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Telecoil and advanced age. Is it the best solution?

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I’d like to find the best solution so that an elderly relative of mine can hear properly on her old 2G mobile phone while wearing . This is the scenario:

  • Very elderly person living in a nursing home. She has severe hand arthritis and a certain degree of cognitive impairment that prevent her from placing outgoing calls; she can only answer them. When she wants to make a call, she asks a caregiver to dial the number.
  • Old-style mobile phone with physical keypad. It also has Bluetooth 3.0 + EDR. The issue with HA connectivity via is that every time the phone goes out of BT operational range, connection is lost and, once back in range, it doesn’t automatically re-connect. I’d left written “instructions” for the connection procedure but, guess what!, the staff aren’t able to manage it. Therefore, in this thread I’ll ignore BT and focus only on .
  • She’s currently wearing without T-coil, so we’ve no direct experience with telecoil. Soon she’ll switch to and I’d like to assess whether ordering them with T-coil could solve this issue.

I’ve already done some research on telecoil and I have the following specific doubts:

  • In our case, the phone is housed in a plastic case. Will the HA telecoil activate properly? If not, I’ve read that adhesive magnets can be attached near the earpiece speaker, eg. they’re recommended on pp.25–26 of these Unitron HAs guide (2018-2019); do they solve the problem? Can multiple magnets be applied if one isn’t sufficient? I’ve also read about a device called “neckloop”, which should in theory be a definitive solution; has anyone tested it and can report how effective it is for phone conversations (speech intelligibility, stability, )?
  • In the same Unitron manual, “ Phone” is mentioned on p.27, and it’d route the signal captured by the T-coil of one HA to both ears; does it work reliably? Do all manufacturers offering T-coil HAs provide this feature?
  • I’ve read that telecoil is susceptible to environmental electromagnetic interference; is that correct? I don’t think there are major sources in a nursing home (eg. there’s no Wi-Fi), but I’d appreciate relevant examples for such an environment.
  • The T-coil must be enabled via fitting SW by the audiologist, moreover via SW it should be possible to configure automatic activation whenever the T-coil detects a magnetic field (eg. from the phone receiver), I mean without any manual intervention from the HA user (eg. no button pressing); can you confirm? I’m referring to Unitron, but confirmation regarding other brands (excluding Sonova) would be highly appreciated :slight_smile:

Given all the above, I’d appreciate feedback from anyone with experience in similar scenarios, to understand whether and to what extent telecoil can effectively solve the issue described in this thread. Thanks in advance :slight_smile:

EDIT: replaced the terms related to “pairing” with “connecting” (bold), following @Michael_Phonak’s correction.

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2G phone? What country is this phone being used? What’s the make and model of the phone? What’s the make and model of the ’s both current and “soon”?

Here in Italy, 2G is still fairly widespread :slight_smile: . The phone is an old Alcatel 2008G, which we bought a long time ago because it was one of those senior-friendly phones with large keys and a high-output loudspeaker, however now the speaker is now clearly insufficient for her degree of hearing loss. From the user manual, I translate the operating bands of the handset as follows:

This phone is a radio transceiver operating on GSM networks in the 850/900/1800/1900 MHz bands.

I’d add that the SIM operator operates only on 900 or 1800 MHz, so I think those are the only two bands actually involved with this phone.
She’s currently using Unitron Moxi Blu with UP receivers (the most powerful ones). We’re evaluating a switch to maximum-power UP . So far I’ve only looked into the Unitron ecosystem, specifically the Unitron Stride B-UP, which includes a (see p.29 of the linked manual). However, I’m open to suggestions regarding other very high-power BTE with telecoil, at least within the scope of this thread :slight_smile:

I might suggest that phone is the limiting factor. Those current aids are bluetooth V4.2. They seem to work with the old phone on (as you say) 3.0 as these things are downward compatible but I wonder if the older version of bluetooth that the phone uses is being a problem.

I just did my own test with my Costco KS10 (Phonak Paradise) which is V4.2. I connected bluetooth to my phone. I walked away. Being away for about 15 seconds the spouse observed the phone bluetooth changing to not connected. Then as I walked back it re-connected.

While I like as a connectivity option, I rarely to never use it. It’s also a bit of a hassle to have a neckloop receiving input to re-transmit up to the telecoil. It works. But it’s a hassle. I’d be looking at a new “senior” phone. Maybe even one that can take voice commands if there is such a thing.

The legacy mobile phone is certainly the limiting factor. Although I have not yet performed specific tests with a smartphone, I am fairly confident that a recent-generation smartphone would have sufficiently advanced Bluetooth hardware and stack management to automatically re-establish pairing when both devices return within operational range. That said, there is also a practical contextual constraint: a smartphone could easily end up crushed under my relative’s weight on an armchair or simply “disappear” (eg. inside a caregiver’s personal handbag :slight_smile: ).
I do not rule out conducting this test in the future-possibly by purchasing a low-cost, second-hand smartphone with up-to-date Bluetooth technology, but for the time being I would prefer to resolve the issue independently of the smartphone.

@z10user2 said:

It’s also a bit of a hassle to have a neckloop receiving input to re-transmit up to the telecoil

That was my expectation as well. From the product images I have seen online, it is clear that persuading my relative to wear a neckloop transmitter for most of the day would be quite a challenge!

I had discussed this automatic Bluetooth re-pairing issue between the phone and the hearing aids in this specific 2024 thread. What came out of that discussion is that the success of automatic reconnection is based on the phone’s technology and on how the operating system is implemented, not on the Bluetooth version itself. I quote this interesting contribution:

@MDB said:

I agree with cvkemp that you can never count on “rock solid bluetooth.” You might get it, but there’s an element of luck. To increase your chances you should be good with any late model, high end iPhone, Samsung or Pixel phone.

What I mean is that I consider it too risky to purchase a feature phone (whether for seniors or not) to run this test, even if it has a recent Bluetooth version. On the other hand, it is almost certain that a recent smartphone, even if second-hand and cheap, would be able to handle automatic re-pairing.

Interesting to see myself quoted! :> I do believe Bluetooth has gotten better (more reliable) but a recent smartphone should be way better than what she’s got for reliability (although maybe not in terms of ease of use)

@MDB : And there I am in that old thread too :slight_smile:

An update to that old thread is that I now have the Samsung A25. That’s the phone used in my recent testing mentioned in this thread.

I would continue to suggest shying away from a smartphone for this use case (which may have been the same in the old thread). A recent model “seniors” flip should have similar reliability. They’re not terribly expensive either.

Yes. My mother struggles to remember how to do things on a smartphone. My mother in law has no problems with an old flip phone. My mother used to use a flip phone but a smartphone was foisted on her and she gets lost in it. I knew it was a mistake to foist it on her but y’know…siblings…what are ya gonna do.
I’ll allow that my mother has some memory issues whereas my MIL still has all her marbles.

In reply to @audio_hunter

@audio_hunter It is key to differentiate “Pairing” from “Connecting” in the Bluetooth world. Pairing is never lost (the very initial setup of two Bluetooth devices).
Your problem is the automatic “Reconnection” after turning on devices / out of range / etc.

I don’t say this to be picky, but to avoid one goes through the full pairing flow again and again.
And as said, its behavior depends on mobile phone and hearing aid. Worst case a user a) has to select the hearing aid from the list of Bluetooth devices in the phone, or b) press the hearing aid button once back in reach of the phone.

Both requires Manual interaction, which in your case seems difficult.
Therefore a simple phone providing tCoil signal, along with a tCoil capable hearing aid, is in principle a nice solution. Just keep in mind: also for tCoil usually the wearer needs to go to the tCoil program manually (there are exceptions via magnet on the phone, but that is not fully reliable either imho).

I guess overall, a simple phone for elderly people with Bluetooth, is the easier option.

You were absolutely right to clarify the difference between pairing and connecting, I’ve corrected my initial post accordingly :slight_smile:

@Michael_Phonak said:

also for tCoil usually the wearer needs to go to the tCoil program manually

As I understand it, for certain hearing aids it is possible to configure automatic activation of the listening program via fitting software whenever the coil is brought sufficiently close to a telephone receiver (or when an adequate magnetic field is detected). This is what I understood regarding the “Easy-T” feature described on p.25 of the Unitron manual I linked in my first post:

Our hearing aids may also have a telephone feature, which automatically switches to a dedicated telephone program when a telephone receiver is brought close to one of your hearing aids. You will hear a short melody when you switch to the Easy-T program. When the telephone receiver is moved away from the hearing aid it will automatically return to the previous listening program.

In the present scenario, this would be an excellent solution precisely because it would require no manual intervention from my elderly relative.
I consider it plausible that this is a software feature shared across Sonova hearing aids equipped with telecoil. Of course, if anyone can confirm if a similar automatic telecoil activation feature is available in other brands, that would be very helpful :slight_smile:

@Michael_Phonak said:

I guess overall, a simple phone for elderly people with Bluetooth, is the easier option.

So let me ask “the” question: can you point me to a simple phone for elderly people with a recent Bluetooth implementation that you are certain will reliably reconnect automatically to hearing aids after a temporary or long disconnection?

No sorry @audio_hunter I never give any commercial product advice but technical view only.

The issue with those magnetic activation is that you still need to hold the phone in the correct position, sometimes even need an extra maget mounted onto the phone. As you described the case, I wasn’t sure your relative would then hold it precisely enough.

In reply to @audio_hunter

No one here and no company is going to say “certain”.

I went here and filtered for flip up, released starting 2023, bluetooth 4.2 and this is what it came back with. If you refine for 2022 then it picks up a few more. If you refine for bluetooth 5 then there are three. Whether they are available to you and whether they work on your cell network is up to you.

Phone Finder results - GSMArena.com4

Another question has come to mind regarding operation, specifically about the automatic telecoil program that activates whenever a sufficient electromagnetic field is detected (eg. from a phone earpiece).
Let’s assume that the automatic telecoil program has been enabled via fitting software (eg. “Easy-T” in the case of Unitron) and that the hearing aids are also paired via Bluetooth to a mobile phone. If the hearing aids are simultaneously within Bluetooth range, so they are connected, and within the magnetic field required to trigger the telecoil (eg. when the phone is actually held to the ear), what happens in practice? Will the hearing aids switch to telecoil mode or will Bluetooth streaming take priority?
For the sake of discussion, I’m assuming that the phone is capable of automatically reconnecting to the hearing aids via Bluetooth.

@z10user2 said:

No one here and no company is going to say “certain”.

That’s precisely the point, I mean the financial risk associated with trying to achieve reliable automatic Bluetooth reconnection: feature phone with a recent Bluetooth version = uncertain; recent smartphone, even if second-hand and cheap = high. I think the cost would likely be similar.

In many places new devices are returnable if they don’t serve your purpose, which can reduce the risk. Even if you find something that “works,” it is unlikely to be 100% reliable, meaning it may sometimes require an intervention by somebody capable of performing it.

My guess, as others have mentioned, is the phone is the roadblock. My 2 year old Android phone can not connect to any hearing aids- or not. My wife’s slightly older Android phone by a different manufacturer can’t connect either.

My wife’s Apple iPad from 2017 has no trouble at all with hearing aids, nor does my Mac computer.

Maybe try pairing the aids with your phone to see if it helps, assuming your phone is newer. Then you’ll know if the patient needs a new phone.
Paul

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