Updated June 06, 2015.

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

It never fails: whenever I talk about hearing aids to a patient, they have a story about a friend or family member that tried hearing aids and the hearing aids just “don’t work”. Hearing aids are complicated electronic devices; think of them as wearable computers. There are many different reasons why a computer doesn’t work; let’s take a look at some of the most common reasons.

Your hearing loss has changed.

I’ve had patients come to my practice with hearing aids that “don’t work” only to find that the patient had not had a hearing test in years. Their hearing loss had become worse,  and the hearing aids were no longer providing enough volume to make speech sounds audible. Sometimes, this is an easy fix and involves reprogramming the hearing aids to the new hearing loss. Other times, especially if has been more than five years, it is time for new hearing aids. Stay in touch with your audiologist and have your hearing tested yearly (or sooner if you suspect a change). This way,  your hearing aids can be adjusted to the small changes in your hearing and can keep you hearing well.

The hearing aids are not taken care of properly.

Hearing aids are small; a tiny bit of earwax or debris can clog them up and keep them from working their best. Keeping the hearing aids clean, changing the wax guards, avoiding wearing them when using hairspray, and using a dry-aid kit are just some of the ways you can keep your hearing aid working well throughout its lifespan.

If you have vision or dexterity issues that keep you from being able to clean your hearing aids well, most audiologists welcome setting up regular appointments just for a clean and check or are happy to teach a family member or caregiver how to keep the hearing aids in tip top shape.

There are changes in the ear canal.

The shape of the ear canal can change when someone gains or loses weight, gets older, or has certain types of facial plastic surgery. In some cases, the changes are enough to cause a slit-leak and allow air to flow around the hearing aid, causing a loose fit and feedback. Excessive wax in the ear canal can also cause feedback. This issue can be fixed by removing excessive ear wax or taking a new ear impression and remaking the hearing aid.

You need more than just hearing aids.

For some people, hearing loss causes a lot of distortion, and they need aural rehabilitation to retrain their brain to make sense of sounds. There may be an underlying auditory processing disorder, especially if there is a history of stroke or traumatic brain injury. Audiologists and speech-language pathologists can provide aural rehabilitation in conjunction with the use of hearing aids. Other devices, such as FM systems may be very useful for people who have a lot of difficulties hearing in background noise.

Your hearing aids were not fit properly.

Verification is an important part of fitting hearing aids. If the sound isn’t audible or is too loud, the hearing aids may be rejected. Real ear verification allows your audiologist to get an objective picture of what the hearing aid is doing to sound and to ensure that your hearing aids are set the way they need to be.

Wearing hearing aids can make a huge improvement in quality of life for people with hearing loss and the people around them. Taking the time to work with your audiologist, discuss any problems that come up, and getting regular follow-ups to maintain the hearing aids and monitor hearing are important keys to success.