I’d have to look that up. But I was wrong, the wire does not determine where the little speaker sits- it is where the power (tulip) dome squeezes tightly in my ear canal. The wire length then only ensures the HA rests well on your ear. It must not be too short, but I don’t this is overly critical for the HA’s performance.
I must say I was far happier with my Phonaks when I got a Naoh and Target myself. I suspect my audiologist was too timid in the original settings, as if I got HAs for the first time, rather than wearing those for five decades…
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Starkey is good. All the big manufacturer products are good so long as they are well-fit. I think Starkey is a little less able to provide good support to clinicians in Canada because they have a smaller presence, but their products are good. If you are looking at rechargeble ITEs, Starkey’s seem (to me personally) to be the most reliable, best fitting ones of the current options.
The most common issue I see with poorly fit ITEs is that the feedback measure is awful because of a poor physical fit in the ear and the provider proceeds anyway even though the gain is being drastically restricted. Either they do not do REM and do not realize how badly things are being impacted, or they do see it but are too new/time restricted/nervous to say, “Look, I know you waited three weeks for this hearing aid to come in but the fit is poor and I cannot in good faith fit this on you”. OR, there are other patient considerations that necessitate an ITE even though it’s not the best fit for them and the clinician is doing the best they can within those limitations. But if your father has a pretty big ear canal and the hearing aid fits extend into the ear and fit snuggly this is really unlikely to be the case–mostly it happens on snub-nosed ITE/ITCs where there is significant canal collapse and so the hearing aid cannot really extend into the ear. The benefit of a well-fitted custom product is that the gain is more likely to hit prescriptive targets without REM than a product that uses a dome, and the gain is generally more stable.
If cognition is in decline that also tends to be correlated with poorer speech in noise scores. The Starkey table mic is a nice device with a lot of functionality, but it may be worthwhile to read through the manual as well as the remote mic manual and consider whether they will be easy to use. I don’t know what his regular noise situations are, but talking to family members about good communication skills, considering acoustics of whatever place you are gathering in, trying to be good at turn-taking in conversation and always making sure your dad can see your faces can go a long way.
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Yes, I also noticed that HCPs are more prone to giving comfort than ensuring audibility, even when we are very experienced users (I use HA since ~2002). This is understandable for beginners, but for me, it is a bit annoying given that I could hear better, e.g., during my studies and student life.
I bought the Noahlink Wireless 2, and even the possibility of making small adjustments and tests like the feedback test or the Speech Enhancer slider gives me more convenience. Maybe I’ll be more “power user” of Target later, I don’t want to make too big adjustments.
@Neville, it is because the receiver is placed closer to the eardrum?
Remember Target always saves a copy of any configuration you transfer to the HAs- so it is very easy to go back to an earlier setting.
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Yes, I know. However, I am a bit ashamed to admit that I am a bit too lazy to fiddle with the settings now, especially since I will be buying the new Sphere soon.
No, a dome can really get in there. More stable because there’s only one way to fit a custom device into the ear and the venting is more controlled. With domes it’s fairly common that the provider will complete REM with a nice deep fit and then the patient will never get it into their ear all the way again, so they walk around pretty under-fit. I’ve seen the reverse as well–the provider fails to seat it well and cranks the gain to compensate and the patient places it deeper and everything sounds weird. And with uncontrolled venting and NO REM sometimes there is almost no gain provided at all and everyone is just confused about why the device is performing poorly. These are all things that can be identified and resolved with a skilled clinician, but in cases where that is questionable a custom product can sometimes be a safer bet.
But then of course it’s also possible to take a bad impression and get a bad physical fit.
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Thanks Neville. Your answer helps me too
Thanks for all that information. Its good to know Starkey has a good reputation. And all that information about the importance of physical fitting an ITE is helpful and I’ll use what you said when I talk to his practitioner next. My dad lost his remote mic. It was the clip on, not the table mic. He lost it because of his poor cognition. He probably threw it out without realizing. I’m going to see about getting another one for him and what the practitioner can do for a discount. I’ll also explain the benefit/importance of turning to face people in conversation.
Thanks for the information on the nuances of fitting. I’ll use this when I deal with his practitioner next. His original practitioner left so he has a new one now. I only had one visit with her and she talked the talk and I could tell she was practiced in saying the right things, but I’m not sure about her skill yet. I’ve taken some of the information shared in this thread and sent it to her and asked for her thoughts. I’m going to test her on this and see what she says and does and what the results are for my dad and then decide if we’ll stick with her or not.
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I missed replying to this post of yours Neville. My dad is 85 years old. I asked the practitioner to go back thru the testing records and let me know about WRS and QuickSIN. She did not tell me about WRS and I forgot to ask her again. But she did say there wasn’t a QuickSIN test, so that will be done at the next visit.
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Or dear, I hadn’t quite imagined that someone would print out what I write and show their provider directly. I’m sure she’ll love me. 
But this is all basic stuff, I’m sure she’ll just go, “yes yes, of course, yes”.
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you are 100% correct. She said yes to everything I mentioned that you mentioned. and without being defensive at all. she even called me last night. She definitely is fully engaged which is nice. Hopefully her actual skills are at the same level as her personality.
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She understands you are double checking things as well. This will keep her on her toes.
You are doing great.
Glad I decided to start this discussion. all the information provided here helped a lot in working on my Dad’s behalf to improve his situation!
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