Candidacy and management of assistive listening devices: special needs of the elderly.

The listening needs of older individuals cannot be successfully addressed with hearing aids alone. Assistive listening devices and systems (ALDs), either solely or in conjunction with the use of personal hearing aids, can facilitate listening in various acoustic environments, especially those in which excessive noise, reverberation and distance exist between the listener and sound source. Listening situations that are especially problematic, even with hearing aids, such as listening in large groups, on the telephone, in restaurants and at concerts and movies are ideally suited for ALD use. ALDs can reduce the impact of hearing loss and also ensure safety for older individuals. Owing to a variety of age-related factors, candidacy for ALD use among older individuals must be carefully considered. In addition, several issues related to the interaction between the older adult and the devices, the compatibility of the devices and hearing aids, as well as professional issues, complicate the fitting of ALDs. The purpose of this article is to explore these issues with a particular emphasis on who are candidates for ALD use, issues related to ALD use by older individuals, fitting considerations, reasons why ALDs are rejected by older adults, and ways to avoid these potential problems.