Processor considerations for elderly users

[Mary Beth]

Recently I have been volunteering with senior citizens who are in their 80s and helping them with their listening needs.  Spending time with seniors who often have limited finger dexterity and reduced vision and watching them manipulate their processors has been enlightening.  They use a variety of CI brands.

These recommendations for a future Med-El BTE processor stem from my recent experiences with seniors who chose BTE versions due to not wanting to deal with off the ear processors and year round hats.

1) having a rechargeable battery unit that is totally encased as a one piece item is VERY beneficial.  The Sonnet series processors use 3 items - rechargeable battery adapter, rechargeable battery and battery cover.  Designs which blend these three items into one sealed rechargeable battery are so much more user friendly.

2) keeping the coil and cable as separate items that can be locked together is helpful as manipulating the processor with reduced dexterity puts added strain on the cable.

3) having one app that does everything for the processor is much more understandable for senior users.  They never have to figure out which app is for what purpose.

4). Naming accessories in a way that clearly identifies its function makes communicating about the accessories much easier.

 

In communicating with these elderly new CI users, the BTE processor ease of use and durability were key reasons they chose their CI brands. 
 

Just sharing in case this is helpful.

@MED-EL Moderator

[Enegra]

The last point applies not just to the elderly. I've witnessed a Med-El employee and audiologists confuse AudioLink and AudioStream in a conversation. Naming everything with "Audio" is not a good design.

[Lauren]

@Mary Beth @Enegra

Great points. It would also be helpful for all users, not a particular group, if replacing parts and maintenance were easier too. My only actual experience is with Med-El but having looked at other brands I always wonder if maintenance and replacement of mic covers and coil/magnet parts requires the same dexterity. 

[Enegra]

1 hour ago, Lauren said:

@Mary Beth @Enegra

Great points. It would also be helpful for all users, not a particular group, if replacing parts and maintenance were easier too. My only actual experience is with Med-El but having looked at other brands I always wonder if maintenance and replacement of mic covers and coil/magnet parts requires the same dexterity. 

i am a member of an international Discord server for CI users/candidates of all the brands; so I have some idea about the competitors' products. Seems like nobody came out with a truly easy system for the microphone filters and magnets. Med-El actually does it decently well, if you don't need to remove the magnet itself, the magnet-locking mechanism is a bit of a PITA.

The group every now and then gets people from the yellow brand asking how to get their magnet unstuck, because theirs is on the surface and body fluids get in between the gaps locking it into place. Not only a bit problematic, but also mildly gross. The same brand also made their latest processors have microphone covers easier to remove and there have been some complaints that now they come off by themselves. So clearly there's some middle ground to be met.

I would like a little bit more consistent behaviour when prying the microphone cover with the tool. Sometimes it's just acting slippery or refusing to pop open.

[Tim]

I'm a member of a similar (same?) discord group.  A user that is also an Audi there says that they have their prospective CI patients try replacing batteries on BTE devices and the decision becomes very clear for them. 

I didn't think to factor integrated battery/sleeve into my device selection but after six months - I can see the benefits.  It may also mean lighter weight and smaller size for the same capacity or more capacity.  Also, fewer areas for moisture intrusion.  Another side benefit is that the batteries being the color of the device means that they might not be black and therefore easier to find/see.

The biggest drawback is that the manufacturer would need separate SKUs for each battery capacity and color combination. 

 

 

 

[MED-EL Moderator]

Hi @Mary Beth,

thank you for sharing your valuable feedback, we've forwarded it to our product experts for future improvements. 
Thank you also everybody for your input, we really appreciate them. 

Kind Regards,

Giulia

[AlanJ]

16 hours ago, Tim said:

I'm a member of a similar (same?) discord group.  A user that is also an Audi there says that they have their prospective CI patients try replacing batteries on BTE devices and the decision becomes very clear for them. 

I didn't think to factor integrated battery/sleeve into my device selection but after six months - I can see the benefits.  It may also mean lighter weight and smaller size for the same capacity or more capacity.  Also, fewer areas for moisture intrusion.  Another side benefit is that the batteries being the color of the device means that they might not be black and therefore easier to find/see.

The biggest drawback is that the manufacturer would need separate SKUs for each battery capacity and color combination. 

@Tim,

What exactly is the integrated battery cover? I haven`t heard of this.

 

 

 

[Tim]

@AlanJ 

Quote

What exactly is the integrated battery cover? I haven`t heard of this.

Well, we don't have an integrated model because the battery cover/sleeve is separate from the battery. 

I believe the "Yellow" company's battery combines or integrates the battery and the cover into a single unit.  This means less manual fidgeting with battery, better space utilization, etc.  (Someone please correct me if I'm wrong.)

Looking forward to where the technology will be in 4.5 years when I qualify for a replacement processor. 

[Enegra]

The battery adapter could be integrated into the rechargeables imo, some people seem to have problems inserting them as they need a specific way and the other is risking breaking the adapter, I've seen pictures of adapters missing the "teeth" in social media. In general the whole mechanism is not super user friendly friendly. I always need to look very close when removing adapter. Something like a righty tighty lefty loosey would've been much easier for me. The "Yellow" company does that.

And the battery sleeves with the requirement of holding down the sides rather than the middle are not very intuitive. I've learned of the central units of Sonnet/Sonnet 2 breaking early on, so I didn't get this issue, but my original processor still had a depression in the middle before I got it switched out. The sleeves can also crack, I recently had one grow a hairline crack out of nowhere despite mostly proper handling. I've seen plenty of complaints about cracked covers from people with children.

A lot of Med-El's marketing features older adults, often past retirement. If that's the group that's the main target, then the products should be made more accessible for them.

[Mary Beth]

@Enegra

In the US there is definitely an increase in older seniors receiving their first cochlear implants after age related hearing loss can no longer benefit from hearing aids.  It is exciting to help this age group regain hearing.  

Having the easy to use one piece processor, Rondo 3 as an option is great but Rondo 3 is not always a good fit for some seniors- especially those who wear hats often and those who want direct streaming options.

If Med-El designed a more robust, easy to use BTE processor then those seniors could benefit from the awesome sound quality of Med-El CIs while also using a sturdy, easy to use BTE processor.

Children as well as the rest of us would benefit too.  Needing to be careful with a processor to avoid breakage is not user friendly.

[Enegra]

@Mary Beth I am the opinion that the Rondo processors should offer same level of connectivity as their BTE counterparts. I don't see why a future Rondo couldn't have proper streaming with BTLE like AudioStream does. If a competing brand can do that, then so should Med-El.

It's really hard to recommend a Rondo 3 for a new recipient when the only advantage it has is "not on the ear", but comes with the retention hurdles and inferior connectivity.

[Mary Beth]

@Enegra

I am hoping to see direct BTLE streaming built into the next Rondo processor too.  And a way to use telecoil without a ticking interference sound.

These seniors have told me that they did not choose one piece processors because they do not feel comfortable with the retention options.  And they want direct streaming.  Which makes me smile because they did not grow up with cell phones yet have embraced the technology fully.  They mention their favorite podcasts and music streaming platforms.  I love helping them reconnect with sound again.  Life changing tech for sure.

[Dianna]

Hey 👋  i love all these comments, and agree with most. Id be afraid of a one piece bte unit for repair purposes. As the owner of a rechargeable one piece hearing aid, i would have to be without if it needed a simple part like battery cover with streaming device or plain listening device.  I am in my 24th month, gotta see what Ci warranties end, lol ( of all these parts)

I have no problem having to replace coil cable or cover and mic cover but that mic cover feels like its gonna break!

It is exciting wondering whats next 🤔 

[Lauren]

3 hours ago, Dianna said:

Hey 👋  i love all these comments, and agree with most. Id be afraid of a one piece bte unit for repair purposes. As the owner of a rechargeable one piece hearing aid, i would have to be without if it needed a simple part like battery cover with streaming device or plain listening device.  I am in my 24th month, gotta see what Ci warranties end, lol ( of all these parts)

I have no problem having to replace coil cable or cover and mic cover but that mic cover feels like its gonna break!

It is exciting wondering whats next 🤔 

@Dianna wow you raised a point I didn’t even think about initially. In the US, people with commercial drivers licenses need to be able to get their assistive listening tech back up and running quickly. With the market growing for rechargeables (CIs and HAs) there’s US CDL folks that can’t get anything with an integrated battery as they’d not qualify to keep their CDL. So it isn’t just a listening concern but would be a concern for job security and insurance.

I didn’t initially know this but my father is semi-retired and has maintained his CDL and mentioned that to me when he had me review his HA choice (disposable battery version). 

[Mary Beth]

@Dianna and @Lauren

The sealed rechargeable battery that we are discussing is ONLY the battery section.  It would replace three separate Sonnet parts (rechargeable battery adapter, rechargeable battery and battery cover).  But the actual control unit is a separate piece.  So if a rechargeable battery unit needed to be replaced, the user can continue hearing with a different rechargeable battery unit or the disposable battery set up.  There would be no off air time.

[John F]

They could do what HA companies currently do.  Make a BTE CI body that is rechargeable, and a version with removable batteries.  Granted, I think a CI processor is much more involved than a HA and definitely pricier but, somebody has to pave the way for innovations.

[Mary Beth]

I believe that competition between the three FDA approved CI brands benefits all users.  Features get introduced by one company and if those features become loved by users, then users of the other brands desire them too.  As a teacher of the deaf I worked with all brands of CIs and now as a volunteer supporting others on their journeys as well as mentoring teachers of the deaf I stay informed of new features and processors offered by all three brands.

 

Every company has had a processor design or feature that users have not embraced.  And every company has had a processor design or feature that users have loved.

 

It is an exciting time to be a deaf CI user.  Advances are happening so quickly.

I appreciate this forum and the opportunity to communicate our desires to Med-El headquarters.  I can’t wait to see what Med-El has in store for my future listening.

I am thankful for this technology every single day.

[Tim]

6 hours ago, John F said:

They could do what HA companies currently do.  Make a BTE CI body that is rechargeable, and a version with removable batteries.  Granted, I think a CI processor is much more involved than a HA and definitely pricier but, somebody has to pave the way for innovations.

I like the battery being user removable from the processor rather than fully integrated like the Rondo 3.  In fact, after the lack of BT streaming, the lack of a user/Audi replaceable battery is probably my next highest issue with the Rondo 3.  

The separate battery is good for many reasons:

• Can detach the battery before putting the processor in the dryer so the battery is not heated which can accelerate battery degradation.  Hence why we cannot put our Rondos in the Sonnet's dryer.  Would need to use non-heating dessicants.
• Rechargeable batteries can go bad prematurely, much better to just replace the battery.
• Easy to have a spare(s) battery for long days or otherwise instead of taking the unit off for charging.
• Battery replacement does not require shipping the whole unit to the manufacturer and being without a processor for days or weeks.
• Much cheaper/easier/faster to get batteries after warranty than paying an out of warranty service on the processor.  (Looking down the road after my 5 year warranty is up in case I opt for a Rondo.)  Risk that a dead battery makes a fully integrated unit into just a really expensive paperweight.  My Rondo 3's battery life will likely be much shorter if I don't replace that. 

Looking at the designs of old CIs makes me really appreciate how far all the designs have come and look forward to what comes next! I think Med-El knows most of our comments or concerns but it might be helpful to see it reinforced with user discussions.

I agree with @Mary Beth about how good it is that there are 3 companies competing and trying new innovations. Companies can otherwise get complacent and settle into conservative incrementalism.

The future's so bright, I gotta wear shades.  😎

 

[Dianna]

On 8/1/2023 at 3:35 PM, Mary Beth said:

@Dianna and @Lauren

The sealed rechargeable battery that we are discussing is ONLY the battery section.  It would replace three separate Sonnet parts (rechargeable battery adapter, rechargeable battery and battery cover).  But the actual control unit is a separate piece.  So if a rechargeable battery unit needed to be replaced, the user can continue hearing with a different rechargeable battery unit or the disposable battery set up.  There would be no off air time.

Im confused, i thought folks were discussing "less parts" and combining units. Including processor. The whole bte unit has to have power , microphone and connection to coil. If these were all combined then it would have to be sent for repair if not working, or all centers would have to be 2 processor centers. I only have one precious processor. ❤️ 

[Dianna]

So one would need 2 of these power units, right? I see 

[Mary Beth]

@Dianna

sorry for the confusion.

People would only need one processor.

Just like now you have more than one rechargeable battery, you would need more than one rechargeable battery encased unit.  It just attaches to the processor and can be swapped out when it dies or at night to charge it up.  It is a style of rechargeable battery that is used by both other FDA approved brands.

[Dianna]

I just realized no sliding!! Yep i would love that!!

[pdk]

On 7/30/2023 at 10:03 PM, Lauren said:

@Mary Beth @Enegra

Great points. It would also be helpful for all users, not a particular group, if replacing parts and maintenance were easier too. My only actual experience is with Med-El but having looked at other brands I always wonder if maintenance and replacement of mic covers and coil/magnet parts requires the same dexterity. 

Replacing mic cover on cochlea n7 is a definite challenge.