but not submicroscopic DSP hearing aid which cost under some arbitrary sum, say $75-100.

Why are hearing aids so expensive?  $2000 or more is just nuts for what is essentially an audio amplifier.

They don't have to be super-miniaturized, really. just work well.

Thanks, my thoughts exactly....surely there is an off the shelf hearing aid i can buy for a reasonable price....or even off the shelf integrated amplifiers etc that i can just solder together?...even if it has a tuning screw to tune the frequency?

[b_force]

A while back there was a discussion about contests..

This would be a good project for a design contest..

people could design a DSP hearing aid and then the winning design, there could be a second contest to miniaturize it?

The problem are the transducers/drivers.
This is a very special kind, although, nowadays sometimes even used in headphones.
The problem is that it really depends what kind of hearing loss you have.
In general, a DSP would suck out WAAY to much energy.
In fact, I can remember very well my friend being all frustrated to actually have to use mechanical lowpass/highpass and noth filters (RF people know what I mean), because there is simply no space for even a tiny opamp and a bunch of passives.

Although the market has changed quite significant the last few years in audio, so it could be that nowadays they have other solutions.

I know this is an electronics forum, and it's probably not the best place to say (hides..), but you simply can't solve all acoustic issues with electronics and DSP's.
(yes you can a lot)

[Dataforensics]

(presbyacusis)  effects nearly everybody later in life to some degree.

Do you remember the names of the drugs they gave you and what they were for? Were they for tinnitus

I can remember pregabalin, amitriptylene, and believe it or not some anti psychotics. They were all used at much lower than normal doses for their side affects rather than main conditions. None were specific for tinnitus, just known to help in some people. None of them helped with my tinnitus.

[Dataforensics]

Sorry deleted too many quote controls, should have looked like.

(presbyacusis)  effects nearly everybody later in life to some degree.

Do you remember the names of the drugs they gave you and what they were for? Were they for tinnitus?

I can remember pregabalin, amitriptylene, and believe it or not some anti psychotics. They were all used at much lower than normal doses for their side affects rather than main conditions. None were specific for tinnitus, just known to help in some people. None of them helped with my tinnitus.

[tggzzz]

It seems to me that the combination of small size, sophisticated DSP and low power some of the cutting edge could be jettisoned to allow people to have a cheap high functioning hearing aid for less.

Such things are already available; over here there are adverts in newspapers that cater to C2/D/E demographics etc.

They very definitely aren't "high functioning".

Even if you redeveloped such a device, there are many other issues such as ear moulds, ensuring ear-safety, EMI immunity.

[tggzzz]

Sorry deleted too many quote controls, should have looked like.

Hints: use the preview button, and after posting use the modify button.

[tggzzz]

A friend of mine works for a company that produces hearing aid transceivers (oddly enough they just call them receivers).
He is actually R&D engineer there.
Guess what the cost when they leave the factory including profit..............................?
And than you have actually a very decent model.
He said that 2-3 bucks is absolute tops.

So a middle man in between is filling his pockets very well. 

A very plausible profit margin, from the little information I have been able to glean.

But before you think middle men are filling their pockets:

• consider that most retail outfits start at a 100% markup, unless the money flow is predictable and assured (e.g. food)
• go and have a look at a retail hearimg aid shop, and guess how many sales will be made per day[1]. Then divide the fixed overheads and salaries by the number of sales, and you will get a not inconsiderable sum

I have been working as an acoustic engineer pretty much my whole career, and I can also tell that everything more than $100-200 is absolute nuts.

Don't confuse engineering expertise with commercial expertise; they aren't fungible.

[1] sounds like a good interview question!

[b_force]

I probably had to be a bit more clear. I am in between engineering and marketing the last few years. So I do have a very good sence about these things.

I also do follow your arguments, but I always find some of them a bad excuse. The fact that your company has to be that expensive is not the customers business. It means you're bad in running a business. Normally that's not an issue because there are enough competitors who make sure there is enough choice.
In this case I know that in some fields (like hearing aids) prices are being kept high. Years ago I even went to a few lectures about exactly this issue.

Because let's be honest, the cost of running a shop for these kind of things are not much higher than any other shop. If you can't earn enough with only haring aids, simply sell other stuff as well or try to come up with a format that makes it cheaper (like an online store or available on amazon or something)

[tggzzz]

I probably had to be a bit more clear. I am in between engineering and marketing the last few years. So I do have a very good sence about these things.

I also do follow your arguments, but I always find some of them a bad excuse. The fact that your company has to be that expensive is not the customers business. It means you're bad in running a business. Normally that's not an issue because there are enough competitors who make sure there is enough choice.
In this case I know that in some fields (like hearing aids) prices are being kept high. Years ago I even went to a few lectures about exactly this issue.

Because let's be honest, the cost of running a shop for these kind of things are not much higher than any other shop. If you can't earn enough with only haring aids, simply sell other stuff as well or try to come up with a format that makes it cheaper (like an online store or available on amazon or something)

It would be helpful if you both expressed yourself and also thought more clearly.

When you say "your company has to be that expensive", exactly which company are you referring to? I have never worked in any part of the audiology or retail fields.

"...simply sell other stuff..." and "...online store..." completely ignores/misunderstands the arguments that you state you follow. In particular:

• dedicated quiet rooms are expensive
• expensive single-purpose equipment
• especially trained staff, with appropriate qualifications
• and, most blatantly, exactly how do you propose that an "online store" tests someone's ears and makes an earmould of their ear canal?

Now the market may be dysfunctional wherever you live (you don't display a country flag), but that doesn't mean it is dysfunctional everywhere.

N.B. if you would satisfied by a generic amplifier, simply buy one of those already on the market for a few 10s of £/$. Many deaf people won't be satisfied by that - just as many people aren't satisfied with supermarket eyeglasses.

[b_force]

Your is more a general term. So your as in 'a company' or 'people' (something)
Maybe it's a matter of speech that some languages/people/cultures are not used to.
Sorry for the confusion.

I am also talking generally, so to speak.
So read my whole post as; 'there are ways to make it happen and it's not an excuse'.
Therefore don't take my suggestions to literal.

To give a similar example.
In a lot of countries you can buy glasses for cheap online.
So what people do is go to the optometrist ones in a while and get their eyes checked.
In many cases that's even free or will cost you somewhere between 20-50 bucks.
Ones you have your prescription, you can buy your glasses online (this is what I meant with 'Amazon').
You can use exactly the same idea for hearing aids.

Btw, you really don't need 'very special dedicated' rooms anymore to check someones hearing.
Same goes for the equipment.
I bet some companies still do, but that's really old fashioned.

I am member of the AES and I have seen proposals to do this even on a way so people can do a decent test at home.
Not saying it's there yet, but it gives a good picture what the possibilities are.

[cdev]

I think that perhaps what tggzzz and I both are concerned about (and with good reason) are declines in assistance to poor people to the lowest common denominator that is viewed as acceptable by society. People don't realize this but all around the world 'regulation' is now only allowed to go downward. That is supposed to create cheap market based solutions, lowering prices to the bone, but instead, well connected entities are trying to hold back competition.

[tggzzz]

Your is more a general term. So your as in 'a company' or 'people' (something)
Maybe it's a matter of speech that some languages/people/cultures are not used to.
Sorry for the confusion.

I take it you reside some place where English isn't the first language. "Your" is a possessive, i.e.
your
j??,j??/
determiner
possesive pronoun: your; possesive pronoun: Your; determiner: Your
    1. belonging to or associated with the person or people that the speaker is addressing.
    "what is your name?"
    2. belonging to or associated with any person in general.
    "the sight is enough to break your heart"


If you want to mean an anonyomous or undefined entity, "a" is the correct form. For a specific entity, use "the".

Ones you have your prescription, you can buy your glasses online (this is what I meant with 'Amazon').
You can use exactly the same idea for hearing aids.

Indeed, but to get to that point you need specialists with special knowledge and special equipment - and that's the expense.

I'd like to see you reliably create moulds of your own ears.

Btw, you really don't need 'very special dedicated' rooms anymore to check someones hearing.
Same goes for the equipment.
I bet some companies still do, but that's really old fashioned.

I don't know what is inside/outside of your definition of "very"; that wasn't a term I used.

But you appear to be arguing that hearing could be tested in general shop with general noise levels and distractions. Please give an indication of how that could be done - because the shops I go into aren't like that.

I am member of the AES and I have seen proposals to do this even on a way so people can do a decent test at home.
Not saying it's there yet, but it gives a good picture what the possibilities are.

AES?

Proposals are 10-a-penny, frequently they are little more than someone floating an idea. I can believe it might be done in some homes, but how is the homeowner's equipment going to be calibrated? Who will assess they are using the equipment correctly, so they have a reliable result?

[cdev]

It could be done by mail, somebody receives the package with special calibrated headphones and tiny touchscreen testing computer, performs the test, goes through a well defined process, and at the end it uploads the results to the server. Then they get the hearing aid in the mail, try them on while the test is being run, and through this process the response is fine tuned automatically, when its done they put the headphone computer auditory testing device in its postage paid envelope and send it back.

This way older, non computer literate people can have the benefit of a long, very precise fine tuned process that likely is much more complete than a ten or twenty minute test in a office park or mall.

Also, whenever there is any change whatsoever in their hearing they just go to a web page and click a box and the next day the tester arrives again to help their doctor figure out if some new threat to their hearing needs to be worried about.

[cdev]

Indeed, but to get to that point you need specialists with special knowledge and special equipment - and that's the expense.

I'd like to see you reliably create moulds of your own ears.

It likely could be done remotely.
I can think of multiple ways it could be done.

A good case can be made that solutions to all these problems are within grasp, and that there is no need to have skilled workers spending their valuable time on processes that can be automated to everybody's benefit.

What could be better than testing hearing aids and hearing in the patients own home interactively, at their own schedule? A dedicated, tablet based  interactive device with calibrated headphones, etc. can come to them by overnight delivery and be returned when the process is done.


If it makes it easier for the millions of people who can't currently afford a hearing aid to get one, why not?

At home is the best way to do it, that seems obvious to me. Many older people are not so mobile, many live in rural areas or never or no longer drive.

I don't know what is inside/outside of your definition of "very"; that wasn't a term I used.

But you appear to be arguing that hearing could be tested in general shop with general noise levels and distractions. Please give an indication of how that could be done - because the shops I go into aren't like that.

[tggzzz]

Nice concepts and good aspirations, cdev, but that's all they are. Unfortunately the devil is in the details.

Do you have any experience getting people to do something novel that they don't understand?
Do you have any experience observing and working with the elderly?
Have you ever had an ear mould made? How could you ensure it was done adequately while avoiding all possibility of damaging the eardrum?
And there are many many more such questions, since there are many ways the process could go badly wrong, unfortunately.

The hearing aid issue is merely one symptom of the uncaring system in the USA. If the system was fixed, then health insurance would be cheaper (I pay ~1/3 the US rate) and many other problems would disappear.

[b_force]

http://www.aes.org/

About the mould, I personally think that part is a bit overlooked, it's mostly just for comfort.
Btw, you can make these moulds yourself, pretty cheap and easy.
It's even being done for hearing protection plugs/buds.

I also really don't see why you need such a super fancy acoustic threaded room.
The background noise simply needs to be low enough, the numbers are a bit rusty, but out of my head that should be something like 24-40dB(a) or thereabouts.
This can be very easily done in a standard room with a proper headphone.
Also getting 'calibrated' headphones with ±1dB isn't that difficult anymore.
In fact, it would be better not to calibrate the headphone, but use a compensation on the source.
(technically speaking that's not calibrating, but I know most people use it that way)

Bit again, we are nit picking details, those can easily be overcome, it's about the general concept.
I have discussed this with quite some engineers in the field (went to a bunch of lectures about this subject).
Although that was probably 7-8 years back or so, but NONE of them (even people that DO have marketing skills) understand why they need to cost around $800-1500.
The only thing I remember is that the market is kind of a locked environment.
So it's very hard to get in as an outsider.

@cdev
I really love your ideas.
Doesn't even need to be really at home, but portable is also fine.
That way someone can go to their homes or like elderly homes and do it on the spot.

Ones again, there is no rocket science in measuring it.

[cdev]

My friend the former drug company CEO gave me this example around twelve years ago.

According to her a five minute dipstick medical test for a crippling disease thats making inroads in the US - that costs less than $1 in Mexico might cost $700 in the US.

The actual tests might originate from the same factory, be sold and interpreted by two subsidiaries of / by the same company! And in fact BE the exact same test.

[tggzzz]

http://www.aes.org/

So an engineering society rather than medical or human factors or business. I have no concept of its relationship with "audiophools", but I bet most of its members have good hearing and are therefore not aware of the realities of hearing deficiencies and what's necessary to correct them.

About the mould, I personally think that part is a bit overlooked, it's mostly just for comfort.

False, pure and simple. It is a critical part of the deafaid and significantly affects its performance.

Btw, you can make these moulds yourself, pretty cheap and easy.
It's even being done for hearing protection plugs/buds.

You might be able to, but I presume that is an unproven assertion. Getting randomers off the street to reliably inject mould material into their own ear canal and then remove it is a rather different proposition.

I also really don't see why you need such a super fancy acoustic threaded room.

Please stop inventing strawman arguments, it doesn't reflect well on the rest of your assertions. You are the only one inventing the concept of a "super duper" room.

The background noise simply needs to be low enough, the numbers are a bit rusty, but out of my head that should be something like 24-40dB(a) or thereabouts.
This can be very easily done in a standard room with a proper headphone.

Correct. The practical issue in a retail context is that such a room would have to be dedicated to this - so the retail "lost opportunity" cost is expensive.

I have discussed this with quite some engineers in the field (went to a bunch of lectures about this subject).

They only see part of the issues; medical and human factors issues are equally (if not more) important.

The only thing I remember is that the market is kind of a locked environment.
So it's very hard to get in as an outsider.

So fix the market! Trying to use technology to fix non-technical problems usually fails.

Ones again, there is no rocket science in measuring it.

You overestimate the competence of average members of the public doing strange and novel activities.

[tggzzz]

My friend the former drug company CEO gave me this example around twelve years ago.

According to her a five minute dipstick medical test for a crippling disease thats making inroads in the US - that costs less than $1 in Mexico might cost $700 in the US.

The actual tests might originate from the same factory, be sold and interpreted by two subsidiaries of / by the same company! And in fact BE the exact same test.

There are many many such disreputable examples in the USA, and in some cases they manage to export their practices to elsewhere.

The US healthcare system and marketplace is either absent or broken, but this isn't the right forum for such a discussion.

However, expecting technology to fix a broken market is usually doomed to failure.

[b_force]

http://www.aes.org/

So an engineering society rather than medical or human factors or business. I have no concept of its relationship with "audiophools", but I bet most of its members have good hearing and are therefore not aware of the realities of hearing deficiencies and what's necessary to correct them.

About the mould, I personally think that part is a bit overlooked, it's mostly just for comfort.

False, pure and simple. It is a critical part of the deafaid and significantly affects its performance.

Btw, you can make these moulds yourself, pretty cheap and easy.
It's even being done for hearing protection plugs/buds.

You might be able to, but I presume that is an unproven assertion. Getting randomers off the street to reliably inject mould material into their own ear canal and then remove it is a rather different proposition.

I also really don't see why you need such a super fancy acoustic threaded room.

Please stop inventing strawman arguments, it doesn't reflect well on the rest of your assertions. You are the only one inventing the concept of a "super duper" room.

The background noise simply needs to be low enough, the numbers are a bit rusty, but out of my head that should be something like 24-40dB(a) or thereabouts.
This can be very easily done in a standard room with a proper headphone.

Correct. The practical issue in a retail context is that such a room would have to be dedicated to this - so the retail "lost opportunity" cost is expensive.

I have discussed this with quite some engineers in the field (went to a bunch of lectures about this subject).

They only see part of the issues; medical and human factors issues are equally (if not more) important.

The only thing I remember is that the market is kind of a locked environment.
So it's very hard to get in as an outsider.

So fix the market! Trying to use technology to fix non-technical problems usually fails.

Ones again, there is no rocket science in measuring it.

You overestimate the competence of average members of the public doing strange and novel activities.

I am sorry, but calling members of the AES just some "audiophools" with only engineering skills and having no knowledge in the medical world, clearly shows you have very little knowledge about this subject.
It's even a pretty disrespectful statement.

Togheter with the ASA they are equivlent to the IEEE. All platforms were researchers share their papers, knowledges and give lectures.
And yes that's about medical stuff as well.
In fact, hearing loss is one of the top discussions in the field.

[tggzzz]

http://www.aes.org/

So an engineering society rather than medical or human factors or business. I have no concept of its relationship with "audiophools", but I bet most of its members have good hearing and are therefore not aware of the realities of hearing deficiencies and what's necessary to correct them.

I am sorry, but calling members of the AES just some "audiophools" with only engineering skills and having no knowledge in the medical world, clearly shows you have very little knowledge about this subject.

Which part of "I have no concept of its relationship with "audiophools"" do you not understand? It seems English is not your first language. Maybe that is the reason for yet another strawman argument.

I also notice you have chosen not to address the other, principally non-technical, points.

[b_force]

http://www.aes.org/

So an engineering society rather than medical or human factors or business. I have no concept of its relationship with "audiophools", but I bet most of its members have good hearing and are therefore not aware of the realities of hearing deficiencies and what's necessary to correct them.

I am sorry, but calling members of the AES just some "audiophools" with only engineering skills and having no knowledge in the medical world, clearly shows you have very little knowledge about this subject.

Which part of "I have no concept of its relationship with "audiophools"" do you not understand? It seems English is not your first language. Maybe that is the reason for yet another strawman argument.

I also notice you have chosen not to address the other, principally non-technical, points.

" but I bet most of its members have good hearing and are therefore not aware of the realities of hearing deficiencies and what's necessary to correct them."
This part, says enough.
But to be honest, even the fact that someone doesn't know the AES.
That's like talking about rockets but not knowing NASA.

And the reason why I am not going into the rest of the arguments is simply because I don't feel this is going to be a constructive discussion at all.
More like some people want to win a discussion. Which I find a waste of my energy and time.
I am simply telling things that thousands of engineers and other people in the field have experience with.
I am even trying to help people with all this information and were to find more about the subject.
But if that's not being taken serious, what is even the discussion worth?
 
But maybe I am simply misreading things.
I also really don't see why it's necessary to think if somebody is a native speaker or not, sounds rather arrogant to me actually.
It's not important for a discussion, if things are unclear, just clarify them.