TV Headphones and Streamers for Hearing Loss

Why the television volume is a problem

• Speech gets lost in the mix. Modern programmes have background music, effects and mumbled dialogue, and flat-screen speakers face away from the viewer.
• Room echo blurs words, especially in tiled, bare rooms.
• Distance: the further the viewer, the weaker the speech.
• Hearing loss affects clarity, not just volume. Louder does not always mean clearer.
• Others suffer: a loud television disturbs family and neighbours, and can cause conflict.
• Safety risk: very loud sound can add to ear damage over time and mask the doorbell and other signals.

Types of TV listening devices

Wireless TV headphones. A transmitter connects to the television (through an audio output) and sends sound wirelessly to a headset. The person wears the headphones and can adjust volume without changing the television's. Many models have separate volume and tone controls, and some have a speech-enhancing setting. Types of wireless link include infrared, radio frequency and Bluetooth; radio frequency often has a longer range and does not need line of sight, while infrared needs a direct path between transmitter and headset. Some systems allow several headsets for a couple.

Neckloops and induction loops. A loop worn around the neck, plugged into the transmitter, sends sound as a magnetic signal to hearing aids that have a telecoil. It avoids wearing headphones over aids and gives the aid's own tuning.

TV streamers for hearing aids. A small device that plugs into the television and streams sound directly to compatible hearing aids by wireless link. Many manufacturers offer one that pairs with their own aids. The viewer hears the sound through the aids, with their personal programming, and can adjust the volume from the aids or an app, while others hear the television at a normal level.

Soundbars with speech mode. A speaker bar beneath the television, with dialogue enhancement settings and a remote. It improves speech clarity for the whole room but does not isolate the person from others.

Personal amplifiers with headphones. A small box and headphones, connected to the television output; often cheaper but with variable quality.

Table-top speakers close to the listener. A small wired or wireless speaker placed near the chair, so the sound is closer to the listener's ears, at a lower volume.

Captions and subtitles. Built into the television or streaming app, they show the words on screen. They are free, help everyone and combine well with the other devices.

Choosing the right one

Consider:

• Does your parent wear hearing aids? If so, a streamer or neckloop that works with the aids may be best; ask the audiologist which are compatible. If not, headphones are easier. Wearing headphones over aids can cause whistling and uncomfortable pressure; open-back or over-ear types should be tested.
• Comfort: light weight, soft ear pads, an adjustable band and a design that does not press on glasses or earrings. Some people prefer an open ear-hook or a neckloop with a small earpiece.
• Controls: large, simple volume knob on the headset, easy to find by touch, with a clear on-off sign. Avoid small touch panels for arthritic fingers.
• Range: the sound should reach the chair without dropouts, including in the next room if the person likes to move around.
• Battery: rechargeable headsets with a charging cradle are convenient but need nightly charging; check battery life, and whether it can be changed. Keep spare batteries if replaceable.
• Sound quality: try speech clarity and a tone control that boosts treble, which helps with high-pitched loss.
• Compatibility with the television: modern televisions may offer headphone jacks, optical outputs, or Bluetooth. Check the available outputs. A technician or family member can help connect.
• Transmitter placement and wires: a tidy set-up avoids trip hazards.
• Number of listeners: couples may want two headsets.
• Cost and warranty: costs vary widely; prefer a reputable maker and a retailer who will help with set-up and service.

Try before buying, ideally with your parent, and ask for a return period.

Setting it up

1. Locate the television's audio output, such as a headphone jack, an optical (digital) output, or analogue red and white sockets. Your family or a technician can help. 2. Connect the transmitter with the cable to the output, and plug in the power supply. Place it near the television, in line of sight if infrared. 3. Charge the headset fully before first use. 4. Switch on both, pair or tune the headset, and adjust the volume to a comfortable level while the television volume is lowered or muted, as the instructions advise. Some televisions mute the speakers when a headphone is connected; others do not. 5. Test the range by walking around. 6. Adjust tone and speech settings to taste, with the audiologist's advice for hearing aid users. 7. Label the controls with large stickers or tape if needed, and write simple steps on a card. 8. Place the charging cradle in a spot near the chair, so that the headset is put back each night.

Safe listening

• Set the volume at a comfortable level, not painfully loud. Very loud listening for long periods can damage hearing further. A good rule is that you should be able to hear nearby sounds, such as someone speaking, when the TV is playing.
• Take breaks, and do not wear headphones for hours without a rest.
• Stay aware of the surroundings: a person wearing headphones may miss the doorbell, smoke alarm, a fall or a caller. Do not wear them while walking, cooking or when alone if safety is a concern. Consider a flashing doorbell or smoke alarm.
• Do not leave the television at full volume when the headphones are taken off.
• Check the ears: if the headphones cause soreness, itching or pain, stop and see a doctor.
• Hygiene: wipe ear pads regularly, especially in hot, sweaty weather.
• Cords and cables: tidy them, so that nobody trips; see flooring, rugs and trip hazards.

If your parent has hearing aids

Ask the audiologist about:

• Direct streaming from a TV streamer to the aids.
• Telecoil and neckloop options.
• Programmes on the aids for television listening.
• Wearing headphones over aids, which may cause feedback.

See hearing aids: types, costs and how to choose and the first weeks with a hearing aid: what to expect.

Other ways to improve television listening

• Turn on captions or subtitles, in the television or the streaming app settings.
• Move closer to the television or the speaker, sitting at a good distance with a clear line of sight.
• Reduce background noise: fans, air conditioners and kitchen sounds.
• Choose programmes with clear speech, news and slower dramas, rather than action films with loud music.
• Adjust the television's sound settings: many sets have a "dialogue" or "clear voice" mode, treble boost or an equaliser.
• Add a soundbar if the television speakers are weak.
• Improve room acoustics with curtains, rugs and soft furnishings to reduce echo.
• Pause and rewind, where possible, to repeat missed lines.
• Try a radio or an audio description if sight is also affected; see hearing and vision loss together: practical support.

Family peace

A TV listening device often solves a daily argument. Introduce it positively, as a way for everyone to enjoy the television, not as a sign of failure. Let your parent choose between options, and try different models. Offer to watch together with the sound from the headset and the captions on. See talking with someone who is hard of hearing and hearing loss and isolation in later life.

Care and maintenance

• Wipe the headset and cradle with a dry or slightly damp cloth.
• Keep away from moisture, heat and direct sun.
• Store on the charger or in a case.
• Replace batteries or ear pads when worn.
• Keep the instructions and warranty card.
• In humid Indian conditions, keep electronics dry and dust-free.
• Power cuts: rechargeable headsets may run low; keep the headset charged.

When to ask a professional

Ask an audiologist to test your parent's hearing and advise whether TV listening devices, hearing aids or both are best. Ask an ENT doctor if there is ear pain, discharge, a blocked ear or sudden change. Seek urgent help for sudden hearing loss, dizziness or weakness. Call 112 for signs of stroke, such as facial droop, arm weakness or speech difficulty.