Hearing aids and cochlear implants can significantly improve accessibility and quality of life for people with aural impairments, but for some users, sociocultural issues and perceived stigma may leave them unwilling to wear the devices.

While some individuals try to conceal their devices, others may choose to abandon them altogether. Other hearing aid users have responded by making their devices more visible through aesthetic customisation.

One such heading aid user is Finnish stylist Jenni Ahtiainen, who began to lose her hearing in 2018 and was fitted with hearing aids. Unsatisfied with their appearance, she made herself small decorative leather holsters to wear over the aids, something of a natural impulse for a designer.

Eventually, this led Ahtiainen to found Deafmetal, a jewellery company that designs pieces for hearing aids and cochlear implants, transforming the medical devices into fashion statements.

“While eyeglasses can be viewed as an attractive fashion accessory, hearing aids and cochlear implants still look like a medical device,” says Ahtiainen. “I believe it is time to change this perception. There are many people who don’t feel stigmatised wearing a hearing device, like myself, but when it is possible now with Deafmetal, why not make them look better?”

Accentuating hearing aids

Research from Aalto University in Finland has demonstrated that personalising assistive products can have a significant positive impact on the user and how they see themselves, by giving aesthetic, social and identity roles to products that have previously been considered as purely functional.

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Ahtiainen says: “Personalising design in hearing aids significantly improves self-image and self-confidence of hearing aid users. Hearing aid stigma is one of the major problems Deafmetal solves: it changes the lifestyle of hearing aids users by offering designs that allow hearing aids to augment an individual’s personal style.”

Deafmetal is far from the only company designing jewellery for hearing aids. Jacqui Larsson Fine Jewellery has produced a ‘snake clip’ earring, while artist and activist Chella Man has worked with streetwear brand Private Policy on a collection of jewellery designed to accentuate hearing aids and cochlear implants.

Still, some hearing aid users may wish to opt for a more subtle design, such as in-the-canal and completely-in-the-canal aids.

S3 Connected Health behavioural scientist Kathleen Ryan says: “Unfortunately there’s still a stigma attached to hearing aid use, and aesthetics of traditional over-the-ear devices certainly don’t encourage patients to wear them. Often adherence can be improved by hiding the device, making it smaller and more inconspicuous.”

Some hearing aid users want more discrete devices

Unfortunately for those who wish to conceal them, small, subtle hearing aids can be more challenging to use than larger, more obvious devices.

However, the additional complexities of these devices have opened up opportunities for significant innovation in the hearing aid space.

“Small devices can be difficult to adjust,” Ryan says. “This is where the opportunity for implantables and companion devices, like mobile apps that enable remote control or hearing aids that automatically adjust to the hearing context, comes in. Not only do they improve the aesthetic element, they are easier to use and often result in a better quality of hearing for the patient, lowering adherence barriers and improving chances of long-term use.”

Ultimately, the decision about whether to emphasise or distract from their hearing aid or cochlear implant comes down to the user. Even for those concerned with their aesthetics, functionality remains the primary concern – jewellery or device design that impairs the basic function of a hearing aid or cochlear implant is never going to get very far. But as technology advances and deaf and hard of hearing people expect more from the medical devices they use, innovative styling and lifestyle features could help to elevate them from a necessity to a desirable accessory for life with hearing loss.